title: Use of an ultrasonic blade facilitates muscle repair after incision injury.
abstract: BACKGROUND
  The ultrasonic Harmonic Blade cuts and coagulates soft tissue at temperatures lower than conventional electrosurgery. This study investigated whether improved hemostatic control and reduced collateral damage in skeletal muscle incisions translates into improved myofiber regeneration, reduced fibrosis and faster muscle recovery.
  
  
  METHODS
  Transections in the left gastrocnemius muscles of mice were made with the Harmonic Blade, and contralaterally, with either cold steel scissors or electrosurgery. Histology up to 8 wk after surgery was performed to evaluate myofiber regeneration and fibrosis. Tissue inflammation (Gr1+ neutrophils) and vascularization (CD31+ capillaries) were assessed immunohistochemically at 1 wk .
  
  
  RESULTS
  Overall the Harmonic Blade showed significantly higher level of muscle regeneration than cold steel. Fibrosis for both the Harmonic Blade and cold steel decreased three-fold over the 8 wk period, while electrosurgery yielded significantly increasing fibrosis through wk 4 before declining. At 1 wk post-surgery the Harmonic Blade induced less inflammation than electrosurgery, and higher vascularization than electrosurgery and cold steel.
  
  
  CONCLUSIONS
  Harmonic Blade-incised tissue showed accelerated vascularization, slight reduction of inflammation, enhanced muscle regeneration and decreased scarring, demonstrating a more effective healing process than electrosurgery.
authors.affiliation: Stem Cell Research Center, Children's Hospital of Pittsburgh of UPMC and Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Arvydas
authors.initials: A
authors.lastname: Usas
authors.forename: Dovile
authors.initials: D
authors.lastname: Usaite
authors.forename: Xueqin
authors.initials: X
authors.lastname: Gao
authors.forename: Johnny
authors.initials: J
authors.lastname: Huard
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Clymer
authors.forename: Prasanna
authors.initials: P
authors.lastname: Malaviya
mesh_terms: D000818:Animals; D001808:Blood Vessels / Q000473:pathology; D004598:Electrosurgery; D005260:Female; D005355:Fibrosis; D051379:Mice; D008810:Mice, Inbred C57BL; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000473:pathology / Q000502:physiology* / Q000601:surgery*; D012038:Regeneration / Q000502:physiology*; D014465:Ultrasonics; D014945:Wound Healing / Q000502:physiology