Zhonghua yi xue za zhi · 2002
[Influence of high-frequency electric surgical knife on healing of abdominal incision, experimental and clinical studies].
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Ji Guangwei, Wu Yuanzhi, Wang Xu, Pan Huaxiong, Li Ping, Du Wanying, Qi Zhi, Huang An, Zhang Liwei, Zhang Li, Chen Wen, Liu Guanghua, Xu Hui, Li Quan, Yuan Aihua, He Xiaoping, Mei Guohua
Аннотация
OBJECTIVE: To study the influence of high-frequency electric surgical knife on abdominal incision healing.
METHODS: Two hundred and forty Wistar rats were randomly divided into two groups of 120 rats to undergo abdominal incision by high-frequency electric knife or common lancet respectively. Each of these two groups was redivided into four subgroups that were injected hypodermically with 0.2 ml of quantitative mixture of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa at the concentrations of 0.24 x 10(2) bacteria (10(2) group), 4.49 x 10(4) bacteria (10(5) group), and 4.11 x 10(7) bacteria (10(8) group) respectively, and normal saline of the same volume (10(0) group). Eight days after the operation, the rats were killed. The infection rate of the operational wound was observed and the tissues around the wounds were examined pathologically. On the basis of the animal experiment, 220 patients undergoing abdominal operation above type II were randomly allocated into one of following three groups: high-frequency electric knife (EK) group (93 cases, high-frequency electric knife was used to cut the abdominal tissues and electro-coagulation was used for hemostasis), electro-coagulation (EC) group (55 cases, the abdominal tissues were cut with common lancet and electro-coagulation was used for hemostasis) and control group (72 cases, common lancet and silk thread suture were used). The healing of wound was observed after operation.
RESULTS: Four rats died of anesthetic accident; the other 236 rats were killed 8 days after. The wound infection rates were 23.33% and 6.60% in the experimental 10(0) group and the control 10(0) group respectively (chi(2) = 3.28, P > 0.05); 37.04% and 13.33% in the experimental 10(2) group and the control 10(2) group respectively (chi(2) = 4.31, P > 0.05), 50.00% and 24.14% in the experimental 10(5) group and the control 10(5) group respectively (chi(2) = 4.22, P > 0.05); and 63.33% and 36.67% in the experimental 10(8) group and the control 10(8) group respectively (chi(2) = 4.27, P > 0.05). Clinical observation showed a delayed wound healing rate of 17.20% (16 cases) in EK group, 16.36% (11 cases) in EC group, and 2.86% (2 cases) in the control group. There was a statistically significant difference in delayed wound healing rate between the EK and control groups (chi(2) = 8.57, P < 0.01) and between the EC and control groups (chi(2) = 5.66, P < 0.05). However, no significant difference in the delayed wound healing rate was seen between the EK and EC groups (chi(2) = 0.017, P > 0.05).
CONCLUSION: High-frequency electric knife remarkably delays the healing of abdominal incision. Its application should be minimized so as to reduce the possibility of postoperative complications.
METHODS: Two hundred and forty Wistar rats were randomly divided into two groups of 120 rats to undergo abdominal incision by high-frequency electric knife or common lancet respectively. Each of these two groups was redivided into four subgroups that were injected hypodermically with 0.2 ml of quantitative mixture of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa at the concentrations of 0.24 x 10(2) bacteria (10(2) group), 4.49 x 10(4) bacteria (10(5) group), and 4.11 x 10(7) bacteria (10(8) group) respectively, and normal saline of the same volume (10(0) group). Eight days after the operation, the rats were killed. The infection rate of the operational wound was observed and the tissues around the wounds were examined pathologically. On the basis of the animal experiment, 220 patients undergoing abdominal operation above type II were randomly allocated into one of following three groups: high-frequency electric knife (EK) group (93 cases, high-frequency electric knife was used to cut the abdominal tissues and electro-coagulation was used for hemostasis), electro-coagulation (EC) group (55 cases, the abdominal tissues were cut with common lancet and electro-coagulation was used for hemostasis) and control group (72 cases, common lancet and silk thread suture were used). The healing of wound was observed after operation.
RESULTS: Four rats died of anesthetic accident; the other 236 rats were killed 8 days after. The wound infection rates were 23.33% and 6.60% in the experimental 10(0) group and the control 10(0) group respectively (chi(2) = 3.28, P > 0.05); 37.04% and 13.33% in the experimental 10(2) group and the control 10(2) group respectively (chi(2) = 4.31, P > 0.05), 50.00% and 24.14% in the experimental 10(5) group and the control 10(5) group respectively (chi(2) = 4.22, P > 0.05); and 63.33% and 36.67% in the experimental 10(8) group and the control 10(8) group respectively (chi(2) = 4.27, P > 0.05). Clinical observation showed a delayed wound healing rate of 17.20% (16 cases) in EK group, 16.36% (11 cases) in EC group, and 2.86% (2 cases) in the control group. There was a statistically significant difference in delayed wound healing rate between the EK and control groups (chi(2) = 8.57, P < 0.01) and between the EC and control groups (chi(2) = 5.66, P < 0.05). However, no significant difference in the delayed wound healing rate was seen between the EK and EC groups (chi(2) = 0.017, P > 0.05).
CONCLUSION: High-frequency electric knife remarkably delays the healing of abdominal incision. Its application should be minimized so as to reduce the possibility of postoperative complications.