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Bioengineering (Basel, Switzerland) Sep 2022This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery...
This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery through histological and immunohistochemical methods. Twenty 12-week-old male rats were assigned to three groups (3, 7, and 14 days). Square-shaped erosion wounds (2 × 2 mm2 diameter) were created on the hard palate of each rat. Two wounds were created using Laser A and a steel scalpel (Bard-Parker No. 15) on the right palate and using Laser B and a steel scalpel on the left side. Rats were sacrificed after 3, 7, and 14 days. Tissues were collected with a margin of 1 mm from the border of the erosional wound of the maxillary hard palate. Histological and immunohistochemical analyses were performed on the tissue samples after 3, 7, and 14 days. The tissue healing pattern and expression of inducible nitric oxide synthase (iNOS) and cluster of differentiation (CD) were observed under a light microscope. Statistical analysis was conducted using the Kruskal−Wallis H test for comparison among the groups (α = 0.05). In comparison to the wounds made with the scalpel, wounds treated with lasers A and B showed delayed healing patterns. There was no significant difference between the two laser treatment groups (p > 0.05). The expression of iNOS and CD68 was not significantly different among the three groups after 3 and 7 days (p > 0.05). On day 14, the groups treated with the dental diode lasers showed higher expression than the group treated with the steel scalpel, but no significant difference was observed (p > 0.05). Laser-induced wounds tended to heal slower than surgical wounds performed using a steel scalpel, but histological and immunohistochemical results showed no significant difference between the dental diode laser and scalpel groups.
PubMed: 36135012
DOI: 10.3390/bioengineering9090466 -
Clinical Oral Investigations Nov 2023This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.
OBJECTIVE
This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.
MATERIALS AND METHODS
Twenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points.
RESULTS
At 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups.
CONCLUSION
While diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures.
CLINICAL RELEVANCE
Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.
Topics: Humans; Lasers, Semiconductor; Gingival Diseases; Lasers, Solid-State; Esthetics, Dental; Hemorrhage; Hyperpigmentation; Pain
PubMed: 37878070
DOI: 10.1007/s00784-023-05310-w -
Gynecologic Oncology Reports Oct 2022It is well known that power morcellation of unexpected uterine sarcoma affects prognosis. There are few reports on the effects of scalpel morcellation or myomectomy of...
OBJECTIVE
It is well known that power morcellation of unexpected uterine sarcoma affects prognosis. There are few reports on the effects of scalpel morcellation or myomectomy of uterine sarcoma on prognosis, which is not well understood. This study investigated the effect on recurrence and prognosis when tumors of uterine sarcoma undergo scalpel morcellation or myomectomy.
METHODS
We performed a retrospective, observational study by collecting data from the medical records of patients who were histologically diagnosed with uterine sarcoma at our hospital between 2005 and 2017. All patients with unexpected uterine sarcoma were diagnosed after laparoscopic hysterectomy with scalpel morcellation or myomectomy (abdominal and laparoscopic) for presumed myoma. We evaluated recurrence rate, recurrence site, progression-free survival (PFS), and overall survival (OS).
RESULTS
A total of 15 patients were examined in this study. Twelve patients underwent myomectomy (7 patients with open surgery, 5 patients with laparoscopic surgery), and 3 patients underwent total laparoscopic hysterectomy with transvaginal scalpel morcellation. There were 11 cases of recurrence, and the recurrence rate was 78 %. The recurrence site was peritoneal dissemination in 10 cases (91 %) and lymph node metastasis in 1 case (9 %). The median PFS was 32 months [95 % confidence interval (CI) = 6.5-NA], and the median OS was 95.5 months [95 % CI = 55.8-NA].
CONCLUSION
Power morcellation, scalpel morcellation, and myomectomy may affect recurrence and prognosis. Further studies are needed in the future.
PubMed: 36164469
DOI: 10.1016/j.gore.2022.101070 -
Journal of Obstetrics and Gynaecology... Jun 2016
Review
PubMed: 27298535
DOI: 10.1007/s13224-016-0850-x -
Photochemistry and Photobiology Oct 2017This review covers photochemical approaches aimed at supplementing surgical instruments with handheld photodynamic therapy (PDT) instruments. PDT is not widely used in... (Review)
Review
This review covers photochemical approaches aimed at supplementing surgical instruments with handheld photodynamic therapy (PDT) instruments. PDT is not widely used in hospitals, because of the laser equipment and expertise needed, and because insurance policies often do not cover the procedure. Accordingly, this review focuses on advances in photochemistry, photophysics, nanotechnology and miniaturization techniques that may likely inspire the use of handheld instruments in PDT. A takeaway point is that the advent of photochemical scalpels or lancets that deliver reactive oxygen species (ROS) on site may better equip medical practitioners and allow for eradication of tumors or infections in general. Specifically, the review is divided into several sections: sensitizer types, multiphoton and plasmonic topics, sensitizer delivery, light delivery, dosimetry, fiber optics and handheld implements in PDT.
Topics: Dose-Response Relationship, Drug; Humans; Optical Fibers; Photochemotherapy; Photosensitizing Agents; Plasma Gases; Reactive Oxygen Species; Surgical Instruments
PubMed: 28374889
DOI: 10.1111/php.12766 -
Nigerian Journal of Clinical Practice Sep 2023Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed...
BACKGROUND
Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed macroscopic and microscopic observations.
AIMS
This study aimed to clinically and histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and radiofrequency.
MATERIALS AND METHODS
An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats weighing 289-428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2, 4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated.
RESULTS
The epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001). Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups.
CONCLUSIONS
Palatal wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However, almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient knowledge and experience.
Topics: Male; Rats; Animals; Lasers, Semiconductor; Steel; Laser Therapy; Rats, Wistar; Wound Healing; Body Weight
PubMed: 37794538
DOI: 10.4103/njcp.njcp_578_22 -
International Journal of Environmental... Mar 2020This is the first systematic review and meta-analysis to ascertain incidences of post-vasectomy pain following traditional scalpel, or non-scalpel vasectomy. Electronic... (Meta-Analysis)
Meta-Analysis
This is the first systematic review and meta-analysis to ascertain incidences of post-vasectomy pain following traditional scalpel, or non-scalpel vasectomy. Electronic databases PubMed, Embase and PsycINFO were searched up to 1 July 2019 for peer-reviewed articles recording post-vasectomy pain. We identified 733 publications, screened 559 after removal of duplicates and excluded 533. Of the remaining 26 full-text articles, 8 were excluded with reasons, leaving 18 for detailed analyses. Meta-analysis was performed on 25 separate datasets (11 scalpel, 11 non-scalpel, 3 other/combined). Study follow-up ranged from 2 weeks to 37 years and sample sizes from 12 to 723 patients. The overall incidence of post-vasectomy pain was 15% (95% CI 9% to 25%). The incidences of post-vasectomy pain following scalpel and non-scalpel techniques were 24% (95% CI 15% to 36%) and 7% (95% CI 4% to 13%), respectively. Post-vasectomy pain syndrome occurred in 5% (95% CI 3% to 8%) of subjects, with similar estimates for both techniques. We conclude that the overall incidence of post-vasectomy pain is greater than previously reported, with three-fold higher rates of pain following traditional scalpel, compared to non-scalpel vasectomy, whereas the incidence of post-vasectomy pain syndrome is similar.
Topics: Humans; Incidence; Male; Pain, Postoperative; Retrospective Studies; Vasectomy
PubMed: 32164161
DOI: 10.3390/ijerph17051788 -
BMC Surgery Apr 2019The gold standard approach for surgical treatment of benign and malignant adrenal lesion is considered the laparoscopic one, due to a lot of advantages compared to open... (Review)
Review
BACKGROUND
The gold standard approach for surgical treatment of benign and malignant adrenal lesion is considered the laparoscopic one, due to a lot of advantages compared to open approach. The rapid propagation of this surgical technique is due to the diffusion of haemostatic devices in laparoscopic adrenal surgery. The principal aim of this study is to analyze the outcome of LA using each energy modality, evaluating the eventual superiority of an instrument over the others.
METHODS
A retrospective study, involving 75 consecutive patients submitted to LA by transperitoneal lateral approach from January 2013 to June 2017, was performed. Age less than 70 years old, adrenal adenomas less than 8 cm in diameter, incidentalomas < 6 cm, myelolipomas < 13 cm, adrenal metastases < 7 cm and ASA score ≤ III were the main surgical inclusion criteria. All involved patients were divided into three group, one for each energy device: group 1 - Harmonic Scalpel, group 2 - Ligasure vessel sealing system and group 3 - Thunderbeat. In each group only one device was applied for dissection and haemostasis during the whole operation. Each group consisted of 25 patients, well matched for histology, tumor size and site, gender and age. The following parameters were collected: age, gender, size of the tumor, side of the affected gland, pathology, operating time, intraoperative blood losses, hospitalization time, complication and conversion rate.
RESULTS
There was no significant statistical difference between groups regarding the relationship between male/female, right site/left site, the mean age, hospitalization time and the tumor size (p > 0.05). Significant statistical difference are detectable in operation time and intraoperative blood losses. Thunderbeat, compared respectively with Ligasure and Harmonic Scalpel, is the fastest device (p < 0,001). The second faster device resulted Harmonic Scalpel, which meanly reduced the operation time compared to Ligasure (p = 0.048). intraoperative blood losses are reduced using Thunderbeat (p < 0,001) and HS (p = 0.006) compared to Ligasure, but between Thunderbeat and Harmonic Scalpel there isn't significant statistical difference (p = 0.178).
CONCLUSIONS
Analyzing the results, laparoscopic adrenalectomy carried out using Thunderbeat appeared to show a statistically significant decrease in operation time and intraoperative blood losses compared with laparoscopic adrenalectomy performed using Harmonic Scalpel and Ligasure, while hospitalization time was superimposable in all groups. According to our data, a responsible use of advanced energy devices can improve surgical outcomes guarantying a cost savings and patient's satisfaction.
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Adrenalectomy; Adult; Aged; Blood Loss, Surgical; Dissection; Female; Humans; Laparoscopy; Male; Middle Aged; Myelolipoma; Operative Time; Retrospective Studies; Surgical Instruments; Ultrasonics; Young Adult
PubMed: 31074403
DOI: 10.1186/s12893-018-0457-5 -
Ultraschall in Der Medizin (Stuttgart,... Jun 2020Artifacts may be part of any 3D sonographic examination during pregnancy and can disturb a routine diagnostic procedure, even simulate fetal malformation. The aim of...
PURPOSE
Artifacts may be part of any 3D sonographic examination during pregnancy and can disturb a routine diagnostic procedure, even simulate fetal malformation. The aim of this study was to classify the artifacts in different types according to their appearance.
MATERIALS AND METHODS
A total of 2349 healthy fetuses examined during the last five years was included in this study. The observed artifacts have been grouped into 6 different types according to their appearance: 1. fetal movement artifacts, 2. shadow artifacts, 3. amputation artifacts caused by the volume box, 4. defects caused by the improper use of the electronic scalpel, 5. artifacts due to an unfavorable threshold adjustment and 6. artifacts due to superimposed objects.
RESULTS
Significant artifacts were found in 119 ultrasound examinations: 39 artifacts were caused by fetal movement, 25 by acoustic shadowing, 19 artifacts occurred due to amputation of objects by the volume box and 15 by the improper use of the electronic scalpel. In 12 cases the threshold adjustment was unfavorable and in 9 cases the artifacts were caused by superimposed objects.
CONCLUSION
In 3D ultrasound some artifacts can be avoided by optimizing the size and position of the volume box or by using a different scanning angle. Other artifacts can be minimized using gain and threshold properly and by precise use of the electronic scalpel. In doubtful situations it is recommended to rescan the volume and to use all diagnostic 3D rendering possibilities. Proper recognition of the artifacts can avoid the risk of misdiagnosis.
Topics: Artifacts; Female; Humans; Pregnancy; Ultrasonography; Ultrasonography, Prenatal
PubMed: 30562798
DOI: 10.1055/a-0790-8163 -
The Clinical Teacher Feb 2024
PubMed: 38302157
DOI: 10.1111/tct.13744