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Indian Journal of Otolaryngology and... Mar 2023The piezo surgery was reported to cause minimal trauma to the soft tissue. The aim of this study was to compare the periorbital edema and ecchymosis after transcutaneous...
The piezo surgery was reported to cause minimal trauma to the soft tissue. The aim of this study was to compare the periorbital edema and ecchymosis after transcutaneous lateral osteotomy in rhinoplasty using 2-mm osteotome versus Piezo scalpel respectively. In a randomized clinical trial and split-mouth-design, we performed primary rhinoplasty in 15 patients (7 men, 8 women; age 18-35 years, mean age 26.6 ± 5.7 years). Transcutaneous lateral osteotomy was performed using a 2-mm osteotome on the one side and a piezo scalpel on the opposite side. We took digital photographs of the face on 1, 3, 7 and 14 postoperative days. Three examiners used a standard 5-point Kara-Gokalan scale to assess the early postoperative periorbital edema and ecchymosis on each side. We found more difficult to use the piezo scalpel via only one incision and found easier to use two stab incisions for inserting the piezo scalpel. The time spend for each osteotomy was similar ( > 0.05). The inter-observer agreement was high (> 0.676). The postoperative edema showed to be significantly different on day 1, 3 and 7 (-value < 0.05), ecchymosis was much less on piezo side but not significantly. It was more difficult to use piezo scalpel via only one incision. The piezo scalpel showed to reduce the postoperative edema significantly and improved the ecchymosis. Swelling and bleeding could have crossed the midline and blurred the comparison of two sides. However, this is the best design to achieve the highest similarity in study condition. Level I, therapeutic study.
PubMed: 37007883
DOI: 10.1007/s12070-022-03378-6 -
Journal of Maxillofacial and Oral... Dec 2019Labial frenectomy is a common procedure in the oral surgery specialty. Nowadays, laser surgery seems to provide better post-operative results than scalpel surgery. Thus,... (Review)
Review
INTRODUCTION
Labial frenectomy is a common procedure in the oral surgery specialty. Nowadays, laser surgery seems to provide better post-operative results than scalpel surgery. Thus, the aim of this study was to analyze whether trans-surgical and postoperative variables of labial frenectomy are better when performed with laser than with conventional scalpel.
MATERIALS AND METHODS
A systematic review has been performed based on PRISMA criteria. The search included three databases, with no limitations of time or language. After screening, seven papers were included in qualitative analysis and six in meta-analysis. Bias analysis was performed according to Cochrane Handbook. Pain during the first (MD - 3.18, 95% CI - 4.03 to - 2.32) and seventh post-surgical days (MD - 1.04, 95% CI - 1.45 to - 0.64); discomfort during speech on the first (MD - 2.15, 95% CI - 3.94 to - 0.37) and the seventh post-surgical days (MD - 1.60, 95% CI - 1.96 to - 1.24); discomfort during chewing on the first (MD - 2.90, 95% CI - 3.35 to - 2.45) and the seventh days (MD - 1.56, 95% CI - 2.21 to - 0.91); and average surgery time (MD - 1.84, 95% CI - 3.22 to - 0.46) were lower in the laser group than in the scalpel group.
CONCLUSION
The results of this systematic review have shown better results to laser group in the following variables: pain, discomfort during speech and chewing. However, the evidence is limited due the high risk of bias.
PubMed: 31624426
DOI: 10.1007/s12663-019-01196-y -
JSLS : Journal of the Society of... 2020Foreign material in the biliary tree may serve as a nidus for stone formation and would usually present as choledocholithiasis with jaundice or cholangitis. Overall it... (Review)
Review
BACKGROUND AND OBJECTIVES
Foreign material in the biliary tree may serve as a nidus for stone formation and would usually present as choledocholithiasis with jaundice or cholangitis. Overall it is a rare occurrence, but there are many anecdotal reports of ingested matter or surgical material such as suture or clips causing biliary stones. Especially interesting are the cases in which there is migration of a metallic clip used in laparoscopic cholecystectomy. Cholecystectomy is such a common operation that although the phenomenon is rare, it is important because it is preventable, and as such a review of the topic seems worthwhile.
METHODS
The available literature was searched using the EMBASE and Ovid databases and reviewed. The various devices and sutures used to occlude the cystic duct in laparoscopic cholecystectomy are discussed with reference to their safety.
RESULTS AND CONCLUSION
We found that the harmonic scalpel is a reasonable alternative with minimal complications but is however limited by cost. Electrosurgical vessel-sealing, ultrasonic shears, absorbable sutures such as endoloops (PDS), and polymer clips as well absorbable magnesium-calcium-zinc alloy clip are discussed.
Topics: Cholecystectomy, Laparoscopic; Choledocholithiasis; Foreign Bodies; Humans; Sutures
PubMed: 32161435
DOI: 10.4293/JSLS.2019.00053 -
The Journal of Thoracic and... Aug 2018
Topics: Embolization, Therapeutic; Stents
PubMed: 29625740
DOI: 10.1016/j.jtcvs.2018.03.027 -
The Journal of Investigative Dermatology Oct 2003Collagenase-3 (matrix metalloproteinase 13, MMP-13) was employed as a surrogate marker to compare the characteristics of incisional wound repair after surgery with the... (Comparative Study)
Comparative Study
Collagenase-3 (matrix metalloproteinase 13, MMP-13) was employed as a surrogate marker to compare the characteristics of incisional wound repair after surgery with the free-electron laser at 6.1 microm and the scalpel. Using a transgenic mouse strain with the MMP-13 or the COL1A2 promoter driving luciferase expression, we observed MMP-13 and COL1A2 expression, tensile strength, macrophage infiltration, and wound histology for up to 62 d. The scalpel incisions showed higher tensile strength than free-electron laser wounds from days 10 to 22 postwounding, despite minimal collateral thermal damage. After 45 d healing was similar. Trichrome staining confirmed that the scalpel incisions had more dense collagen deposition than free-electron laser incisions up to 36 d postinjury, but at day 45 they became similar. MMP-13 expression was biphasic, with peak activities at days 15 and 37 after injury, whereas free-electron laser wounds showed greater luciferase activity than scalpel wounds. Peak COL1A2 activity preceded the MMP-13 maximum. MMP-13 expression localized predominantly to dermal fibroblasts near the epidermis at day 15, and in the region of the deep dermis, muscle, and fascia at day 37 postwounding. Migrating muscle cells, but not all skeletal muscle cells, also expressed MMP-13. Free-electron laser incisions contained more macrophages than scalpel wounds at days 2 and 7 postinjury, suggesting that free-electron laser irradiation exacerbated the inflammatory response and thereby stimulated MMP-13 expression. These results revealed that MMP-13 was involved in a series of coordinated events during wound healing, not only the long-term remodeling of wound connective tissue, but also skeletal muscle repair. MMP-13 activity in vivo may correlate with the extent of tissue damage.
Topics: Animals; Collagen; Collagen Type I; Collagenases; Fibroblast Growth Factor 2; Gene Expression Regulation, Enzymologic; In Situ Hybridization; Laser Therapy; Macrophages; Matrix Metalloproteinase 13; Mice; Mice, Transgenic; Promoter Regions, Genetic; RNA, Messenger; Skin; Skin Physiological Phenomena; Surgical Instruments; Tensile Strength; Wound Healing
PubMed: 14632214
DOI: 10.1046/j.1523-1747.2003.12497.x -
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 -
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 -
Indian Journal of Otolaryngology and... Dec 2022Tonsillectomy is one of the most commonly performed surgical procedure in otolaryngology especially in children. This is an age old procedure which has seen continuous...
Tonsillectomy is one of the most commonly performed surgical procedure in otolaryngology especially in children. This is an age old procedure which has seen continuous changes in the surgical technique from guillotine method to snare technique to coblation tonsillectomy, and is still evolving day by day. But there are no consensus as to which technique is the best or most appropriate for tonsillectomy. The objective of this study is to compare three different surgical techniques of tonsillectomy namely the Cold dissection snare technique (CDST), Bipolar electro-dissection technique (BEDT) and Harmonic scalpel technique (HST) and to identify the method which is safe, with less operative time, which offers decreased intra-operative blood loss and with lowest post-operative morbidity and complications. This prospective and comparative study was conducted over a time duration of 1 year 6 months from January 2018 to July 2019 after the approval from ethical committee. Total 150 cases of tonsillectomy were done by dividing into three groups of 50 cases each. The study showed maximum cases of tonsillitis in the age group less than 10 years and the most common indication for tonsillectomy being chronic recurrent tonsillitis. Harmonic scalpel technique (HST) had least operative time, least intra-operative blood loss, took minimum time for resumption of normal diet and normal activity and also had least pain score on post-operative day 1st, 5th, 10th and 15th. STATISTICS: Kruskall-Wallis and the non-parametric Analysis of variance (ANOVA) tests were applied to determine statistically significant variances. All the differences are found to be significant < 0.05. Harmonic Scalpel Technique (HST) is the latest technique as it is associated with quicker procedure, less intraoperative blood loss and less post-operative pain.
PubMed: 36742922
DOI: 10.1007/s12070-021-02948-4 -
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 -
Cureus Oct 2023An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral...
An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral fibrous hyperplasia, and traumatic fibroma. Chronic irritation from things like biting one's lips or cheek, orthodontic treatments, rubbing against a hard tooth, or wearing dentures or other dental prostheses is frequently the cause. It is often the same colour as the surrounding mouth lining, but occasionally, it can be paler or appear darker if it has bled. Trauma can cause the surface to become rough and scaly or ulcerated. It is primarily dome-shaped and similar to a pedunculated polyp. A traumatic fibroma most frequently occurs on the inside of the cheek. The inside of the lower lip, the gingiva, and the sides of the tongue are other frequent locations. The given case series reported traumatic fibroma associated with anterior teeth and buccal mucosa treated with a conventional scalpel and diode laser techniques, respectively. Diagnosing and treating the aetiology and educating the patient about the same is essential in fibroma cases. The clinical features of both claims and mere aetiology confirmed the diagnosis. The sole option available when therapy is needed is a surgical fibroma excision. Surgical excision is the most popular method for treating oral or traumatic fibromas. Two ways are available for the surgical removal of an oral fibroma: with a scalpel or using a diode laser. Both case presentations demonstrate that surgical excision with a scalpel and diode laser was discovered to be a simple, efficient, and affordable method for treating traumatic fibroma in this report, which presents two traumatic fibromas with different locations with varying aetiology. Traumatic fibromas reported here were in the aesthetic zones, which need to be treated as they can cause traumatic occlusion and difficulty chewing and speech. The patients reviewed for the next three months revealed complete satisfactory healing and no recurrence in both cases.
PubMed: 38021932
DOI: 10.7759/cureus.47810