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Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel

Loh, Shang A., M.D.; Carlson, Grace A., M.D., M.B.A.; Chang, Edward I., M.D.; Huang, Eric, M.D., Ph.D.; Palanker, Daniel, Ph.D.; Gurtner, Geoffrey C., M.D.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 1849-1859
doi: 10.1097/PRS.0b013e3181bcee87
EXPERIMENTAL: ORIGINAL ARTICLES
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Background: The PEAK PlasmaBlade is a new electrosurgical device that uses pulsed radiofrequency to generate a plasma-mediated discharge along the exposed rim of an insulated blade, creating an effective cutting edge while the blade stays near body temperature.

Methods: Full-thickness incisions were made on the dorsums of pigs with the PlasmaBlade, a conventional electrosurgical device, and a scalpel, and blood loss was quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage.

Results: Bleeding was reduced significantly (59 percent) in PlasmaBlade incisions compared with scalpel incisions, and acute thermal damage from the PlasmaBlade (66 ± 5 μm) was significantly less than both cut and coagulation mode electrosurgical incisions (456 ± 35 μm and 615 ± 22 μm, respectively). Histologic scoring for injury and wound strength was equivalent between the PlasmaBlade and scalpel incisions. By 6 weeks, the healed PlasmaBlade and scalpel incisions were approximately three times stronger, and scar cosmetic appearance was significantly better compared with electrosurgical incisions.

Conclusions: The PlasmaBlade is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal bleeding, tissue injury, and scar formation.

Stanford, Palo Alto, and San Francisco, Calif.

From the Department of Surgery, Division of Plastic Surgery, and the Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, PEAK Surgical, Inc., and the Department of Pathology and Laboratory Medicine, University of California, San Francisco.

Received for publication February 17, 2009; accepted June 9, 2009.

Disclosure:Geoffrey C. Gurtner received a research grant to support study costs provided by PEAK Surgical, Inc.; Shang A. Loh and Edward I. Chang received education grants provided by PEAK Surgical, Inc.; Grace A. Carlson is Vice President of Clinical and Regulatory Affairs for PEAK Surgical, Inc.; and Daniel Palanker is a shareholder and consultant for PEAK Surgical, Inc.

Geoffrey C. Gurtner, M.D.; Department of Surgery; Division of Plastic Surgery; 257 Campus Drive, GK-201; Stanford, Calif. 94305-5148; ggurtner@stanford.edu

©2009American Society of Plastic Surgeons