Comparative Healing of Rat Fascia Following Incision with Three Surgical Instruments

Background Incisional hernia and fascial dehiscence are associated with significant postoperative morbidity. Electrosurgical devices using pulsed radiofrequency energy and a novel electrode design markedly reduce thermal injury during cutting and coagulation while maintaining equal surgical performance. In this study, we examine fascial healing dynamics in a rat model following incision with a pulsed radiofrequency energy device (PRE), a conventional electrosurgical device, and a standard “cold” scalpel. We hypothesize that incisions made with the pulsed radiofrequency energy device will result in a superior fascial healing profile compared with conventional electrosurgery. Materials and Methods Full thickness surgical incisions were created in rat fascia using a commercially available PRE device, conventional electrosurgery, and a scalpel. Harvested fascial specimens were analyzed for burst strength testing and healing-associated histologic characteristics at d 7, 14, 21, and 42. Results PRE incisions were fully healed by 6 wk with normal tissue architecture. By all measures, wounds created by the PRE device were comparable to those made with the standard scalpel. Compared with PRE, conventional electrosurgery incisions exhibited a larger zone of tissue injury (68% greater in Coag mode, P P P = 0.001). Conclusions The favorable fascial healing profile of the PRE device suggests that it is a promising new surgical technology. The early improved strength of wounds made with this device is of particular interest, as wound dehiscence is of greatest concern early in the healing process.