Y Ziv1, T Brosh, G Lushkov, A Halevy. 1. Department of Surgery B, Assaf Harofeh Medical Center, Zerifin (Affiliated to Sackler Faculty of Medicine, Tel Aviv University), Israel. y_ziv@hotmail.com
Abstract
BACKGROUND: The method of midline laparotomy incision and closure remains a complex surgical problem. OBJECTIVE: To compare the mechanical properties at the interface of midline laparotomy incision made by scalpel versus electrocuting current in rats. METHODS: A sharp midline laparotomy incision was made in 60 Wistar female rats using a scalpel or electrocautery to open the fascia. The fascial and skin wounds were closed separately with a continuous nylon. Fascial specimens were analyzed for mechanical properties at the midline incision using a loading machine. The load-extension curve was recorded during tensile loading at a steady extension rate of 15 mm/min. RESULTS: There was no statistically significant difference between the two groups in either wound-bursting force (PPEAK) or the strain energy spent until the point of measured PPEAK. Each load-extension curve showed a characteristic pattern in all rats. Tissue stiffness was greater in the scalpel group than in the electrocautery group (P = 0.02). Correlations were found between tissue stiffness and strain energy, between tissue stiffness and bursting force, and between bursting force and strain energy. CONCLUSIONS: While tissue stiffness was greater when a scalpel was used compared to electrocuting to incise the midline abdominal fascia in rats, there was no difference in the bursting force required to disrupt the wound.
BACKGROUND: The method of midline laparotomy incision and closure remains a complex surgical problem. OBJECTIVE: To compare the mechanical properties at the interface of midline laparotomy incision made by scalpel versus electrocuting current in rats. METHODS: A sharp midline laparotomy incision was made in 60 Wistar female rats using a scalpel or electrocautery to open the fascia. The fascial and skin wounds were closed separately with a continuous nylon. Fascial specimens were analyzed for mechanical properties at the midline incision using a loading machine. The load-extension curve was recorded during tensile loading at a steady extension rate of 15 mm/min. RESULTS: There was no statistically significant difference between the two groups in either wound-bursting force (PPEAK) or the strain energy spent until the point of measured PPEAK. Each load-extension curve showed a characteristic pattern in all rats. Tissue stiffness was greater in the scalpel group than in the electrocautery group (P = 0.02). Correlations were found between tissue stiffness and strain energy, between tissue stiffness and bursting force, and between bursting force and strain energy. CONCLUSIONS: While tissue stiffness was greater when a scalpel was used compared to electrocuting to incise the midline abdominal fascia in rats, there was no difference in the bursting force required to disrupt the wound.