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Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment

BACKGROUND: Improving the performance of bipolar coagulation forceps is crucial for safer and more accurate neurosurgery. In our department, we found that bone wax (BW) melted by thermal effect of bipolar electrocoagulation can achieve more efficient hemostasis and reduce the amount of BW in neurosu...

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Autores principales: Shi, Jichun, Wei, Wei, Wang, Zhen, Ren, Haobin, Jia, Chenguang, Dong, Lixin, Li, Zhengwei, Zhang, Jianjian, Feng, Yu, Huang, Kaixin, Li, Xiang, Chen, Jincao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8810544/
https://www.ncbi.nlm.nih.gov/pubmed/35127808
http://dx.doi.org/10.3389/fsurg.2021.816295
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author Shi, Jichun
Wei, Wei
Wang, Zhen
Ren, Haobin
Jia, Chenguang
Dong, Lixin
Li, Zhengwei
Zhang, Jianjian
Feng, Yu
Huang, Kaixin
Li, Xiang
Chen, Jincao
author_facet Shi, Jichun
Wei, Wei
Wang, Zhen
Ren, Haobin
Jia, Chenguang
Dong, Lixin
Li, Zhengwei
Zhang, Jianjian
Feng, Yu
Huang, Kaixin
Li, Xiang
Chen, Jincao
author_sort Shi, Jichun
collection PubMed
description BACKGROUND: Improving the performance of bipolar coagulation forceps is crucial for safer and more accurate neurosurgery. In our department, we found that bone wax (BW) melted by thermal effect of bipolar electrocoagulation can achieve more efficient hemostasis and reduce the amount of BW in neurosurgical procedures associated with bleeding from emissary and diploic veins. Nevertheless, relevant studies are still lacking to verify our finding. OBJECTIVE: The study objectives were to evaluate the performance and safety in electrocoagulation: (1) compare the performance of BW coated bipolar coagulation forceps and the conventional anti-stick forceps in vivo, and (2) assess the safety of electrocoagulation with BW coated bipolar coagulation forceps in rat primary motor cortex. METHODS: Tissue adhesion was evaluated by comparing the wetting tension and the amount of protein adhered to the forceps tips after electrocoagulation. Thermal damage was assessed by analyzing the thermography and H&E staining of coagulated rat brain tissues. The hemostatic efficiency was reflected by the number of electrocoagulation until complete hemostasis and the condition of damaged common carotid arteries. The safety of BW coated forceps in electrocoagulation was assessed by evaluating the inflammation of coagulated rat primary motor cortex and the motor functions at the 7th day postoperatively. RESULTS: Bone wax coated forceps had a significantly higher contact angle and adhered less coagulum. Thermography was acquired at 3 s, 6 W units in rat primary motor cortex in vivo. The highest temperature recorded during BW coated tips application was significantly lower than the uncoated. In addition, there was a relatively smaller tissue injury area produced by the BW coated forceps. Additionally, BW coated forceps improved the hemostatic efficiency and caused fewer injuries on the damaged arteries (3 s, 10 W units). More importantly, electrocoagulation with BW coated forceps led to no significant motor function impairments and less glial and microglia responses. CONCLUSION: This study reveals that BW coated bipolar coagulation forceps can provide a convenient, cost-efficient, safer, and more efficient way for hemostasis. More research is needed to evaluate the electrocoagulation with BW in the long term and verify our finding in human beings.
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spelling pubmed-88105442022-02-04 Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment Shi, Jichun Wei, Wei Wang, Zhen Ren, Haobin Jia, Chenguang Dong, Lixin Li, Zhengwei Zhang, Jianjian Feng, Yu Huang, Kaixin Li, Xiang Chen, Jincao Front Surg Surgery BACKGROUND: Improving the performance of bipolar coagulation forceps is crucial for safer and more accurate neurosurgery. In our department, we found that bone wax (BW) melted by thermal effect of bipolar electrocoagulation can achieve more efficient hemostasis and reduce the amount of BW in neurosurgical procedures associated with bleeding from emissary and diploic veins. Nevertheless, relevant studies are still lacking to verify our finding. OBJECTIVE: The study objectives were to evaluate the performance and safety in electrocoagulation: (1) compare the performance of BW coated bipolar coagulation forceps and the conventional anti-stick forceps in vivo, and (2) assess the safety of electrocoagulation with BW coated bipolar coagulation forceps in rat primary motor cortex. METHODS: Tissue adhesion was evaluated by comparing the wetting tension and the amount of protein adhered to the forceps tips after electrocoagulation. Thermal damage was assessed by analyzing the thermography and H&E staining of coagulated rat brain tissues. The hemostatic efficiency was reflected by the number of electrocoagulation until complete hemostasis and the condition of damaged common carotid arteries. The safety of BW coated forceps in electrocoagulation was assessed by evaluating the inflammation of coagulated rat primary motor cortex and the motor functions at the 7th day postoperatively. RESULTS: Bone wax coated forceps had a significantly higher contact angle and adhered less coagulum. Thermography was acquired at 3 s, 6 W units in rat primary motor cortex in vivo. The highest temperature recorded during BW coated tips application was significantly lower than the uncoated. In addition, there was a relatively smaller tissue injury area produced by the BW coated forceps. Additionally, BW coated forceps improved the hemostatic efficiency and caused fewer injuries on the damaged arteries (3 s, 10 W units). More importantly, electrocoagulation with BW coated forceps led to no significant motor function impairments and less glial and microglia responses. CONCLUSION: This study reveals that BW coated bipolar coagulation forceps can provide a convenient, cost-efficient, safer, and more efficient way for hemostasis. More research is needed to evaluate the electrocoagulation with BW in the long term and verify our finding in human beings. Frontiers Media S.A. 2022-01-20 /pmc/articles/PMC8810544/ /pubmed/35127808 http://dx.doi.org/10.3389/fsurg.2021.816295 Text en Copyright © 2022 Shi, Wei, Wang, Ren, Jia, Dong, Li, Zhang, Feng, Huang, Li and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Shi, Jichun
Wei, Wei
Wang, Zhen
Ren, Haobin
Jia, Chenguang
Dong, Lixin
Li, Zhengwei
Zhang, Jianjian
Feng, Yu
Huang, Kaixin
Li, Xiang
Chen, Jincao
Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title_full Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title_fullStr Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title_full_unstemmed Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title_short Evaluation of Bone Wax Coated Bipolar Coagulation Forceps: Performance and Safety Assessment
title_sort evaluation of bone wax coated bipolar coagulation forceps: performance and safety assessment
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8810544/
https://www.ncbi.nlm.nih.gov/pubmed/35127808
http://dx.doi.org/10.3389/fsurg.2021.816295
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