To assess and compare the outcomes of the cutaneous neck dissection incision taken by colorado microdissection needle, surgical blade and cutting electrocautery in patients with oral squamous cell carcinoma: A prospective study.

Aim: To assess and compare the outcomes of the cutaneous neck dissection incisions taken by Colorado microdissection needle, surgical blade and cutting electrocautery in patients with oral squamous cell carcinoma. Materials and Methods: A prospective, randomized control, comparative study was carried out on 21 patients. These patients were divided into 3 groups containing 7 patients in each group. The intra operative and post operative outcomes were evaluated. Statistical analysis was done by using descriptive and inferential statistics using Chisquare test, Fisher's Exact Test, one way ANOVA and multiple comparison Tukey Test and software used in the analysis were SPSS 27.0 version and GraphPad Prism 7.0 version and P < 0.05 is considered as level of significance. Results: The time taken for placing cutaneous skin incision and blood loss was more in the surgical blade group as compared to the Colorado microdissection needle and electrocautery. Statistically no significant difference between the three group while comparing the cutaneous neck incision healing and post operative scar formation. Conclusion: This study proves the superiority of the Colorado microdissection needle in terms of time taken and blood loss with similar aesthetic outcome in terms of cutaneous wound healing and post operative scar formation when compared to surgical blade and cutting electrocautery.

The short-term outcomes of surgical scars in head and neck surgery comparing between surgical blade and geometric electron modulation electrocautery.

BACKGROUND: Scar formation after neck surgery is a frequent concern, impacting patients both physically and psychologically. Cosmetic appearance plays a crucial role in assessing surgical success. At present, the evolving medical technologies introduces innovations like Geometric Electron Modulation (GEM) electrocautery. GEM technology offers potential benefits such as reduced thermal injury and consistent heat emission during surgery compared to conventional electrocautery. OBJECTIVES: To compare the difference between postoperative neck scars from the surgical blade as the gold standard and geometric electron modulation electrocautery. MATERIAL AND METHODS: A randomized controlled study was performed on the patients who were diagnosed with surgical conditions requiring neck surgery at the Department of Otolaryngology Head and Neck Surgery, King Chulalongkorn Memorial Hospital, from 2023 to 2024. The Patient and Observer Scar Assessment Scale was utilized to assess scar appearance at 1 and 3 months following the surgery, and the amount of blood loss during incision was recorded. RESULTS: 22 patients were enrolled to this study. At 1-month follow-up, we saw significant difference between GEM (20.32 ± 4.11) and the surgical blade (23.27 ± 4.59) (P = 0.008) from POSAS, patient scale but no significant difference in doctor scale, (GEM 21.55 ± 7.34, surgical blade 24.27 ± 7.88, P = 0.155). At 3-month follow-up, there were no significant difference between the groups both doctor (GEM 16.45 ± 4.62, surgical blade 17.65 ± 4.50, P = 0.411) and patient scale (GEM 13.15 ± 2.96, surgical blade 14.05 ± 3.33, P = 0.328). CONCLUSION: GEM electrocautery had a superior scar outcome to a surgical blade at 1 month from the patient perspective. There was also significantly less blood loss in GEM compared with the surgical blade.

Unusual case of bladder stone with an embedded scalpel blade.

ME is an 84-year old man who presented with a 3-year history of storage urinary symptoms associated with strangury. He had an open radical prostatectomy and direct visual internal urethrotomy 10 years prior to presentation for early prostate cancer and partial urethral stricture, respectively. A plain abdominal X-ray revealed a bladder stone in which there was an opaque foreign body embedded within the stone. A cystolithotomy was done, and the retrieved stone was cracked open, revealing a surgical blade.The patient had an uneventful recovery postoperatively.

Evaluation of Perceived Pain, Discomfort, Functional Impairments, and Satisfaction When Relieving Crowded Lower Anterior Teeth in Young Adult Patients Using Corticision-Assisted Fixed Orthodontic Treatment: A Randomized Controlled Trial.

Background No previous trial (randomized and controlled) studied the levels of pain, discomfort, and acceptability associated with acceleration of dental movement during orthodontic treatment using corticision. The purpose of this study is to compare the pain, discomfort, ease of procedure, patient satisfaction, and analgesic use during corticision-assisted (without extraction) decrowding of the lower anterior teeth with the traditional orthodontic method. Materials and Methods Fifty-two patients (38 females, 14 males; mean age: 21.38 ± 1.05) were randomly distributed into two groups: the corticision group (CORT, n=26) and the control group (CONT, n=26). Corticision was applied by a surgical blade and a hammer at three anterior regions on the lower jaw using three radiological guides. The levels of pain, discomfort, swelling and chewing difficulties were registered on a visual analog scale (VAS) at one, seven, and 14 days after applying the first wire (0.14-inch NiTi archwire). Questionnaires were administered to assess the level of satisfaction, ease of the procedure, and the number of analgesics patients took. Mann-Whitney U tests were used to detect significant differences between the two groups. The Chi-Square test was used to study the significance of differences in taking analgesics during the first week of treatment. Results One day following the intervention, there were no statistically significant differences between the two groups concerning pain levels, discomfort, and difficulties of mastication (P=0.293, P=0.166, P=0.538; respectively), but there was a statistically significant difference in the perceived swelling (P=0.012). On the seventh and 14th days of assessment, there were no statistically significant differences between the two groups regarding the previous variables. In the CORT group, the proportion of patients who were satisfied with treatment was approximately 94%, the proportion of those who found the treatment easy was 96%, 84% of patients wanted to repeat the procedure, and 92% of them would recommend this procedure to a friend. Conclusions There were no statistically significant differences in pain perception, discomfort, difficulties with mastication, and analgesic consumption between the interventional group and the control group. The perception of swelling was greater in the experiment group (the corticision group) at 24 hours following the first archwire engagement, and then it gradually decreased. Patients in both groups showed high levels of satisfaction following leveling and alignment. Those in the experimental groups showed a high level of willingness to undergo the same procedure again and a high level to recommend this procedure to a friend.

Broken surgical blade retrieval following lumbar discectomy through paravertebral/lateral transpsoas approach: A case report.

BACKGROUND: There are rare reports of broken surgical blades occurring during lumbar discectomy, and even fewer that discuss their retrieval. CASE DESCRIPTION: While a 54-year-old male was undergoing a lumbar discectomy, the knife blade was broken. As it was difficult to retrieve the fragment through the original incision, the patient was closed, and a postoperative angio-computerized tomography (CT) was obtained. When the CT angiogram (CTA) documented the retained fragment had become lodged near the iliac vein within the psoas muscle, a second operation for blade retrieval, consisting of a paravertebral, lateral transpsoas approach, was successfully performed. CONCLUSION: In some cases, it is difficult to retrieve a broken scalpel blade during the index surgery. When this occurs, we would recommend closing the patient, and obtaining a CTA to better document the location of the retained foreign body. Based upon these findings, a safer second stage procedure may be performed (e.g., as in this case using a paravertebral lateral transpsoas approach) to avoid undue sequelae/morbidity.

The Influence of Iodine-Impregnated Incision Drapes on the Bacterial Contamination of Scalpel Blades in Joint Arthroplasty.

BACKGROUND: Prosthetic joint infections (PJI) are a disastrous and feared complication in arthroplasty. Over the past decades, surgeons have tried to lower infection rates through all sorts of improvements. At present, it is impossible to reduce the risk to zero. As the contamination of surgical instruments and the surgical field has been identified as a remaining gap prone for infection, scalpel blades among others have become a focal point of several studies. This study is the first to compare the effect of adhesive incision drapes on contamination rates of scalpel blades in primary arthroplasty of the hip and knee. METHODS: A total of 344 microbiologic blade culture results from 2 study groups with and without drape usage and 1 group with known PJI were analyzed and compared to histopathologic and microbiologic tissue results. RESULTS: In 78% of all positive cultures, the bacteria were part of the local skin flora. The contamination rate for the skin blades with a drape was 3.81% vs 12.19% without drape usage. A significant difference was determined between positive skin blade culture results incision drape usage (P = .031). The different pathogens likely responsible for the PJI correlated with the deep blade cultures (P ≤ .01). The overall contamination rate of surgical blades (1.37%) is comparatively low to the results obtained from other surgical equipment in literature. None of those blade-positive patients developed a surgical site infection during 12-month follow-up. CONCLUSION: Iodine-impregnated incision drapes are able to reduce surgical skin blade contamination. Further studies may be needed to assess the relationship between blade contamination and surgical site infections.

Comparison of Endonasal DCR Surgery Using Cautery and Surgical Blade Technique in Cases of Chronic Dacryocystitis.

Dacryocystitis is defined as inflammation of lacrimal sac. This can be congenital or acquired. Congenital dacryocystitis is commonly chronic while acquired dacryocystitis is acute and chronic both. Endonasal DCR surgery is the most commonly used treatment in chronic DCR but recent use of cautery technique in endonasal DCR surgery rather than traditional surgical blade technique has emerged with promising results with good success rate and fewer complications.

Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up.

Gingival melanin hyperpigmentation is an esthetic concern for many individuals. In this study, we compared the standard surgical removal method with two different Er,Cr:YSGG laser settings in order to find the best treatment method. In 33 dental arches, the following three treatment groups were comparatively evaluated: (1) surgical stripping, (2) removal with laser setting 1 (4.5 W, 50 Hz, 100% water, 80% air, 60 µs, 800 µm Tip; MZ8), and (3) laser setting 2 (2.5 W, 50 Hz, 20% water, 40% air, 700 µs, 800 µm Tip; MZ8). We comparatively evaluated pain, patient satisfaction and wound healing, treatment time, and the amount of bleeding. Re-pigmentation was evaluated after 1 and 12 months by Hedin and Dummet pigmentation scores. Laser setting 1 had the best results regarding pain and patient satisfaction, although not statistically significant (P > 0.05). Wound healing results were better using lasers compared to surgical stripping (P < 0.05). Laser setting 1 was a faster procedure with mild amounts of bleeding. The least amount of bleeding was seen with laser setting 2. After 1 month, only two cases of the laser setting 2-treated areas showed an isolated pigmented area in the papilla; at 12 months, the mean Hedin indexes were still less than 2 and mean Dummett index less than 1 in all treatment techniques, with the lowest scores seen in the laser setting 1 sites. Based on our results, Er,Cr:YSGG laser can be more convenient for gingival depigmentation compared to surgical blade. Although not statistically significant, laser setting 1 with shorter pulse duration and higher water spray showed better overall results. However, laser setting 2, with longer pulse duration and less water spray, resulted in better coagulative effects and can be used to control bleeding wherever necessary in clinical practice.

Comparison of Fungal Culture Positivity using Surgical Blade and Emery Board in Onychomycosis Patients / 대한의진균학회지

BACKGROUND: Usually, we did the fungus culture by collecting nail samples using a surgical blade, but this procedure showed low positive culture rate. An emery board is a tool used to gently grind down and shape the edges of nails. OBJECTIVE: The aim of this study is to compare positive culture rates of nail sampling techniques in diagnosis of onychomycosis using surgical blade and emery board. METHODS: We collected and assessed data of 49 patients in total, with chief complaints of nail problem, and showed positive results in KOH smear. Fungus culture was performed twice in each patient, both by scraping nail with surgical blades and grinding nail piece with emery board. After 4 weeks from culture, we compared positive culture rates of two nail sampling techniques. RESULTS: In 49 patients, 16 patients were male and the other 33 were female, with average age of 51.4 years. When classified by morphological type, there were 45 cases of distal lateral subungual onychomycosis (DLSO) and 4 cases of white superficial onychomycosis (WSO). Culture using emery board produced 18 positive results (36.7%) out of 49 patients, and that using surgical blade produced 9 positive results (18.4%); the difference were statistically significant. In other words, nail sampling using emery board rather than surgical blade resulted in higher positive culture rate. CONCLUSION: Therefore, emery board can be used as a useful device for diagnosis and identification of causative fungi in onychomycosis in clinical practice and a method to enhance positive rates of cultures.

Comparison of surgical blade and cryosurgery with liquid nitrogen techniques in treatment of physiologic gingival pigmentation: short term results.

STATEMENT OF THE PROBLEM: Melanin pigmentation of the gingiva is a crucial esthetic problem. A variety of methods have been used for gingival depigmentation. PURPOSE: The purpose of this study was to compare the results of two treatment modalities: scalpel technique and cryotherapy with liquid nitrogen in treatment of gingival pigmentation. MATERIALS AND METHOD: Twenty patients with chief complaint of gingival pigmentation participated in our study. 10 patients were treated with cryotherapy and remaining 10 participants were undergone the scalpel technique surgery. We evaluated acquiescence and comfort of the patients, degree of depigmentation, based on the area of pigmentation shown by gridlines option in Microsoft Paint software, and the presence or absence of gingival recession before and one month after treatment. Data was analyzed using Mann-Whitney and Chi-Square tests. A significance level of p≤ 0.05 was adopted. RESULTS: Mean value and standard deviation of depigmentation for group A and group B was 96.17±2.51 and 95±2.48, respectively. The difference was not statistically significant (p= 0.225). There was no association between the treatment modality and the gingival recession (p= 0.303) or the treatment modality and the patient satisfaction (p= 0.346). No significant difference was found between gingival recession measures before and after the operation in the two treatment modalities. CONCLUSION: Surgical blade and cryosurgery with liquid nitrogen had no significant difference in treatment of physiologic gingival pigmentation. Both Techniques are acceptable in the treatment of gingival pigmentation.