Experimental and clinical study of influence of high-frequency electric surgical knives on healing of abdominal incision

AIM： To study the influence of high-frequency electric surgical knives on healing of abdominal incision. METHODS： Two hundred and forty white rats were divided into 10^0, 10^2, 10^5, and 10^8 groups and rat models of abdominal operation were induced by using electric surgical knives and common lancets respectively. Then they were respectively given hypodermic injections of normal saline and 0.2 mL quantitative mixture of Escherichia coil, Staphylococcus aureus and Pseudornonas aeruginosa at a concentration of 10^2, 10^5 and 10^8. On the basis of the animal experiment, 220 patients undergoing abdominal operations （above type Ⅱ） were randomly allocated into one of following three groups： electric knife （EK, 93 cases）, electro-coagulation （EC, 55 cases） and control （72 cases）. High-frequency electric surgical knives were used to dissect abdominal tissues and electro-coagulation for hemostasis in EK group. Common lancets and electro-coagulation were applied in EC group. Common lancets and tieing silk suture were used in the controls. RESULTS： In all the groups except group 10^0, infection rate of incisional wounds made by electric surgical knives were remarkably higher than that with common lancets. Furthermore, there were significant differences in groups 10^2, 10^5, and 10^8 （P 〈 0.05）, but not in group 10^0 （P 〉 0.05） between EK and EC groups. Clinical studies showed a delayed wound healing in 16 cases （17.20%） in EK, 11 cases （16.36%） in EC and 2 cases （2.86%）in the control groups. A significant difference between EK and the control groups （χ^2= 8.57, P 〈 0.01）, and between EC and the control groups （χ^2 = 5.66, P 〈 0.05） was observed, but not between EK and EC （χ^2= 0.017, P 〉 0.05）. CONCLUSION： High-frequency electric knives may remarkably delay abdominal incision healing. Its application should be minimized so as to reduce the possibility of postoperative complications.

Heterotopic ossification beneath the upper abdominal incision after radical gastrectomy:Two case reports

BACKGROUND Heterotopic ossification(HO)is a rare clinical phenomenon that refers to bone formation in nonossifying tissues.CASE SUMMARY This report presents two cases of HO beneath the upper abdominal median incision after radical gastrectomy.The first patient had postoperative pain below the incision area.There were no signs of anastomotic leakage,and the wound healed.Computed tomography(CT)findings 2 wk postoperatively were negative for HO,but the 6-wk CT showed HO beneath the incision.The patient refused reoperation,and after conservative therapy,the pain was gradually relieved after 2 wk.In the second case,postoperative recovery was uneventful,and HO was only detected on routine follow-up CT after 4 mo.An anti-adhesion membrane was applied beneath the peritoneum in both patients.Our findings suggest that HO beneath the abdominal incision might form at approximately 1 mo postoperatively.It may cause intractable pain;however,reoperation is usually not required.CONCLUSION In our cases,we suspect that HO may be related to the use of foreign materials beneath the peritoneum,which needs to be further investigated.

Risk factors and strategy for surgical incision infection in department of abdominal surgery

Objective To study the risk factors of surgical wound infection among the patients in department of abodominal surgery. Methods The factors on surgical wound infection were investigated by retrospective study. The diagnosis standard was based on Diagnosis Standard of Hospital Infection published by Ministry of Health.