Pakistan Veterinary Journal
Pakistan Veterinary Journal
Pakistan Veterinary Journal
Department of Pathobiology, 1Department of clinical studies, Veterinary Faculty, Karaj branch, Islamic Azad University,
Karaj; 2Department of Anatomy and embryology, Veterinary Faculty, Science and Research branch, Islamic Azad
University, Tehran; 3Veterinary Faculty, Karaj branch, Islamic Azad University, Karaj, Iran
*Corresponding author email: drbhoseini@yahoo.de
382
383 Pak Vet J, 2012, 32(3): 382-385.
microscope to observe tissue damages and healing process µm² were measured by Photoshop Cs5 software. We
improvements in 12 mice, in 21 days after cutting the compared the healing process between two incisions and
ventral skin to help choosing the best technique after all. the results are explained below step by step. Inflammatory
cells after cutting with the scalpel cause delay in healing
MATERIALS AND METHODS and thickness of fibrosis tissue in the cutting site after 21
days, versus necrosis by cicatrical process in the cutting
An experimental study was designed in that twelve edge with radio frequency helps rapid repair and less scar
female mice of same age (from Pasture Institute) were tissue that is observable after 14 days of cutting. The results
randomly selected. As we want to compare scalpel blade showed that using radio surgical instruments cause less
surgery and radio surgery, so two different incisions were tissue damage and more rapid healing process in
made in one mouse. Therefore they assigned into three comparison the scalpel blade.
groups consisting four mice with two incisions on each one.
They kept for one week in their cage as adaptive period. 0-day sample: Scalpel blade incisions (group 1) had
The upper incision made by scalpel blade were named as straight edge without necrosis. Connective tissues and
group 1 and the lower incision made by radio surgery were muscles in dermis were situated in normal place. In group
named as group 2. 2, samples incised by radio frequent instrument showed
Immobilization of the mice was performed by a coagulative necrosis deep up to 63 µm. Dermis’ measure
cotton soaked in Ether solution (Merk, Germany) the each was about 69 µm (Fig.1, 2).
mouse anesthetized with intramuscular injection of 60
mg/kg ketamine hydrochloride (Alfasan, Netherland) and 7-day sample: In group 1 samples, there were fibroblasts
10 mg/kg xylazine hydrochloride (Alfasan, Netherland). and inflammatory cells under the epidermis. Thickness of
After the ventral abdominal skin was shaved with povidine epidermis increased in comparison to the skin in 0-day
iodine solution (Behvazan Lab, Iran), two 3 cm long - sample in the same group from about 4 to 15 µm. Dermis
incision with 4 cm distance apart were made transversally was thickened up to 174 µm while it was about 76µm in
deep to the full skin thickness, one by number 15 scalpel first day of sampling in the same group and it is because of
blade and the second one by radio frequent instrument some degrees of hyperplasia in it around incision margins.
(Radio Surgery Equipment, Ellman, USA). Tangstan In group two, epidermis which were necrotized in first day
needle electrode by purred waves of 4 MHz and 100 watt by radio surgical instrument, was repaired, its thickness was
electricity power were used for cutting and coagulating more than 0-day sample (from 5µm to 16µm) and barely
combination. Two mice were euthanized and considered for the cutting edge was recognizable. Granulation tissue in
immediate sample as 0-day sample and the other incisions dermis composed of vessels, fibroblasts, macrophages and
were re- approximated with non-absorbable suture new generated collagen fibers. Granulation tissue was about
(number4-0 silk, merslene-eticon suture, USA). Wounds 123µm. Some degrees of hyperplasia in dermis layers were
were sutured by interrupted simple pattern and dressed by observed and its thickness was 85 µm (Fig. 3, 4)
Nitroforazone topical ointment. Mice were kept separately
in individual cages and fed by normal commercial diet 14-day sample: In group one sample, there were some
(pasture Institute, Iran). They had 12 hours light and 12 wound contractions to inside the incision margin was
hours darkness. Skin samples (3x1 cm size) were collected observable; collagens in dermis were presents with
from the incision sites from the two randomly selected mice scattered macrophages and Skin accessories like hair
at 0, 7, 14 and 21 days post-incision and fixed in 10 follicles, they were 1.4 hair follicle in each 50µm². Dermis
percent buffered (with phosphate mono and di basic) was thinner in comparison to the first day in the same group
formalin. These skin samples were processed according to and it was about 25µm. In group two, epidermis thickness
standard histological techniques and embedded in paraffin. was back to normal like in first day of sampling and it was
Sections of 5 µm were cut and stained by H and E staining about 7µm. Dermis regeneration was accomplished by hair
method for light microscopic study. Changes in the incision follicles; sebaceous gland and collagens composition, there
area were compared between scalpel blade and radio were 2.2 hair follicles in each 50µm². Collagen layer in
surgery incision techniques. Data were collected on the dermis was about 60µm and in parallel order (Fig. 5, 6).
healing process including re-epithelialization, inflammatory
reaction, collagen regeneration, granulation tissue 21-day sample: Skins were completely repaired and the
composition and measurement of the epidermis, dermis, incision site could hardly be recognized.
collagen thickness, inflammatory cells and granulation
tissue region, on date of 0,7,14, and 21 days after incision. DISCUSSION
The measurements were done by Photoshop CS5, the mean
of results simply compared between two methods. The purpose of the study was to compare difference of
the healing process between scalpel blade and radio
RESULTS surgical incisions. The results suggest that the healing of
the incision by radio frequency was processed sooner than
To compare scalpel blade and radio surgical equipment scalpel blade incision. This is possibly due to several
cutting edge in detail, we observed tissue damage rate and interfering factors such as more inflammatory cell’s
the healing process improvements of both methods in presence in scalpel blade incision site in the first week.
ventral skin samples. Data were collected in days 0, 7, 14, Second, cicatricle process in radio surgical incision could
and 21 after procedure. Epidermis, dermis, inflammatory help rapid wound healing, which has also been observed
cell layer, collagen layer, number of hair follicles in each 50 in the previous study in that using scalpel blade need
384 Pak Vet J, 2012, 32(3): 382-385.
Fig. 1: Mouse ventral skin sample in day 0, cutting by scalpel, straight Fig. 4: Mice ventral skin sample in day 7, cutting by radio frequency,
cutting edge without necrosis (H&E, X10). epidermis: 16µm and dermis: 85µm with more granulation tissue layer
with inflammatory cells (arrow) was 123µm (H&E, X10).
Fig. 3: Mice ventral skin sample in day 7, cutting by scalpel, more Fig. 6: Mouse ventral skin sample in day 14, cutting by radio frequency,
inflammatory cells (arrow) in dermis with thickness of 175µm (H&E, epithelial complete formation and back to normal thickness about 7µm,
X10). Dermis: 60µm with 2.2 hair follicles in each 50µm² and more collagen in
parallel order(arrow) (H&E, X10).
longer time especially for repairing, but radio surgery by
haemostatic characteristic, delicate cutting, variety of cellular proliferation, and skin reconstruction would be in
electrode, and less tissue damages was better technique and better in radio surgery which were confirmed in other
helps faster healing process (Saidi et al., 1994). And finally, investigation of healing and repairing in diabetic rats (Li
the wound contraction, granulation tissue formation et al., 2011).
385 Pak Vet J, 2012, 32(3): 382-385.
The data are in agreement with Niamtu (2005) comparing to the Laser in cutting, and returning the
histological studies that showed tissue damages by radio investments on this equipment considering to no need to
surgery were lesser than ordinary scalpel blade like cold buy scalpel blades, make this technology very useful and
blade. Our findings support those of Brown et al. (2000), valuable for the surgeons. Our data also show some
Niamtu (2005), Silverman et al. (2007) and Li et al. benefits, however it needs more detailed researches by
(2011), in decreasing the wound contraction, better new molecular methods in tracing the related molecules in
collagen formation and less following problems after healing process.
surgery with radiofrequency in comparison with the
scalpel blades. Collagen alignments and rapid maturity REFERENCES
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