Comparison of wound-healing and tissue effects using the Gyrus PlasmaKnife with monopolar, Coblation, and Harmonic Scalpel methodologies

The aim of this study was to assess the histological and thermal effects of different dissection technologies on tissue around incision and to consider their comparative wound healing profiles. The technologies used were Gyrus PlasmaKnife, monopolar electrode, Coblation wand, and Harmonic Scalpel. Single incisions were made using each device on the internal peritoneal surface at four test sites per porcine subject. The incision sites were assessed to determine the extent of tissue and thermal damage around the incision site in the first animal and the formation of wound cover and degree of inflammation 14 days post-procedure in the second. The PlasmaKnife was easier to handle and more controllable than the other devices and resulted in a precise incision with only localised thermal damage. The other technologies produced either deep lesions extending into the muscle and/or considerable lateral damage across the mesothelial surface. Of all the devices only the PlasmaKnife resulted in compact well-organised wound cover showing vascularisation and neo-collagenesis. The notably better wound healing profile and reduced inflammatory response seen suggest that use of the PlasmaKnife in the clinical setting may lead to reductions in both wound healing times and post-operative pain.