Anesthesia-related Safety Profile of a High-energy Ultrasonic Scalpel in Oropharyngeal and Laryngeal Surgery: An Ex Vivo Model.
ex vivo model
laryngeal surgery
safety
ultrasonic scalpel
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
29 Jul 2019
29 Jul 2019
Historique:
entrez:
3
10
2019
pubmed:
3
10
2019
medline:
3
10
2019
Statut:
epublish
Résumé
Introduction The aim of this study was to evaluate the fire risks associated with a harmonic scalpel, with an established avian model simulating oropharyngeal/laryngeal surgery. Methods A standard polyvinyl-chloride (PVC) endotracheal tube (ETT) was inserted into a degutted, whole raw chicken through which 100% oxygen was piped at 10 L/min. The inflated cuff of the tube was grasped and sectioned with the jaws of a standard high-power ultrasonic dissection system Ultracision (Ethicon Endosurgery, Cincinnati, Ohio, USA). Then, the whole ETT was grasped and cut, leaving the device in contact with the ETT for two more minutes. In a second step under the same conditions, an electrosurgical device was placed into the chicken cavity and activated at the chicken tissue near the ETT at a setting of 20 W. All trials were repeated to ensure accuracy. Results No ignition could be produced with the harmonic scalpel under any operation mode settings. In all cases, the ETT was cut through with some fumes and brown discoloration at the site of contact. The electrosurgical device easily caused flash ignition within seconds. Conclusion The harmonic scalpel appears to be a safer tool than electrosurgical devices in the setting of open cavity surgery in oxygen-enriched environments with respect to the presence of flammable medical PVC devices as ETT or catheters.
Identifiants
pubmed: 31576259
doi: 10.7759/cureus.5266
pmc: PMC6764607
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e5266Informations de copyright
Copyright © 2019, Sapundzhiev et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Am J Otolaryngol. 2011 Mar-Apr;32(2):109-14
pubmed: 20392535
Int J Pediatr Otorhinolaryngol. 2011 Feb;75(2):227-30
pubmed: 21145598
J Craniomaxillofac Surg. 2014 Jul;42(5):544-7
pubmed: 24289871
Am J Otolaryngol. 2011 Nov-Dec;32(6):553-6
pubmed: 21306794
Surg Laparosc Endosc Percutan Tech. 2010 Oct;20(5):e150-9
pubmed: 20975490
Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Jun;131(3):197-9
pubmed: 24703002
Am J Otolaryngol. 2010 Sep-Oct;31(5):356-9
pubmed: 20015787
Qual Saf Health Care. 2004 Dec;13(6):467-71
pubmed: 15576710
Ultrasound Med Biol. 2003 Feb;29(2):301-9
pubmed: 12659918
Ann Surg. 2003 Feb;237(2):186-91
pubmed: 12560776
Anaesth Intensive Care. 2010 Mar;38(2):400-1
pubmed: 20369786
Head Neck Oncol. 2009 Jun 24;1:21
pubmed: 19552821
World J Surg Oncol. 2011 Aug 01;9:83
pubmed: 21806825
Masui. 2000 Nov;49(11):1261-2
pubmed: 11215238
Med Sci Monit. 2008 May;14(5):PI1-5
pubmed: 18443561
Acta Otolaryngol. 2012 Mar;132(3):299-304
pubmed: 22201296
Chest. 1998 Jul;114(1):349-50
pubmed: 9674503
Ear Nose Throat J. 2004 Oct;83(10):707-10
pubmed: 15586874
Anesthesiology. 2005 Apr;102(4):870-1
pubmed: 15791128
Oral Oncol. 2014 Jan;50(1):32-9
pubmed: 24269533
Br J Oral Maxillofac Surg. 2014 Oct;52(8):769-70
pubmed: 25042161