The Ophthalmology Microscalpel versus Standard Scalpels and Wound Healing in a Rat Model

Abstract

Objective We tested the hypothesis that the ophthalmology microscalpel, compared to standard incisional instruments, causes less trauma during incisions resulting in decreased inflammation and greater tensile strength of wounds. Study Design Prospective animal study. Setting Animal laboratory. Subjects and Methods Thirty-four Sprague-Dawley rats received dorsum skin incisions with the microscalpel, electrosurgical device, 11 blade scalpel, and 15 blade scalpel. Wounds were harvested at 1 week, 2 weeks, 3 weeks, and 6 weeks, then analyzed histologically in a blinded manner for inflammation markers and tested for tensile strength. Results The microscalpel wounds had significantly higher tensile strength compared to the 15 blade ( P = .045) and electrocautery device ( P = .000) but equivocal strength to the 11 blade ( P = .457). The electrocautery wounds were weaker than all 3 steel blades. No significant difference was found between the microscalpel, 11 blade, and 15 blade incisions for the 5 markers of inflammation. Electrocautery wounds had significantly worse inflammatory scores, specifically, higher angiogenesis and larger wound gap compared to the microscalpel ( P = .004, P = .002), 11 blade ( P = .007, P = .023), and 15 blade ( P = .010, P = .003), respectively. Conclusion Microscalpel incisions result in less inflammation and increased tensile strength compared with electrocautery and higher tensile strength compared to the 15 blade in the rat model. Inflammation scores were equivocal between the microscalpel, 11 blade, and 15 blade. Our findings support the use of the microscalpel blade for facial plastic and reconstructive procedures. Prospective, randomized human studies are warranted.