Thermal Injury Matters
Less Damage Improves Healing and Clinical Outcomes
Detail - PEAK PlasmaBlade device cut vs. traditional electrosurgery cut
Since Bovie and Cushing used the first electrosurgical instruments in 1928, little has been done to reduce the collateral thermal damage inherent to this technology. Although thermal injury depth may vary with power setting, pass rate, electrode design, and tissue type, traditional electrosurgical instruments demonstrate average injury values of 500μm to 1.5mm deep to incised tissue. Comparatively, the PEAK PlasmaBlade™ surgical device demonstrates thermal injury values on the order of 50μm to 250μm with superior cutting performance compared to traditional electrosurgery.1
The postoperative benefits of low thermal technology are well known. Multiple human and animal clinical studies have demonstrated that a reduced thermal injury profile results in improved healing characteristics. Specific to the PEAK PlasmaBlade device, additional clinical research has demonstrated significant reduction in inflammatory cell counts, improvement in healed wound strength, and equivalent cutaneous scarring to the scalpel.2
Detail - Wound strength comparison: PEAK PlasmaBlade device, scalpel, and traditional electrosurgery
When this reduction in thermal injury compared to traditional electrosurgery is applied over a large area – as with surgeries requiring extensive electrosurgical tissue dissection – use of the PEAK PlasmaBlade device has resulted in macroscopic postoperative benefits, including:
Detail - Infrared temperatures: PEAK PlasmaBlade device vs. traditional electrosurgery
- Decreased serous drainage and seroma formation3
- Improved VAS pain scores and narcotic consumption3
- Increased diet volume and return to normal activity level3
Other preclinical studies have demonstrated that the PEAK PlasmaBlade surgical instrument cuts tissue at an average temperature that is half that of traditional electrosurgical devices, thus reducing the potential for injury to adjacent tissue structures during dissection.4
Based on these results, the PEAK PlasmaBlade device provides surgeons with a novel alternative to traditional technology that improves postoperative outcomes, operative efficiency, and the cost-effectiveness of healthcare.5
References/Footnotes
- Data on file. ETR-00127.
- Ruidiaz ME, Messmer D, Huang EJ, Atmodjo DY, Vose JG, Rosenberg HL, Kummel AC, Gurtner GC. Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel. Journal of Plastic and Reconstructive Surgery. 2011; 128(1): 104-111. Chronic wound healing study conducted in subjects undergoing abdominoplasty.
- Gurtner GC, et al. Results of the PRECISE Abdominoplasty Study: Improved Outcomes with the PEAK PlasmaBlade Compared to Scalpel and Traditional Electrosurgery. American College of Surgeons Annual Meeting, Chicago, IL, October 20, 2009.
- Data on file. ETR-00023.
- Data on file. VR-0083.
PRECISE Studies for PEAK PlasmaBlade Technology
Lowering Thermal Damage Improves Outcomes
The PRECISE family of clinical studies encompasses PEAK PlasmaBlade™ research in plastic, breast, orthopaedic, and oncologic surgery. This work has demonstrated that the PEAK PlasmaBlade System produces significantly improved postoperative outcomes in humans compared to the standard of care technology. Additional pre-clinical research in animal models has supported these results.
The first PRECISE study was a randomized, controlled trial (RCT) of patients undergoing abdominoplasty. It demonstrated significantly improved narcotic consumption and pain scores, return to normal activity and diet volume levels, and less blood loss compared to scalpel and traditional electrosurgery.
Results of the PRECISE studies with the PEAK PlasmaBlade device
The results of the abdominoplasty study were presented at the 2009 annual meetings of the American College of Surgeons and European Society of Plastic, Reconstructive, and Aesthetic Surgery.
Thermal injury depth: PEAK PlasmaBlade device vs. Bovie
Additional studies in orthopaedic surgery1 are examining the effects of less inflammation on recovery from total joint replacement (TJR). In breast reduction2 and mastectomy,3 preliminary study results have demonstrated that the PEAK PlasmaBlade device improves cutting performance compared to traditional electrosurgery.2
Examples of reduced thermal injury with the PEAK PlasmaBlade device
Scientific Literature about PEAK PlasmaBlade Technology
Research documenting the preclinical and clinical performance of the PEAK® System has been published in major peer-reviewed journals and awarded podium presentations at international surgical conferences including the annual meetings of the American College of Surgeons, Plastic Surgery Research Council, American Society of Breast Surgeons, American College of Obstetrics and Gynecology, and the European Plastic Surgery Research Council.
PEAK PlasmaBlade Technology – GeneralPEAK PlasmaBlade Technology – General
Peer-Reviewed Publications
- Chang EI, Carlson GA, Vose JG, Huang EJ, Yang GP. Comparative Healing of Rat Fascia Following Incision with Three Surgical Instruments. E-Published, January 2011. J Surg Res. 2011; 167(1): e47-54. Chronic wound healing study conducted in living rat model.
- Vose JG, Berkowitz JM. Reducing Scalpel Injuries in the Operating Room. Journal of the AORN. 2009; 90(6):867-872.
- Palanker DV, Vankov A, Jayaraman P. On Mechanisms of Interaction in Electrosurgery. New Journal of Physics. 2008 Dec;10: 123022.
- Palanker DV, Vankov A, Huie P. Electrosurgery with Cellular Precision. IEEE Transactions on Biomedical Engineering. 2007 Feb;55(2 pt 2): 838-841.
- Vankov A, Palanker DV. Nanosecond plasma-mediated electrosurgery with elongated electrodes. Journal of Applied Physics. 2007;101: 124701.
- Stoker R, Vose JG. Advances in Electrosurgery: Safety and Economic Benefits for Patients, Surgeons, and Hospitals. Managing Infection Control Magazine. 2009; 9(8): 42-47.
Reconstructive and Plastic SurgeryReconstructive and Plastic Surgery
Peer-Reviewed Publications
- Ruidiaz ME, Messmer D, Huang EJ, Atmodjo DY, Vose JG, Rosenberg HL, Kummel AC, Gurtner GC. Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel. Journal of Plastic and Reconstructive Surgery. 2011; 128(1): 104-111. Chronic wound healing study conducted in subjects undergoing abdominoplasty.
- Punthakee X, Keller GS, Vose JG, Stout W. New Technologies in Aesthetic Blepharoplasty and Brow-Lift Surgery. Facial Plastic Surgery. 2010;26:260-265.
- Loh S, Carlson GA, Chang EI, Huang EJ, Palanker D, Gurtner GC. Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel. Plas Reconstr Surg. 2009; 124(6):1849-1859. Chronic wound healing study conducted in living porcine model.
Invited Podium Presentations
- Chang EI, et al. Comparative Healing of Surgical Incisions in Rat Fascia Created by the PEAK PlasmaBlade™, Conventional Electrosurgery, and a Standard Scalpel. Plastic Surgery Research Council Annual Meeting, San Francisco, CA, May 24, 2010.
- Gurtner GC, et al. Results of the PRECISE Abdominoplasty Study: Improved Outcomes with the PEAK PlasmaBlade Compared to Scalpel and Traditional Electrosurgery. American College of Surgeons Annual Meeting, Chicago, IL, October 20, 2009.
- Vose JG, et al. A Randomized Controlled Trial of the PEAK PlasmaBlade vs. Scalpel and Traditional Electrosurgery in Abdominoplasty. European Plastic Surgery Research Council Annual Meeting, Hamburg, Germany, August 22, 2009.
- Keller G, et al. Evaluation of the PEAK PlasmaBlade™ for Facial Plastic Surgery. American Academy of Facial Plastic Surgery Annual Meeting, Chicago, IL, October 21, 2008.
- Loh SA, et al. Comparative Healing of Surgical Incisions Created by Conventional Electrosurgery, a Standard Scalpel Blade, and the PEAK PlasmaBlade™. Plastic Surgery Research Council Annual Meeting, Springfield, IL, May 28-31, 2008.
- Loh SA, et al. Comparative Healing of Surgical Incisions Created by Conventional Electrosurgery, a Standard Scalpel Blade, and the PEAK PlasmaBlade™. American College of Surgeons Annual Meeting, New Orleans, LA, October 9, 2007.
Peer-Reviewed Posters and Abstracts
- Evaluation of the PEAK PlasmaBlade for Facial Plastic Surgery. Keller GS, Huang EJ, Carlson GA, Vose JG. American Academy of Facial Plastic Surgery Annual Meeting, Chicago, IL, September 18-21, 2008.
General Surgery – Surgical Oncology General Surgery – Surgical Oncology
Peer-Reviewed Publications
Peer-Reviewed Posters and Abstracts
- Naruns P, Vose JG, Atmodjo DY, Sangoi A. A Randomized Controlled Trial of the PEAK PlasmaBlade™ in Open Breast Biopsy Compared to Scalpel and Traditional Electrosurgery. American Society of Breast Surgeons Annual Meeting, Las Vegas, NV. April 28 – May 1, 2010.
- Ruidiaz ME, Martin DT, Ta CN, Cortes-Mateos MJ, Vose JG, Wang-Rodriguez J, Kummel AC, Blair SL. A Prospective Controlled Trial of the PEAK PlasmaBlade™ in the Evaluation of Breast Cancer Surgical Specimens with Touch Prep. Presented at the American Society of Breast Surgeons Annual Meeting, Las Vegas, NV. April 28 – May 1, 2010.
- Post-Surgical Incision Healing of Fascia and Skin: A Comparative Evaluation of the PEAK PlasmaBlade, Scalpel, and Traditional Electrosurgery. Loh SA, Chang EI, Jacobson MT, Huang EJ, Vose JG, Carlson GA, Gurtner GC, Yang GP, Berek JS. Society of Gynecologic Oncology Annual Meeting, San Antonio, TX, February 5 – 8, 2009.
Pacemaker/ICD Implants and Revisions
Peer-Reviewed Publications
Invited Podium Presentations
- Weisberg IL, Desai S, Davison P, Shah D, Baez-Escudero J, Beshai J, Burke MC, Knight BP. Effects of Pulsed RF Energy Compared to Standard Electrocautery on Transvenous Lead Insulation Materials. Cardiostim Annual Meeting, Nice, France, June 18, 2010.
Peer-Reviewed Posters and Abstracts
- Weisberg IL, Desai S, Davison P, Shah D, Baez-Escudero J, Beshai J, Burke MC, Knight BP. Effects of Pulsed RF Energy Compared to Standard Electrosurgery on Transvenous Lead Insulation Materials. Heart Rhythm Society Annual Meeting, Denver, CO, May 12 – 15, 2010.
CardiothoracicCardiothoracic
Peer-Reviewed Publications
- Vose JG, Ihnken K, et al. Comparison of Porcine Internal Thoracic Artery Harvest with the PEAK PlasmaBlade™ vs. Harmonic Scalpel and Traditional Electrosurgery. Cardiothoracic Surgery Symposium, San Diego, CA, February 22, 2009.
Peer-Reviewed Posters and Abstracts
- Comparison of Porcine Internal Thoracic Artery Harvest with the PEAK PlasmaBlade vs. Harmonic Scalpel and Traditional Electrosurgery. Vose JG, Atmodjo DY, Schwartz SP, Ihnken K. Cardiothoracic Surgery Symposium, San Diego, CA, February 22, 2009.
Obstetrics and Gynecologic Surgery Obstetrics and Gynecologic Surgery
Peer-Reviewed Publications
- Jacobson MT. Pulsed Electron Avalanche Knife PlasmaBlade™. Expert Reviews in Obstetrics and Gynecology. 2010; 5(1):19-22.
Peer-Reviewed Posters and Abstracts
- Jacobson MT, Chang EI, Huang EJ, Carlson GA, Vose JG, Yang GP, Berek JS. Evaluation of Midline Fascia Healing with the PEAK PlasmaBlade™ vs. Traditional Electrosurgery and Scalpel. Presented at the American College of Obstetrics and Gynecology Annual Meeting, Chicago, IL. May 2 – 6, 2009.
- Post-Surgical Incision Healing of Fascia and Skin: A Comparative Evaluation of the PEAK PlasmaBlade, Scalpel, and Traditional Electrosurgery. Loh SA, Chang EI, Jacobson MT, Huang EJ, Vose JG, Carlson GA, Gurtner GC, Yang GP, Berek JS. Society of Gynecologic Oncology Annual Meeting, San Antonio, TX, February 5 – 8, 2009.
- Evaluation of PEAK PlasmaBlade for Obstetric and Gynecologic Surgery vs. Traditional Electrosurgery. P Blumenthal, MT Jacobson, E Huang, GA Carlson, and JS Berek. American College of Obstetrics and Gynecology 2008 Annual Meeting, New Orleans, LA, May 3-7, 2008.
NeurosurgeryNeurosurgery
Peer-Reviewed Posters and Abstracts
- Evaluation of the PEAK Electrosurgical Tool in Neurosurgery Applications Compared to Standard Electrosurgical Tools and Standard Scalpel Blade. Carlson GA, Taylor S. Congress of Neurological Surgeons Annual Meeting, San Diego, CA, September 15-20, 2007.
ENT Surgery ENT Surgery
Invited Podium Presentations
- Vose JG, Atmodjo DY, Weeks W. A Randomized, Controlled Study of the PEAK PlasmaBlade TnA in Adult Tonsillectomy Compared to Traditional Electrosurgery. American Academy of Otolaryngology Annual Meeting, San Francisco, CA, September 11 - 14, 2011.
- Chang KW, et al. Evaluation of the PEAK PlasmaBlade™ for ENT Surgery. American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting, Chicago, IL, October 23, 2008.
OtherOther
Peer-Reviewed Publications
- Palanker DV, Vankov A, Huie P. Anterior Capsulotomy with a Pulsed Electron Avalanche Knife. Journal of Cataract Refractive Surgery. 2010 Jan; 36(1):127-32.
- Priglinger SG, Palanker DV, Alge CS, Kreutzer TC, Haritoglou C, Grueterich M, Kampik A. Pulsed electron avalanche knife: new technology for cataract surgery. British Journal of Ophthalmology. 2007 Jul;91(7):949-54.
- Priglinger SG, Haritoglou C, Palanker DV, Kook D, Grueterich M, Mueller A, Alge CS, Kampik A. Pulsed electron avalanche knife for capsulotomy in congenital and mature cataract. Journal of Cataract and Refractive Surgery. 2006 Jul;32(7):1085-1088.
- Priglinger SG, Haritoglou C, Mueller A, Grueterich M, Strauss RW, Alge CS, Gandorfer A, Palanker DV, Kampik A. Pulsed electron avalanche knife in vitreoretinal surgery. Retina. 2005 Oct-Nov;25(7):889-896.
- Priglinger SG, Haritoglou C, Palanker DV, Alge CS, Gandorfer A, Kampik A. Pulsed electron avalanche knife (PEAK-fc) for dissection of retinal tissue. Archives of Ophthalmology. 2005 Oct;123(10):1412-18.
- Miller JM, Palanker DV, Vankov A, Marmor MF, Blumenkranz MS. Precision and safety of the pulsed electron avalanche knife in vitreoretinal surgery. Archives of Ophthalmology. 2003 Jun;121(6):871-877.
- Palanker DV, Marmor MF, Branco A, Huie P, Miller JM, Sanislo SR, Vankov A, Blumenkranz MS. Effects of the pulsed electron avalanche knife on retinal tissue. Archives of Ophthalmology. 2002 May;120(5):636-640.
- Palanker DV, Miller JM, Marmor MF, Sanislo SR, Huie P, Blumenkranz MS. Pulsed electron avalanche knife (PEAK) for intraocular surgery. Invest Ophthalmol Vis Sci. 2001 Oct;42(11):2673-78.
