External eye surgery Meibomian gland cyst excision, eyelid inversion trichiasis correction, ptosis, strabismus correction; eyelid mass excision, blepharoplasty cosmetic surgery, nasal dacryocystorhinostomy, etc.

Conjunctival area surgery such as pterygium excision, conjunctival cyst excision.

Small vessel hemostasis (eg, conjunctiva, connective tissue) in routine ophthalmic surgery.

Small-scale electrical resection and hemostasis in stye, chalazion surgery.

Incision and hemostasis in ocular trauma surgery.

Eye muscle surgery (strabismus conjunctiva incision, muscle surface vascular coagulation, muscle incision separation and hemostasis......).

Incision and hemostasis during nasolacrimal duct surgery.

Efficacy evaluation of single-use portable electrocoagulation knife in eyelid surgery
Liu Shuyi, Wu Jinmei, Li Wanzhen, Wu Pengsen, Lu Wei
Department of Ophthalmology, Second Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning, China

 

Summary：Objective: To compare and analyze the single-use portable electrocoagulation knife and conventional electrocoagulation pen in the treatment of eyelid surgery. METHODS: A retrospective analysis of 278 patients with 481 eyes of outpatient and inpatient eyelid disease admitted to the Department of Ophthalmology of the Second Affiliated Hospital of Dalian Medical University from October 2016 to January 2018 was performed. 233 eyes) and the control group (139 cases, 248 eyes). The observation group was treated with a disposable portable electrocoagulation knife, and the control group was treated with a conventional electrocoagulation pen. The patients were followed up for 6 months to evaluate the curative effect. Results: The hemostatic effectiveness of the observation group was higher than that of the control group, and the incidence of postoperative adverse reactions was lower than that of the control group, and the difference was statistically significant (P<0.05). And the single-use portable coagulation knife has the advantages of simple operation, safe use, and accurate cutting. Conclusion: The use of disposable portable coagulation knife can replace conventional coagulation pen, which is the development direction of high-quality ophthalmic plastic surgery.
Key words：eyelid surgery; eye plastic surgery; electrocoagulation; high-frequency electrocautery; hemostasis; clinical efficacy
Classification no. of Chinese Library：R766.9    Document identification code：A    Article ID：1671-5837（2018）02-0031-01

In order to further improve the safety of electrocoagulation pen used in ophthalmic plastic surgery, the accuracy of cutting and the effectiveness of hemostasis, reduce the incidence of postoperative adverse reactions, and improve the satisfaction of patients. This study compared and analyzed the efficacy of single-use portable coagulation knife and conventional coagulation pen in eyelid surgery. The characteristics of intraoperative hemostasis were observed, the postoperative recovery was observed after 6 months of follow-up, and the therapeutic effects were summarized. The reports are as follows:

 

1 Materials and Methods

1.1 Normal information

From October 2016 to January 2018, outpatient and inpatient eyelid disease patients admitted to the Department of Ophthalmology of the Second Affiliated Hospital of Dalian Medical University were selected as the research objects. Inclusion criteria: ① eyelid disease meets the criteria for surgical treatment; ② no other serious organic diseases are combined; ③ signed informed consent. Exclusion criteria: refusal to participate in the study. A total of 278 patients (481 eyes) were selected, including 138 males (223 eyes) and 140 females (258 eyes), aged 2-86 years, with an average age of 49.5±4.7 years. 97 cases (178 eyes) of eyelid mass, 54 cases (89 eyes) of ptosis, 36 cases (70 eyes) of double blepharoplasty, 39 cases (67 eyes) of upper and lower blepharoplasty, and lower eyelid blepharoplasty Thirty-seven cases (53 eyes) were operated on, and 15 cases (24 eyes) of palpebral laxity were performed. The random number table method was used to group the observation group (139 cases, 233 eyes) and the control group (139 cases, 248 eyes). There was no significant difference in age, gender and other clinical data between the two groups (P>0.05).

 

1.2 Surgical equipment

The disposable portable electrocoagulation knife used by the observation group in this study is the BDD-YA-1 electrocoagulation pen produced by Cixi Shunye Medical Equipment Co., Ltd. It consists of protective cap, application part (pen tip, heating wire), switch, pen Body, battery (internal power supply); heating wire is made of iron-chromium alloy. The parameters are as follows: the diameter of the heating wire is 0.3mm, and the rated voltage of the power supply is 3.0V according to the model. The principle of action is battery-powered, and the resistance wire is controlled by the switch to heat and burn, and the heating wire is aimed at the microvessels to burn and stop bleeding in a touch-type manner. When in use, remove the protective cap, press the switch lightly, the power is turned on, and the heating wire at the front end will heat up immediately. Open the circuit. Cutting and coagulation are performed strictly according to the requirements of the surgical procedure and the type of surgical tissue. The conventional electrocoagulation pen used in the control group was the OBS-Ds#0065S-01J ablation electrode produced by Guangdong Baisheng Medical Equipment Co., Ltd.

 

1.3 Method

All eyelid surgeries were performed by the same operator under local infiltration anesthesia. The observation group used a new type of disposable portable electrocoagulation knife, and the control group used a conventional electrocoagulation pen, both of which were combined with traditional ophthalmic surgical instruments.

 

1.4 Observation Indicator

Intraoperative safety, ease of operation, cutting accuracy and hemostatic effectiveness were observed. The success rate of one-time hemostasis, the incidence of charring and carbonization, and the operation time were compared between the two groups, and the difference between the two groups was statistically significant. The patients were followed up for a period of 6 months after operation, and the incidence of postoperative adverse reactions in the two groups during the follow-up period, including the incidence of postoperative eyelid rebleeding, hematoma, infection, and scarring, was compared between the two groups. study meaning.

 

1.5 Statistical analysis

SPSS 22.0 was used for statistical analysis of the data in this study. The measurement data was described by (X±S), the independent sample t test was used to compare the differences between groups, the count data was described by n (%), and the categorical data distribution was described by X². Tests were used to compare the differences between groups, all tests were two-sided, and p<0.05 indicated that the differences were statistically significant.

 

2 Result

2.1 Comparison of intraoperative hemostasis

The average operation time of the observation group was (32.17±3.34) minutes, the success rate of one-time hemostasis was 93.56%, and the incidence of charring and carbonization was 10.73%. In the control group, the average operation time was (40.55±3.65) minutes, the success rate of one-time hemostasis was 82.66%, and the incidence of charring and carbonization was 18.95%. The independent samples t test was used to compare the difference in operation time between the observation group and the control group. The results showed that the operation time of the observation group was significantly lower than that of the control group, and the difference was statistically significant (t=-19.969, P<0.001). The X² test was used to compare the two groups. The one-time hemostasis success rate and the incidence of charring and carbonization of the patients showed that the one-time hemostasis success rate of the observation group was 93.56%, which was significantly higher than that of the control group, which was 82.66%, and the difference was statistically significant ( X²=13.462, P<0.001 ); the incidence of charring and carbonization in the observation group was 10.73%, which was significantly lower than 18.95% in the control group, and the difference was statistically significant (X²=6.380, P=0.012). Compared with the control group, the observation group had high cutting accuracy and obtained an ideal surgical incision. During the operation, the surgical field of view was clear, and the anatomical level of the surgical site was clear and intuitive, which could effectively reduce the damage to the secondary injury and the surrounding tissue. In the observation group, the success rate of one-time hemostasis was high, the incidence of charring and carbonization was low, the amount of bleeding was small, the hemostatic effect was high, and the operation time was significantly shortened.

 

2.2 Comparison of postoperative adverse reactions

The patients were followed up for a period of 6 months after operation. In the observation group, 2 eyes had eyelid bleeding and hematoma again, 1 eye had infection, and 15 eyes had scars, which returned to normal after treatment. No other serious complications occurred in other patients. On the basis of the obvious improvement of eye shape and functional recovery, the patients achieved the improvement of appearance and rejuvenation of the eyes, and all patients achieved satisfactory results. In the control group, 10 eyes had rebleeding and hematoma of the eyelid, 3 eyes had infection, and 24 eyes had scars, which had returned to normal after treatment. No other serious complications occurred in other patients. The incidence of postoperative eyelid bleeding and hematoma in the observation group was 0.86%, which was significantly lower than 4.03% in the control group, and the difference was statistically significant (X²=4.975, P=0.026); the incidence of infection in the observation group was 0.43%, It was lower than 1.21% in the control group, and the difference was not statistically significant (X²=0.193, P=0.660). The incidence of scar in the observation group was 6.44%, which was lower than 9.68% in the control group, and the difference was not statistically significant (X²=1.692, P=0.660). =0.193).

 

3 Discuss

Compared with the conventional electrocoagulation pen, the disposable portable electrocoagulation knife in this study has the following advantages: (1) Simple operation: it is a pen-type wireless operation, small in size and light in weight, the patient does not need to stick electrodes, and the doctor does not need to debug, It is ready to use after unpacking the sterilized package, and it is easy to operate. (2) High safety: There are few factors to be evaluated by the doctor of the disposable portable electrocautery knife, because there is no need for the electrocautery host during use, the human body does not need to be connected to the circuit, no negative plate, and the human body is not affected by current, which has higher safety. (3) High cutting accuracy: Compared with the conventional electrocoagulation pen, the tip width is about 2mm, and the diameter of the heating wire of the disposable portable electrocoagulation knife is 0.3mm, which can achieve better and precise cutting for eyelid surgery. (4) High intraoperative hemostasis effectiveness: One-time use of the portable electrocoagulation knife has a high success rate of one-time hemostasis, low incidence of charring and carbonization, less bleeding, high hemostasis effectiveness, significantly shortened operation time, and improved operation efficiency. . (5) The incidence of postoperative adverse reactions is low: the incidence of postoperative eyelid rebleeding and hematoma is low, which can promote the early recovery of patients on the basis of reducing the risk of surgery and improve the satisfaction of patients. The results of this study showed that the patients with eyelid hand wood who used the disposable portable electrocoagulation knife achieved good surgical results, and the patients had high rest satisfaction, which made the ophthalmic plastic surgery tend to be perfect. Therefore, the single-use portable coagulation knife has broad application prospects in clinical practice.

References

[1] Fan Xianqun. Eye Plastic Surgery [M]. Beijing: Beijing Science and Technology Press, 2009:008.

January 31, 2018