Thermal necrosis induced by electrocauterization as a local adjuvant therapy in local aggressive bone tumors, what is the safe limit for surgical margins? An experimental study

• Published in: Archives of orthopaedic and trauma surgery 2015-08, Vol.135 (8), p.1071-1076
• Main Authors: Aydin, Murat, Basarir, Kerem, Armangil, Mehmet, Yildiz, Huseyin Yusuf, Saglik, Yener, Bilgili, Hasan, Yumusak, Nihat
• Format: Article
• Language: English
• Subjects: Animals; Bone cancer; Bone Neoplasms - pathology; Electrocoagulation - methods; Male; Medicine; Medicine & Public Health; Models, Animal; Necrosis; Orthopaedic Surgery; Orthopedics; Periosteum - pathology; Rabbits; Tibia - pathology; Tibia - surgery
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-015-2262-2

Objective In the current study, it was aimed to investigate the temperature change in the cavity wall and pathologic necrosis occurred during cauterization, which was applied at different voltages and time intervals. Materials and methods The right tibias of 32 male rabbits were used. Three 2-mm-diameter holes were created on the cortical surface of the tibia using a hand-held drill. Using an electrocautery device, 55 mV was applied for 3 and 5 s and 65 mV was applied for 3 and 5 s. Maximum temperatures at 3 and 6 mm distance from the application site were measured. Biopsy specimens obtained at 3 and 6 mm distance from the application site were evaluated microscopically for bone cell viability and periosteal necrosis. Results Thirty-two rabbits were divided into four groups. In all groups, periosteal bone cells located at the region, extending from the application site to 3 mm distance, died. In this region, application of 55 mV for 3 s caused peripheral necrosis. There were significant differences between the four groups in terms of maximum temperatures measured at 3 mm distance from the application site ( p  = 0.027). On the other hand, no significant differences were noted between the four groups in terms of maximum temperatures measured at 6 mm distance from the application site ( p  > 0.05). Conclusions Cauterization of the cavity wall in the spray mode at 55 mV for 3 s after tumor resection caused necrosis in the cavity wall, extending from the application site to 3 mm distance. Level of evidence: Experimental animal study, Level II.