Planatome Technology’s surgical blade incisions show a more uniform collagen deposition and produce a better scar, due to faster collagen reorganization from a reduction in tissue disruption.
By Tonya Johnson
Planatome Technology, the company that founded a patented, nano-polishing technology used in microchip manufacturing and applied it to medical devices to create a patient-focused surgical blade, recently released study results in the Open Access Journal of Surgery (OAJS).
The study was designed to determine if highly polished surgical scalpel blades would result in reduced tissue damage, subsequent inflammation and scarring, compared to clinical standard scalpel blades.
Planatome conducted the research with Duroc pigs to compare scarring resulting from polished standard commercial surgical blades at three levels of enhanced surface finish to commercially available blades. Differences in scar formation (area and width) were compared among the groups at various time points (day 5, day 30 and day 60).
Blades were polished using a variant of chemical mechanical planarization, (CMP), which is a well-established process widely employed in the manufacturing of semiconductors that are used for memory storage and data processing.
“Practicing surgeons and lay people alike believe that blade sharpness and the ease of tissue incision is associated with healing. To a significant extent, these are decoupled, what we call ‘contraindicators’”, says Planatome Technology chief technology officer, Clifford L. Spiro, who is a seasoned research and development leader, who in 2003, was appointed as vice president of R&D for the Cabot Microelectronics company that provides the chemical mechanical planarization polishing technology. He was always so curious, and wondered ‘Where else can we apply this technology to add enormous value?”
In 2004, Spiro teamed up with plastic surgeon Raphael C. Lee, MD, ScD, DSc (Hon), who has devoted his life to wound healing. Together the two continued to build on the collective of findings and began the initial process that led to their current study with fellow research experts. When they first met, Lee, who was head of reconstructive surgery at University of Chicago, felt dissatisfied with the declining quality and consistency of the current scalpel offering. This is something that has continued to plague working surgeons, says Spiro. He explains that some surgeons believed that you needed to trigger the wound healing system with trauma, and the more trauma, the more healing. On the other hand, as a plastic surgeon, Lee wanted to do as little harm as possible. “Would a much-lower-trauma incision still trigger wound healing? We know know that is indeed the case,” Spiro notes.
He shares this analogy: “Consider making a cut in a sapling with either a saw or a knife. A saw will cut a sapling with ease, but it is likely to do a lot of damage. A knife will make a nice clean slice with only a small scar, but it may not take the tree down very easily. Looking at the commonly-used scalpel blades of today under a microscope, we see that they are really sawing the tissues, whereas Planatome is a true perfect knife-edge that makes a clean incision which is smaller and heals faster with less scarring.”
The study results showed the following:
- At every postoperative time point, the polished blades demonstrated significantly smaller scar area (p < 0.05) than the corresponding control group ( Bard-Parker #15 blades).
- Redness in wounds was minimal by day 30. Some scarring occurred adjacent to incisions due to suture placement, but most likely did not have a significant effect on histological measurements since biopsies were taken between suture segments. Moreover, it appears that the redness of the incisions created by the polished blades decreased faster than the others, which indicates that this type of blade may result in reduced tissue damage and inflammation.
- Polished blades had significantly smaller scar width and width variance than tested commercial blades at day 60 (p < 0.05). The explanation for this effect is related to the reduced tissue trauma caused by scalpel blades produced by the fine-finishing process.
- Polished blades also demonstrated less scar formation than all the commercial blades at day 5 and day 30. All the results suggest that polished blades may benefit wound healing by generating less tissue damage and reducing inflammatory response.
Overall, the data supports the hypothesis that surgical incisions from extremely finished blades result in considerable reduction in scarring, subsequent inflammation and scarring compared to clinical standard scalpel blades. The highly polished blades appeared to benefit wound healing by reducing tissue damage and the inflammatory response.
But, if surgeons are going to make a decision to adopt Planatome solely on its feel, Spiro adds, they will often get this wrong. While they may love the consistency and precision of Planatome, he says, they may also somehow believe there will be dramatically less force required to make the cut. Spiro predicts that this may cause them to revert to the cheap option that, in the end, may increase trauma, pain and medication; could slow down the healing process; lead to scarring; and perhaps an expensive secondary scar-revision surgery.