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Surgical or medical treatment of polycystic ovary syndrome: a cost-benefit analysis.

With the availability of laparoscopic ovarian cautery, there has been a resurgence in interest in the surgical treatment of clomiphene citrate-resistant polycystic ovary syndrome (PCOS). Comparison of ovulation and pregnancy rates has found no difference in success rates between ovarian cautery and gonadotropin ovulation induction for such women. We have therefore compared the cost of laparoscopic ovarian cautery with that of a typical cycle of gonadotropin ovulation induction, and also found that there is little difference. Because of the potential advantages of ovarian cautery, we recommend this surgery as the next line of treatment if clomiphene citrate fails to induce ovulation in PCOS patients, before gonadotropins are introduced.

Cautery↗

Laparoscopic myomectomy technique. Use of colpotomy and the harmonic scalpel.

OBJECTIVE: To describe the use of colpotomy and the harmonic scalpel in laparoscopic myomectomy and to compare estimated blood loss when using unipolar cautery versus the harmonic scalpel and surgical time for colpotomy versus morcellation. STUDY DESIGN: A retrospective, cohort study was performed on 168 patients who were diagnosed with and treated for uterine leiomyomata between January 1992 and January 2000. Patients presented with infertility, menometrorrhagia, dysmenorrhea, masses on ultrasound or a combination of these symptoms. Two patients required hysterectomy, and 1 required conversion to laparotomy due to bleeding, leaving 165 patients who underwent laparoscopic myomectomy, 143(87%) by colpotomy and 22 (13%) by morcellation. Unipolar cautery was used for uterine incision in 112 of the 165 myomectomies (68%) and the harmonic scalpel in 53 (32%). Surgery was performed at one of two community hospitals in the Seattle area or a general hospital in Taiwan. RESULTS: Mean estimated blood loss using the harmonic scalpel (243 mL, range 150-350) was significantly less (P < .01) than that using unipolar cautery (378 mL, range 203-800) for uterine incision. Mean surgical time for colpotomy (144 minutes, range 110-260) was less (P < .05) than that for morcellation (168 minutes, range 140-244) despite having removed a larger median number of myomata per patient of comparable or larger size (seven by colpotomy versus four by morcellation). CONCLUSION: These data suggest that the harmonic scalpel is effective for uterine incision during myomectomy and may result in less bleeding than unipolar cautery while offering some advantages in safety. Multiple leiomyomata can generally be extracted more quickly via posterior colpotomy than by morcellation. This difference is smaller and therefore less important in patients with only a few small to medium-sized (< 10 cm) fibroids. For these patients, the minimal invasiveness of morcellation may offer a more significant benefit.

Adolescent↗

Mild and moderate endometriosis. Comparison of treatment modalities for infertile couples.

A series of 1,268 consecutive patients with stage I and II endometriosis (American Fertility Society classification) were treated for the disease. In 675, no other factors contributed to their infertility. Among these patients, with no problems other than mild endometriosis, 57% (16/28) became pregnant when treated expectantly, 54% (51/95) after being treated medically, 47% (9/19) after laparoscopic cautery treatment, 81% (147/181) after laparoscopic laser treatment and 84% (97/116) after conservative surgery (laparotomy). Statistical analysis of the pregnancy rates revealed no difference between expectant, medical and laparoscopic cautery treatment. No difference was noted between laparotomy and laser laparoscopy; however, there was a statistically significant difference between these treatments and expectant, medical and cautery treatment. Similar results were seen with stage II endometriosis in couples with no contributing factors other than endometriosis: 39% of patients (23/59) became pregnant after medical treatment, 70% (80/115) after laser laparoscopy and 74% (46/62) after undergoing major conservative treatment (laparotomy). A statistically significant difference between medical treatment and laparotomy as well as laser laparoscopy was noted. However, no such difference existed between laparotomy and laser laparoscopy. Therefore, it appears that in experienced hands the use of laser laparoscopy in stage I and II endometriosis is as successful as major surgery and statistically significantly better than expectant, medical and laparoscopic cautery treatment.

Adult↗

Cerebrospinal fluid leakage complicating orbital exenteration.

In three cases of cerebrospinal fluid leakage complicating orbital exenteration, leakage occurred intraoperatively following relatively low-power (0 to 25 W), high-frequency monopolar cautery to the orbital roof. Six cadaver orbits and 25 dried skulls were examined to investigate possible causes of intraoperative cerebrospinal fluid leakage. In this experimental model, monopolar cautery to the orbital roof did not cause cerebrospinal fluid leakage; however, cautery to preexistent foramina or experimentally created defects in the orbital bones did. In exenteration, monopolar cautery may transmit thermal energy through extant body defects in the orbital roof directly to the dura, resulting in its disruption. These defects may be congenital, tumor related, or iatrogenic. Alternative methods of hemostasis should probably be employed to control bleeding that occurs along the orbital roof during exenteration.

Aged↗

Early results of 500 cases of no-stitch cataract surgery.

My first 500 cases of no-stitch cataract surgery were evaluated in a randomized prospective study to compare the results of a 4.0 mm incision (foldable intraocular lens [IOL]) and a 5.2 mm incision (poly[methyl methacrylate] [PMMA] IOL). An additional group of 7.0 mm incision (PMMA IOL) no-stitch cases were studied retrospectively. One-day postoperative intraocular pressure averaged 20 mm Hg for both the 4.0 mm and 5.2 mm incision groups and 23 mm Hg for the 7.0 mm incision group. Hyphema occurred in 5% of the 4.0 mm incision group, in 1% of the 5.2 mm incision group, and in 5% of the 7.0 mm incision group. Surgically induced astigmatism, as absolute change in cylinder (without regard to axis) at three months postoperatively averaged 0.46 diopter (D) for the 4.0 mm incision group, 0.57 D for the 5.2 mm incision group, and 0.52 D for the 7.0 mm incision group. A prospective comparison of cold versus warm (room temperature) balanced salt solution irrigation during phacoemulsification demonstrated no statistically significant difference in effect on either the hyphema rate or astigmatism. However, the effect of scleral cautery on astigmatism, comparing cautery completely to the limbus with cautery only posterior to the insertion of Tenon's fascia, demonstrated a significant difference: an average of 50% reduction in the one week postoperative induced astigmatism was observed when the cautery was not carried all the way to the limbus. At three months, a 20% difference was still present.(ABSTRACT TRUNCATED AT 250 WORDS)

Astigmatism↗

Cortisol responses of calves to two methods of disbudding used with or without local anaesthetic.

Cattle are disbudded or dehorned using a variety of methods. In this study, plasma cortisol concentrations were used to monitor distress in 6-week-old Friesian calves during the 9 hours following disbudding. Disbudding was carried out with a cautery iron or a dehorning scoop, with or without local anaesthetic. Cautery caused a transient rise in cortisol concentrations which returned to control values within 3 hours. The cortisol response to the scoop was more prolonged, as the plasma cortisol concentrations did not return to control levels until 7.5 hours after disbudding. The administration of a local anaesthetic reduced the cortisol response during the first 2 hours after scoop dehorning. This reduced response was followed by a delayed rise in cortisol concentrations between 2 and 7.5 hours. Cautery caused less distress than the scoop. The administration of local anaesthetic had little effect in alleviating distress in calves disbudded using the cautery iron.

Journal Article↗

Frequency and patterns of early recanalization after vasectomy.

BACKGROUND: Our understanding of early post-vasectomy recanalization is limited to histopathological studies. The objective of this study was to estimate the frequency and to describe semen analysis patterns of early recanalization after vasectomy. METHODS: Charts displaying serial post-vasectomy semen analyses were created using the semen analysis results from 826 and 389 men participating in a randomized trial of fascial interposition (FI) and an observational study of cautery, respectively. In the FI trial, participants were randomly allocated to vas occlusion by ligation and excision with or without FI. In the cautery study, sites used their usual cautery occlusion technique, two with and two without FI. Presumed early recanalization was based on the assessment of individual semen analysis charts by three independent reviewers. Discrepancies were resolved by consensus. RESULTS: Presumed early recanalization was characterized by a very low sperm concentration within two weeks after vasectomy followed by return to large numbers of sperm over the next few weeks. The overall proportion of men with presumed early recanalization was 13% (95% CI 12%-15%). The risk was highest with ligation and excision without FI (25%) and lowest for thermal cautery with FI (0%). The highest proportion of presumed early recanalization was observed among men classified as vasectomy failures. CONCLUSION: Early recanalization, occurring within the first weeks after vasectomy, is more common than generally recognized. Its frequency depends on the occlusion technique performed.

Follow-Up Studies↗

Inhibin secretion by the sheep ovary.

An in-vitro bioassay for inhibin based on FSH content or release by rat pituitary cells was validated for measuring inhibin activity in ovine plasma and lymph. Dose-dependent increases in inhibin activity were detected in peripheral plasma of 4 ovariectomized ewes 1 min after i.v. injections of ovine follicular fluid, and the half-life of inhibin in plasma for 2 ewes was 45 and 50 min, respectively. Inhibin was detected in ovarian lymph but not in ovarian or jugular venous plasma, even after treatment of ewes with PMSG to induce folliculogenesis. Destruction of visible follicles (greater than 0.5 mm diameter) on the ovaries of 4 PMSG-treated ewes by electrocautery was followed by a rapid and sustained decline in secretion of inhibin in ovarian lymph for up to 4 h. Ovarian lymph flow rates were either unchanged or slightly increased after cautery. Oestrogen concentrations in peripheral venous plasma declined within 15-30 min of cautery, but concentrations remained well above baseline. There was a significant decrease in peripheral progesterone concentrations in these same samples, but not until 2-3 h after cautery. FSH in peripheral plasma was depressed or non-detectable in PMSG-treated ewes and neither FSH nor LH concentrations in peripheral plasma were significantly altered up to 4 h after cautery of ovarian follicles. It is concluded that (a) antral follicles (greater than 0.5 mm) are the source of inhibin present in ovarian lymph, and (b) the ovarian lymphatic system is a route by which inhibin could reach the peripheral circulation, particularly in the luteal phase when ovarian lymph flow rates are high.

Animals↗

Association between surges of follicle-stimulating hormone and the emergence of follicular waves in heifers.

The effects of ablation of a dominant follicle and treatment with follicular fluid on circulating concentrations of follicle-stimulating hormone (FSH) were studied and the temporal relationships between surges of FSH and follicular waves were studied in heifers with two or three follicular waves/interovulatory interval. Cauterization of the dominant follicle on Day 3 or Day 5 (ovulation on Day 0) (six control and six treated heifers/day) resulted in a surge (P less than 0.05) in FSH beginning the day after cautery. The FSH surge prior to wave 2 (first post-treatment follicular wave) occurred 4 days (Day 3 cautery) and 2 days (Day 5 cautery) before the surge in control groups, corresponding to a 4-day and a 2-day advance in emergence of wave 2 compared with controls. It was concluded that the dominant follicle on Day 3 and Day 5 was associated with the suppression of circulating FSH concentrations. Heifers (n = 4/group) were untreated or treated intravenously with a proteinaceous fraction of bovine follicular fluid on Days 0-3, 3-6, or 6-11. Concentrations of FSH were suppressed (P less than 0.05) for the duration of treatment, regardless of the days of treatment. Cessation of treatment was followed within 1 day by the start of a surge in FSH. The FSH surge prior to wave 2 occurred 2 days earlier (treatment on Days 0-3), 1 day later (treatment on Days 3-6), and 6 days later (treatment on Days 6-11) than in controls, corresponding to an equivalent advance or delay, respectively, in the emergence of wave 2 compared with controls. The results suggest that the effects of exogenous follicular fluid on follicular development were mediated, in whole or in part, by altering plasma FSH concentrations. Control heifers combined for the two experiments were separated into those with 2-wave (n = 11) or 3-wave (n = 5) interovulatory intervals. Two-wave heifers had two FSH surges and 3-wave heifers had three apparent FSH surges during the interovulatory interval. Results of the cautery and follicular fluid experiments indicated that a surge in FSH necessarily preceded the emergence of a wave. The FSH surges in treated and control heifers began 2-4 days before the detectable (ultrasound) emergence of a follicular wave (follicles of 4 and 5 mm), peaked 1 or 2 days before emergence and began to decrease approximately when the follicles of a wave begin to diverge into a dominant follicle and subordinate follicles (follicles 6-7 mm).

Animals↗

Fibrin glue treatment for epistaxis.

Our study was made to prove the second-generation surgical fibrin sealant Quixil to be an effective substitute for nasal packing, chemical coagulation and cautery in management of patients with epistaxis. Our series includes 204 patients with anterior epistaxis (186), and with posterior epistaxis (18) as results of trauma, clotting disorders, chronic and/or atrophic rhinitis and upper respiratory infections, and hypertension. Patients were randomly divided into four groups: with fibrin glue (67) (Quixil), with electric cautery (61), with silver nitrate coagulation (60), and with foam nasal packing (16). For the fibrin glue group, hemostasis was achieved by spraying with 0.3 ml Quixil fibrin glue to each bleeding nostril. The results were excellent in all of the 62 (92.5%) patients of the fibrin glue group with complete and immediate hemostasis. We found good healing of bleeding sites, no swelling and secondary bleeding, no inflammation, no plaque or crists. Three months monitoring of atrophic changes of the nasal mucosa proved absence of atrophy of the nasal mucosa. In this group, the bleeding time averaged 2 min 30 sec since the moment of admittance. In the groups where cautery, coagulation, or nasal packing was used, we found local swelling, pain, and slow healing of the bleeding site with accidental atrophy of the nasal mucosa. The rates of these side effects were significantly higher in comparison with the fibrin glue group. The bleeding time was also longer. We found that the fibrin glue is more effective hemostatic in comparison with foam nasal packing, cautery and coagulation, and provides no complications usual for these types of treatment of epistaxis.

Adolescent↗

Laparoscopic pomeroy tubal ligation: a comparison with tubal cauterization in a teaching hospital.

OBJECTIVE: To compare laparoscopic Pomeroy tubal ligation to standard bipolar tubal cauterization for the outcome measures of failure rate, complication rate and procedure duration, with an analysis of the effect of resident experience on procedure duration. STUDY DESIGN: Retrospective study of patients presenting for interval sterilization between August 1998 and June 2000. RESULTS: The characteristics of the laparoscopic Pomeroy (n = 99) and bipolar cautery (n = 62) patients were comparable. The mean procedure duration was 40.8 +/- 14.6 minutes for laparoscopic Pomeroy and 39.6 +/- 18.8 minutes for bipolar cautery (p < 0.68). Multiple regression analysis revealed that procedure duration was a function of both months in residency (R2 = .098, p < 0.007) and number of laparoscopic Pomeroy procedures performed (R2 = .082, p < 0.01). One complication occurred with each procedure (p < 0.576). Two sterilization failures occurred after bipolar cautery and 1 after laparoscopic Pomeroy (p < 0.33). The laparoscopic Pomeroy failure occurred in the shortest tubal segment obtained, 0.7 cm, versus the average segment length, 2.07 +/- .79 cm. CONCLUSION: Laparoscopic Pomeroy did not differ from bipolar cautery for the outcome measures studied. Both time in residency and procedure-specific experience affect the duration of laparoscopic Pomeroy. A tubal segment length of 1 cm should be removed to limit sterilization failures.

Clinical Competence↗

[Treatment of early gastric cancer by endoscopic double snare polypectomy (EDSP)].

The indication for EDSP was studied in 75 patients with early gastric cancer diagnosed endoscopically which had been obtained over a period of 11 years (1979 to 1985) at the Cancer Institute Hospital, Tokyo and the following results were obtained. EDSP consists of two procedures using double channel fiberscope; a sessile or depressed lesion pulled upward by one snare cautery (standard EDSP) is transformed into a subpedunculated one, which allows another snare cautery of pseudostalk, and it is excised by using coagulation current. EDSP was performed in 53 cases of IIa type and 22 cases of IIc type. Excision by one snare cautery was possible in 90.9% (40/44) of IIa lesion measuring less than 2 cm and in 100% (14/14) of IIc lesion measuring less than 1 cm, the total being 85.3% (64/75). There was no residual cancer in 41 cases of IIa lesion (93.2%) and 17 cases (85.0%) of IIc lesion with two recurrent cancers confirmed by follow-up endoscopy. Residual cancer was found in 6 cases (9.1%) which were operated on. The results mentioned above show the usefulness of EDSP and selection of case without lymph node metastasis permitting complete excision by one snare cautery is of much importance. EDSP is indicated for IIa lesion of differentiated type measuring less than 2 cm, IIc lesion of differentiated type without ulceration measuring less than 1 cm and IIc lesion of undifferentiated type without ulceration measuring less than 0.5 cm that is not located in the fundic gland area.

Gastroscopes↗

[Effects of carbon monoxide produced during laparoscopic surgery].

One of the complications of laparoscopic surgery is carbon monoxide (CO) production under the use of electro-cautery. We studied 11 patients undergoing laparoscopic urological surgery. The concentrations of CO in peritoneal cavity and carboxyhemoglobin (HbCO) in arterial blood were measured before the operation under laparoscopy, during the use of electro-cautery and after the operation. The concentration of CO in peritoneal cavity reached 78 ppm during the use of electro-cautery but the HbCO level was unchanged. In the study on laparoscopic cholecystectomy (LC) performed previously, we had found no change of HbCO. The increase of CO on LC was more pronounced than in the present study. The concentration of CO in peritoneal cavity might be more dependent on the intensive use of electro-cautery than on operation time. Additionally the frequency of the insertion and extraction of the instruments through the trocar could have influenced it. CO could also be produced in the carbon dioxide cylinder. It should be investigated since it might contaminate the operating room.

Adult↗

Inflammable antiseptics and theatre fires.

This paper describes an investigation designed to find out if theatre fires could be started by the antiseptic painted on the patient's skin being ignited by cautery or diathermy. It was found that hot wire cautery or diathermy generated enough heat to ignite all alcohol-based antiseptics even if these contained as little as 20 per cent alcohol. They could also cause iodine to explode in the presence of nitrous oxide, and nobecutane to explode in the presence of nitrous oxide or increased oxygen. The likelihood of these combinations causing fires is discussed, and it is recommended that when diathermy or cautery is to be used near the surface of the body, either an aqueous-based antiseptic is used or if spirit solutions are required they are carefully dried off before proceeding.

Anti-Infective Agents, Local↗

Endoscopic control of posterior epistaxis.

Control of bleeding vessels by suction cautery under endoscopic vision was used on 38 patients suffering from posterior epistaxis. Twelve patients also required the insertion of nasal tampons at the end of the cautery procedure. Eight patients, six of them hypertensive, had recurrent epistaxis post-operatively. Five patients needed further cautery in order to control the bleeding. Three patients required temporary balloon tamponade, and a single patient had internal maxillary ligation. Temporary palatal numbness in three patients was the only post-operative complication. Otherwise, the technique has the potential advantages of simplicity, safety, effectiveness and simplified post-operative care.

Cautery↗

Model of robust induction of glomerulosclerosis in mice: importance of genetic background.

BACKGROUND: Increasing evidence suggests that genetic background plays an important role in the development of progressive glomerulosclerosis. The remnant kidney model (RKM) of progressive renal disease has been used extensively in rats. However, C57BL/6 mice are resistant to glomerulosclerosis with RKM induced by either pole amputation or renal artery ligation. A pole resection protocol, applied in 129/Sv mice, induced only mild glomerulosclerosis. We present here a highly reproducible, modified RKM approach to successfully establish a glomerulosclerosis model in mice. METHODS: Male C57BL/6 (N = 17), 129/Sv (N = 20) and Swiss-Webster (N = 3) mice underwent RKM as follows: the lower branch of the left renal artery was ligated to produce about one third infarct; the upper pole of the left kidney (about one third kidney size) was removed by cautery and the right kidney was nephrectomized to induce a total 5/6 nephrectomy (Nx). In some C57BL/6 mice, 7/8 nephrectomy was induced by removing additional renal mass from the upper pole of the left kidney by cautery. Systolic blood pressure (BP) was measured in conscious mice using a tail-cuff blood pressure monitor and animals were sacrificed at 9, 12, 18, and 24 weeks after nephrectomy. Kidneys were harvested for morphologic analysis. RESULTS: BP in C57BL/6 mice increased slightly after 5/6 nephrectomy over time without significant difference compared to baseline blood pressure except at 8 weeks (blood pressure at week 0, 98 +/- 1 mm Hg; week 4, 105 +/- 2 mm Hg; week 8, 113 +/- 4 mm Hg; and week 12, 110 +/- 3 mm Hg). Blood presssure remained normal in C57BL/6 mice at 18 weeks after 7/8 nephrectomy (103 +/- 2 mm Hg). Blood pressure in 129/Sv mice increased significantly after 5/6 nephrectomy from 4 to 12 weeks (week 0, 112 +/- 3 mm Hg; week 4, 161 +/- 9 mm Hg; week 8, 166 +/- 5 mm Hg; and week 12, 176 +/- 5 mm Hg; P < 0.01 weeks 4, 8, and 12 vs. week 0 blood pressure). Urine protein excretion in C57BL/6 mice increased only at 4 weeks after 5/6 nephrectomy, and was back to normal at 8 and 12 weeks (week 0, 13.2 +/- 1.4 mg/24 hours; week 4, 20.5 +/- 1.8 mg/24 hours; week 8, 18.8 +/- 1.6 mg/24 hours; and week 12, 17.2 +/- 1.2 mg/24 hours, P < 0.05 week 4 vs. week 0). 129/Sv mice developed significant proteinuria 12 weeks after 5/6 nephrectomy compared to their baseline and to levels achieved in C57BL/6 mice (week 0, 17.2 +/- 1 mg/24 hours; week 4, 14.9 +/- 1.8 mg/24 hours; week 8, 23.8 +/- 6.7 mg/24 hours; and week 12, 36.3 +/- 6.6 mg/24 hours, P < 0.01 week 12 vs. week 0; P < 0.01 129/Sv vs. C57BL/6 at week 12). Mortality varied in response to nephrectomy injury in the different strains. Ten percent of C57BL/6 and 43% of 129/Sv died within 12 weeks after 5/6 nephrectomy. Although 50% of C57BL/6 mice died by 12 weeks after 7/8 nephrectomy, there was only mild glomerulosclerosis (<5%) in C57BL/6 mice even at 24 weeks after 5/6 nephrectomy or 18 weeks after 7/8 nephrectomy. In contrast, glomerulosclerosis was marked in both 129/Sv mice and Swiss-Webster mice as early as 9 weeks after 5/6 nephrectomy: 42% of glomeruli showed sclerosis in 129/Sv mice [average sclerosis index (SI), 0 to 4+ scale, 1.08] vs. 24% in Swiss-Webster mice (average SI, 0.57). Tubulointerstitial fibrosis developed in parallel with glomerulosclerosis in both 129/Sv and Swiss-Webster mice. CONCLUSION: We conclude that genetic background is one of the important factors determining the susceptibility to the development of glomerulosclerosis in mice. We speculate that the superior effects of renal artery ligation plus cautery to produce glomerulosclerosis may result from higher blood pressure responses due to local ischemia activating the renin-angiotensin system.

Animals↗

An effective extraction technique for the treatment of closed macrocomedones.

BACKGROUND: Closed macrocomedones are unsightly lesions that may be resistant to medical treatments and comedone extractors. Light cautery has been used to treat macrocomedones, which are 1 to 3 mm in size; however, its success in larger and chronic lesions is limited. OBJECTIVE: To introduce an alternative treatment technique for this neglected problem. METHODS: We treated these lesions by using cautery and standard dissecting forceps. After puncturing the macrocomedones in the center using the sharp-tipped cautery point, we grasped the base of the comedone using standard dissecting forceps and squeezed and pulled out the contents. RESULTS: Twelve patients were treated with this technique, all of whom tolerated the procedure well and judged the cosmetics results as very good. CONCLUSION: We recommend this procedure for patients who have closed macrocomedones larger than 3 mm in size, although it is an effective treatment for macrocomedones of any size.

Acne Vulgaris↗

The effect of high temperature intraoperative molding on bioabsorbable PLLA-PGA craniofacial fixation.

Bioabsorbable internal fixation has become an established part of the surgeons' armamentarium. There are several unique aspects of bioabsorbable polymers that can enhance their versatility. One of these is the application of heat to adapt the implant. Hot-tip cautery has been used for years to cut and otherwise customize bioabsorbable implants intraoperatively. As the tips of these devices can reach temperatures of over 1,000 degrees C, there is the potential that such practice can modify the degradation properties of these polymers. This study was performed to better understand the extent to which this potential exists. Screw heads of an 82:18 poly-L-lactic acid and poly-glycolic acid copolymer were modified by repeated passage of a hot-tip cautery wire, deforming the hex geometry to that of a ball. There was no significant difference between the glass transition temperature (approximately 59 degrees C) and inherent viscosity (approximately 1.45 dL/g) of treated and untreated screw heads, indicating no overall change in these properties throughout the mass of the screw head. Additionally, these properties were measured and comparisons made between the treated screw heads and untreated plates made of the same polymer during 28-day exposure to an in vitro bath (pH 7.4, 37 degrees C). The glass transition temperature and inherent viscosity exhibited declines during this period, with no significant differences between the two groups. Collectively, these results suggest that hot-tip cautery results in no substantial changes in the degradation characteristics of this polymer.

Absorbable Implants↗