Brent Skippen, Peter Smart, Clayton Barnes
Purpose: * Recent studies have compared the Colo- rado monopolar needle with scalpel incisions in terms of early postoperative ecchymosis and scar cosmesis after upper eyelid blepharoplasty. The PEAK PlasmaBlade is a novel, low-thermal-injury electrosurgical instrument which may provide clini- cally meaningful advantages over conventional upper eyelid surgery for wound healing.
Methods: * Single-centre, prospective, randomized, double-blind, interventional, comparative case series. Informed written consent was provided by each patient. Patients underwent bilateral upper eyelid blepharoplasty in all cases. Each eyelid was randomized to either PEAK PlasmaBlade, scalpel/ scissors or Colorado monopolar needle. Ecchymosis was evaluated using a 5-point haemorrhage scale and the wounds using the Stonybrook scar score. The margins of excised tissues were evaluated histologically.
Results: * 30 eyelids of 15 patients were included in the study. All patients had cosmetically accept- able results. No signiftcant difference was observed in ecchymosis on postoperative day 1 and 7 and scar cosmesis at week 1 and month 3 between the three techniques. Histologically, there was a signiftcant increase in haemorrhage using the scalpel compared to the PEAK PlasmaBlade and Colorado needle. Mean electrocautery effect was greater with the PEAK PlasmaBlade compared with the Colorado needle.
Conclusion: * No difference is noted between the PEAK PlasmaBlade, Colorado needle and scalpel incisions in terms of ecchymosis and scar cosmesis after upper eyelid blepharoplasty. Important consid- erations when performing blepharoplasty surgery include surgical experience, anatomical knowledge, careful planning and discussion with the patient to ensure optimal functional and aesthetic results.