IS IT SAFE TO USE ELECTROCAUTERY AFTER COMPLETING AN ARTHROSCOPIC REPAIR?

Abstract

The purpose of the study was to determine how suture materials commonly used in arthroscopic surgery were affected by electrocautery. The effects of electrocautery were evaluated on four different suture materials commonly used in arthroscopic surgery; PDS, Ethibond, Orthocord and Fibrewire. Single suture strands were tied around two plastic rods immersed in a saline filled water bath at 37°C. Sutures were exposed to heat using the Mitek VAPR 3 electrosurgical unit and a corresponding side electrode. This was used on the high intensity vaporisation setting, at a power level of 240W. The electrode was applied directly to the suture strand, under tension, until the strand was completely burnt through. Fibrewire demonstrated a significantly higher burn through time in comparison to the other materials tested (83.30±38.69s, p< 0.001). Orthocord also demonstrated high heat tolerance (38.96±12.64s), which was significantly higher than both PDS (1.61±0.25s) and Ethibond (0.93s±0.06s) (p< 0.001). This is the first study to our knowledge assessing the tolerance of suture materials to electrocautery. This has important implications for the arthroscopic surgeon. On completion of an arthroscopic repair, the surgeon must always be extremely cautious, for fear of damaging the suture material and compromising their soft tissue repair. This study demonstrates that both Fibrewire and Orthocord can tolerate prolonged, direct heat application from electrocautery. We therefore conclude that short bursts of soft tissue vaporisation, after completing an arthroscopic repair with Fibrewire or Orthocord, are unlikely to have a detrimental effect on the suture material. However care should be exercised by the surgeon using Ethibond or PDS.