Evaluation of early healing of postoperative wounds oral mucosa depending on the method of hemostasis and connection of wound edges
Authors:   National University of Health of Ukraine named after P.L. Shupyka, Kyiv, Ukraine, Pavlenko O. , Boiko M. ,   National University of Health of Ukraine named after P.L. Shupyka, Kyiv, Ukraine, Kabanchuk S. ,   National University of Health of Ukraine named after P.L. Shupyka, Kyiv, Ukraine
Published: December 2021

Actuality. The final and obligatory stage of each surgical intervention in the oral cavity is the tight connection of the wound edges and ensuring quality hemostasis, in order to prevent postoperative complications and the fastest recovery of tissues. The literature describes various techniques for joining soft tissues, using suture material, staples, fabric adhesive compositions, but due to the emergence of new methods, it is important to compare them. Goal. Compare and evaluate the early stage of healing of postoperative wounds in the oral cavity after open alveolectomy and the use of three methods for hemostasis and connection of wound edges (high-frequency electric welding, suturing nylon 5/0 and N-butyl-2-cyanoacrylate medical adhesive composition). Materials and methods. The study involved 42 patients aged 56 to 83 years, who were in the stage of surgical preparation for prosthetics with removable dentures and required open alveolectomy. Patients with cognitive impairment, cancer, systemic disease, recent acute or long-term chronic cardiovascular and musculoskeletal disorders did not participate in the study. All patients who participated in the study were randomly divided into 3 groups according to the methods of hemostasis and connection of the wound edges. After performing an open alveolectomy, hemostasis and joining of the wound edges were performed. In group 1 (electric welding) consisting of 14 patients, hemostasis and connection of wound edges were performed by welding soft tissues with the device «EKVZ-300M1». In group 2 (suturing) consisting of 14 patients, hemostasis of the wound was performed by connecting its edges with suture material nylon 5/0. In group 3 (adhesive composition) consisting of 14 patients, hemostasis of the wound was performed by joining its edges with a synthetic N-butyl-2-cyanoacrylate medical adhesive composition. Assessment of pain in patients of each group was performed according to the visual-analog scale (VAS). Determination of postoperative wound healing was performed on the basis of the wound healing index according to Landry, Turnbull and Howley. The average time to achieve intra-wound hemostasis and connection of wound edges in each of the groups were determined. The average values of the length of the trapezoidal section in each of the groups were also determined. Results. The analysis of the obtained results showed statistically significant differences (p ≤ 0.05) on the first day in terms of pain sensitivity between groups 2 (sutures) and 3 (glue). On the third day on both indicators (pain and wound healing) between groups 2 and 3 there were no statistically significant differences (p > 0.05). Group 1 (electric welding) has no statistically significant differences in pain sensitivity for the first day with other groups (p > 0.05). Statistically significant differences (p ≤ 0.01) appear on the third day both in terms of pain sensitivity and in terms of wound healing. Conclusions. The method of high-frequency electric welding can be used for intra-wound hemostasis with almost simultaneous connection of the wound edges after open alveolectomy. We found that electric welding has better hemostatic properties, faster connection of wound edges, reduced surgical time, postoperative pain and better results of wound healing compared to suture and adhesive methods. The method of high-frequency electric welding can be an alternative to suture and adhesive methods of hemostasis and joining the edges of the wound oral mucosa after open surgery on the jaws. Key words: oral cavity, mucous membrane, high-frequency electric welding, nylon sutures, adhesive composition, hemostasis, connection, index assessment, oral surgery.