Analysis of the Mechanism for Development of Postoperative Gluteal Muscle and Skin Damage Using a Finite Element Method

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  • 有限要素法による周術期大臀筋・臀部皮膚傷害発生機序解析のこころみ
  • ユウゲン ヨウソホウ ニ ヨル シュウジュツキ ダイデンキン ・ デンブ ヒフ ショウガイ ハッセイ キジョ カイセキ ノ ココロミ

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<p>We recently demonstrated that gluteal muscle damage can be detected by MRI in a negligible number of patients who had undergone abdominal, urologic, or gynecologic surgery. We also found that gluteal skin damage was concurrent in some of the patients who exhibited gluteal muscle damage and that the damage observed in the gluteal muscle differed from compression-induced deep tissue injury. In this report, we hypothesized that the gluteal muscle damage was caused by the heat produced during the passage of electric current between the tip of the electric scalpel and the return electrode. We used finite element method to simulate the distribution of generated heat from the electric scalpel; this was based on universal 3D reconstructions model of the abdomen and pelvis. Under conditions in which the electric scalpel was used in the lower abdomen, the simulation analysis suggested that the calorific value, which is the quantity of heat generated per unit of time, became remarkably higher in the region of the gluteus muscle. We therefore speculate that this heat generated by electric current could cause both gluteal muscle and skin injury. We hope that our proposal of a new mechanism underlying postoperative gluteal muscle and skin injury can contribute to the prevention of this overlooked iatrogenic tissue damage.</p>

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