Artery weld strength after bipolar electrocoagulation is affected by electrolyte solutions around the artery

We have recently shown that artery weld strength is significantly increased by increasing bipolar electrocoagulation time in fresh rabbit arteries, which had either 2 or 20 seconds of electrocoagulation under uniform conditions. In this study we investigated the effect of using either distilled water or physiologic saline around the artery during electrocoagulation in a total of 27 experiments, because it is the current practice to wash clot and liquid blood off bleeding ulcers with water. Fresh rabbit arteries were used, with a bipolar coagulation time of 2 seconds, with a constant weight of 500 gm applied to the head of the probe to standardize conditions. The bursting pressure of the coagulum was determined by cannulating the artery and increasing the pressure until the coagulum seal fractured. The artery weld strength was significantly lower when distilled water was used (median, 87.5 mm Hg; range, 10 to 225 mm Hg) compared with results when normal saline was used (median, 150 mm Hg; range, 100 to 850 mm Hg); by Mann-Whitney tests U = 42.5, Z = 2.36, and p = 0.018. These data suggest that more effective hemostasis of bleeding arteries may be achieved by not only more prolonged use of the diathermy probe, but also by using physiological saline as the washing solution instead of water, as is currently practiced.