A Prospective Randomized Trial Comparing Harmonic Scalpel versus Electrocautery for Pectoralis Major Myocutaneous Flap Dissection

Abstract

The results of the study indicate that it is feasible to dissect pectoralis major myocutaneous flaps using the harmonic scalpel with less operative time, blood loss, drainage volume, and morbidity in comparison with electrocautery.

Comparison of pain and postoperative stress in dogs undergoing natural orifice transluminal endoscopic surgery, laparoscopic, and open oophorectomy

“…A wider zone of coagulation injury was seen with the NOTES technique and could have influenced the results of this study. 12,13 More rapid return of GI motility was seen postoperatively in the NOTES group compared with the open group. Other studies also demonstrate earlier recovery of bowel motility with laparoscopic compared with open procedures.…”

“…The higher cortisol concentrations in the NOTES animals can potentially be explained by pneumoperitoneum with higher intra-abdominal pressures, 23 longer operating times, 24 or differences in thermal injury. 12,13,25 Systemic stress response IL-6 is a cytokine and CRP is an acute-phase protein initiated by surgical trauma, and plasma concentrations may be an effective measure of the extent of trauma. 26,27 IL-6 stimulates acute-phase protein production by the liver and has been shown to increase shortly after major abdominal surgery and peaking in 24 hours.…”

The Use of Ultrasonic Shears for the Harvest of Perforator Free Flaps

“…Second, our study does not compare the outcomes achieved using ultrasonic shears with those achieved with bipolar electrocautery or hemoclips. Deo et al 7 have shown certain benefits of using ultrasonic shears over electrocautery in myocutaneous regional flaps (eg, decreased operative time). However, based on our data and study design, we are unable to claim that ultrasonic shears are more efficacious and/or safer than electrocautery or hemoclips for the harvest of perforator free flaps.…”

“…However, studies involving the use of ultrasonic shears in reconstructive surgery are sparse. Deo et al 7 demonstrated that the use of ultrasonic shears resulted in shorter flap dissection time, decreased blood loss, and lower total drainage volume in patients who were undergoing pectoralis major myocutaneous regional flaps to repair head and neck defects. Based on a review of the available literature, we believe that this is the first analysis of the use of ultrasonic shears for the harvest of perforator free flaps.…”

Use of the Harmonic Blade in Face Lifting: A Report Based on 420 Operations

“…Deo et al recently published favorable results using the ultrasound in dissecting the pectoralis major myocutaneous flap. 8 The Harmonic device has the appearance of a curved blade. The Harmonic blade (Ethicon Endo-Surgery, Cincinnati, Ohio) is made up of three components: a generator, a hand piece, and blades ( Fig.…”