Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) versus conventional electro surgery in post‐bariatric body‐contouring procedures: A retrospective randomised clinical study

Abstract

Postoperative wound-healing problems are relatively high in post-bariatric bodycontouring procedures, partly because of electrosurgery and the associated thermal tissue damage. This study is a retrospective randomised evaluation of the effect of a low-thermal plasma dissection device (PEAK PlasmaBlade, Medtronic, Minneapolis, Minnesota) in comparison with conventional electrosurgery. A total of 24 patients undergoing upper arm or medial thigh lifting were randomised to PEAK PlasmaBlade on one side and to monopolar electrosurgery on the other side of the same patient. Wounds of 10 patients were examined histologically for acute thermal injury depth. Significantly lower total volume of drain output (61,1 ± 70,2 mL versus 95,1 ± 176,0 mL; P = .04) was found on the PEAK PlasmaBlade side compared with the electrosurgery side. Furthermore, the PEAK PlasmaBlade side showed fewer seromas (no case of seroma versus three seromas in the electrosurgery group) and less thermal damage (40% versus 70%; P = .26).Acute thermal injury depth from the PEAK PlasmaBlade was less than from monopolar electrosurgery (425 ± 171 μm versus 686 ± 1037 μm; P = .631).PEAK PlasmaBlade appears to be superior to traditional monopolar electrosurgery for post-bariatric body-contouring procedures because it demonstrated less tissue damage, lower total volume of drain output, and fewer postoperative seromas resulting in faster wound healing. K E Y W O R D Sbody-contouring procedure, drain output, electrosurgery, PEAK PlasmaBlade, seroma

Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) vs conventional electrosurgery in post‐bariatric abdominoplasty: A retrospective randomised clinical study

“…We found a reduction of this percentage to 0%, when PEAK PlasmaBlade was used. Also, PEAK PlasmaBlade in patients undergoing post‐bariatric body‐contouring procedures, such as brachioplasty and thighplasty, demonstrated fewer postoperative seroma than conventional electrosurgery (no seroma vs three seroma; P = .08). In this study, PEAK PlasmaBlade patients demonstrated 30% less drainage volume compared with standard of care (Table ).…”

“…In order to improve outcomes in post‐bariatric patients undergoing abdominoplasties, we evaluated a novel electrosurgical dissection technique, PEAK PlasmaBlade, in comparison with conventional electrosurgery. A recently published study of our department has shown that PEAK PlasmaBlade used in post‐bariatric patients undergoing brachioplasty and thighplasty induced less tissue damage and resulted in less total volume of drain output and fewer postoperative seroma compared with standard of care …”

“…In patients undergoing mastectomy, PlasmaBlade also shortened the drainage duration time and reduced the drainage amount compared with electrocautery . As recently shown, PEAK PlasmaBlade, used in patients undergoing post‐bariatric body‐contouring procedures, such as brachioplasty and thighplasty, caused significantly less total volume of drain output and fewer postoperative seroma compared with conventional electrosurgery …”

“…In order to prevent the occurrence of wound complications and to improve the postoperative results obtained in post‐bariatric patients undergoing abdominoplasties, in the present study, we evaluated two dissection techniques, that is, PEAK (pulsed electron avalanche knife) PlasmaBlade (Medtronic, Minneapolis, Minnesota) and monopolar electrosurgery. Based on previous work, it can be assumed that PEAK PlasmaBlade improves postoperative wound healing by reducing thermal tissue damage in post‐bariatric population undergoing abdominoplasty …”

“…Based on previous work, it can be assumed that PEAK PlasmaBlade improves postoperative wound healing by reducing thermal tissue damage in postbariatric population undergoing abdominoplasty. 3,4 Conventional monopolar electrosurgical device, which uses continuous-waveform radiofrequency energy delivered by an uninsulated metal electrode to cut tissue by thermal ablation, in this way producing simultaneous haemostasis, is commonly used in open and minimally invasive procedures. 5,6 The operating temperature of this dissection technique ranges from 250 C to 350 C. 7 This explains some disadvantages associated with traditional electrosurgery, such as significant thermal damage to incised tissues, low surgical precision with the potential injury to adjacent structures (eg, bowel, nerves, blood vessels), and delayed wound healing.…”