Preventive Effect on Seroma of Use of PEAK PlasmaBlade after Latissimus Dorsi Breast Reconstruction

Abstract

Summary:Postoperative seroma is still the main complication after a latissimus dorsi (LD) flap procedure. The etiology of seroma is currently thought to comprise tissue fluids resulting from inflammatory reactions in affected tissue caused by the use of monopolar electrocautery (EC). It is possible that seroma formation can be reduced by using alternative devices such as the PEAK PlasmaBlade (PPB), which provides atraumatic scalpel-like cutting precision while the blade temperature remains close to body temperature. The subjects were 44 patients who underwent breast reconstruction with LD flaps from August 2015 to April 2017. They were retrospectively split into groups treated with a PPB (n = 21) and with conventional EC (n = 23). Outcomes such as rate of seroma formation, total drain discharge volume, indwelling period of drainage at the donor site, length of hospital stay, and operation time were compared between the 2 groups. The incidence of seroma was significantly lower in the PPB group (19.0%) than in the EC group (47.8%). The total drain discharge volume was significantly lower and the indwelling period of drainage and length of hospital stay were significantly shorter in the PPB group. In summary, use of PPB in an LD flap procedure can reduce seroma formation and the lengths of the drainage period and the hospital stay.

Bilateral reduction mammaplasty with pulsed electron avalanche knife PlasmaBlade™ and conventional electrosurgical surgery: A retrospective, randomised controlled clinical trial

“…In particular, a study published only a few months later with 44 subjects who underwent latissimus dorsi breast reconstruction was able to show significantly lower total drainage volumes, shorter hospital stay, and rate of seroma formation. 15 Similar results have been found for other types of operations as well. The use of PEAK PlasmaBlade™ for tonsillectomy in adults led to shorter time to pain-free swallowing and patient satisfaction compared with monopolar electrocautery.…”

“…That study was most likely limited by its small sample size of only 20 subjects, which could explain why many of the results did not reach statistical difference. In particular, a study published only a few months later with 44 subjects who underwent latissimus dorsi breast reconstruction was able to show significantly lower total drainage volumes, shorter hospital stay, and rate of seroma formation 15 …”

“…The PEAK PlasmaBlade™ has significantly lower working temperatures than conventional electrosurgery devices but seems to demonstrate both the same level of accuracy as the scalpel and the same amount of bleeding control as traditional electrosurgery technologies. 11,12 The low-thermal energy dissection technique has produced excellent results and reduced postoperative wound pain and seroma incidence in breast cancer surgery 13,14 and is thought to have a preventive effect on seroma in latissimus dorsi breast reconstruction procedures 15 and reduced drainage volumes in nipple-sparing mastectomy. 16 Apart from a manufacturer-sponsored clinical trial, 17 we were unable to identify a single study examining the operative performance of PEAK PlasmaBlade™ in breast reduction surgery.…”

Comparison of PEAK PlasmaBlade™ to conventional diathermy in abdominal-based free-flap breast reconstruction surgery—A single-centre double-blinded randomised controlled trial

“…Different experimental studies in both animal and human models comparing the PEAK PlasmaBlade ™ and other surgical dissection devices for incisions have shown a reduction in width of zone of thermal injury, reduction in wound inflammation, increased wound strength and reduced scaring in favour of the PEAK PlasmaBlade ™ [20][21][22][23]. Some clinical studies comparing the PEAK PlasmaBlade ™ to other modalities for tissue dissection show a reduction in total drainage, drain requirement and/ or seroma formation [24][25][26][27].…”

Comparative healing of swine skin following incisions with different surgical devices

“…At present, this technology is widely used in surgical procedures abroad (9,10). However, there has been inconsistent evidence regarding the comparative effectiveness of PB and ES in terms of the length of procedure time, drainage volume (11,12), postoperative seroma (11,12), and postoperative infection rates (9,13,14). Therefore, more improvements should be made for better clinical effectiveness.…”