Usefulness of Harmonic Focus during Anterolateral Thigh Flap Elevation

Atsumori Hamahata; Takashi Saitou; Kazuyuki Kubo; Takeshi Beppu; Takashi Yamaki; Hiroyuki Sakurai

doi:10.1055/s-0032-1326739

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2012; 28(09): 615-618
DOI: 10.1055/s-0032-1326739

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Usefulness of Harmonic Focus during Anterolateral Thigh Flap Elevation

Atsumori Hamahata

¹Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan

²Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan

,

Takashi Saitou

²Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan

,

Kazuyuki Kubo

²Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan

,

Takeshi Beppu

³Department of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan

,

Takashi Yamaki

¹Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan

,

Hiroyuki Sakurai

¹Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan

› Institutsangaben

Abstract

Meticulous hemostasis and careful ligation of branches are necessary for pedicle dissection during flap elevation. The aim of this study was to evaluate the effectiveness of the Harmonic Focus handpiece (Ethicon Endo-Surgery, Inc., Blue Ash, Cincinnati, OH, USA) in reducing operation time, bleeding volume, and volume of postoperative drainage during anterolateral thigh flap elevation. Ten patients requiring flap elevation were divided into two groups: (1) Harmonic Focus group (three men, two women), and (2) control group (three men, two women). Operating time was found to be lower in the Harmonic Focus group than in the control group. Bleeding volume and postoperative drainage volume were nearly identical in the Harmonic Focus group and the control group, and the number of silk ligatures was significantly lower in the Harmonic Focus group compared with the control group. Although somewhat costly, the Harmonic Scalpel with the Harmonic Focus handpiece is advantageous for flap elevation, and it is likely that Harmonic Scalpel use will increase in plastic surgery.

Keywords

Harmonic Focus - Harmonic Scalpel - flap

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Referenzen

References
1 O'Connor JL, Bloom DA, William T. Bovie and electrosurgery. Surgery 1996; 119: 390-396
2 Jackson LL, Gourin CG, Thomas DS, Porubsky ES, Klippert FN, Terris DJ. Use of the harmonic scalpel in superficial and total parotidectomy for benign and malignant disease. Laryngoscope 2005; 115: 1070-1073
3 Amaral JF, Chrostek C. Comparison of the ultrasonically activated scalpel to electrosurgery and laser surgery for laparoscopic surgery. Surg Endosc 1993; 7: 114-141 (abst)
4 Amaral JF. Laparoscopic cholecystectomy in 200 consecutive patients using an ultrasonically activated scalpel. Surg Laparosc Endosc 1995; 5: 255-262
5 Deo S, Hazarika S, Shukla NK, Kar M, Samaiya A. A prospective randomized trial comparing harmonic scalpel versus electrocautery for pectoralis major myocutaneous flap dissection. Plast Reconstr Surg 2005; 115: 1006-1009
6 Firmin FO, Marchac AC, Lotz NC. Use of the harmonic blade in face lifting: a report based on 420 operations. Plast Reconstr Surg 2009; 124: 245-255
7 Burdette TE, Kerrigan CL, Homa K. Harmonic scalpel versus electrocautery in breast reduction surgery: a randomized controlled trial. Plast Reconstr Surg 2011; 128: 243e-249e
8 Cavallaro G, Polistena A, D'Ermo G , et al. Usefulness of harmonic focus during axillary lymph node dissection: a prospective study. Surg Innov 2011; 18: 231-234
9 Mourad M, Rulli F, Robert A, Scholtes JL, De Meyer M, De Pauw L. Randomized clinical trial on Harmonic Focus shears versus clamp-and-tie technique for total thyroidectomy. Am J Surg 2011; 202: 168-174
10 Di Rienzo RM, Bove A, Bongarzoni G, Palone G, Corradetti L, Corbellini L. [Comparison of conventional technique, Ligasure Precise and Harmonic Focus in total thyroidectomy]. G Chir 2010; 31: 296-298
11 Ostapoff KT, Euhus D, Xie XJ, Rao M, Moldrem A, Rao R. Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®. World J Surg Oncol 2011; 9: 90
12 Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984; 37: 149-159
13 Salami A, Dellepiane M, Bavazzano M, Crippa B, Guastini L, Mora R. Harmonic Scalpel vs “cold knife” dissection in uvulopalatopharyngoplasty. Am J Otolaryngol 2010; 31: 442-447
14 Emam TA, Cuschieri A. How safe is high-power ultrasonic dissection?. Ann Surg 2003; 237: 186-191
15 Miccoli P, Berti P, Dionigi G, D'Agostino J, Orlandini C, Donatini G. Randomized controlled trial of harmonic scalpel use during thyroidectomy. Arch Otolaryngol Head Neck Surg 2006; 132: 1069-1073
16 Hallgrimsson P, Lovén L, Westerdahl J, Bergenfelz A. Use of the harmonic scalpel versus conventional haemostatic techniques in patients with Grave disease undergoing total thyroidectomy: a prospective randomised controlled trial. Langenbecks Arch Surg 2008; 393: 675-680
17 Barczyński M, Konturek A, Cichoń S. Minimally invasive video-assisted thyreoidectomy (MIVAT) with and without use of harmonic scalpel—a randomized study. Langenbecks Arch Surg 2008; 393: 647-654
18 Kinoshita T, Kanehira E, Omura K, Kawakami K, Watanabe Y. Experimental study on heat production by a 23.5-kHz ultrasonically activated device for endoscopic surgery. Surg Endosc 1999; 13: 621-625
19 Landman J, Kerbl K, Rehman J , et al. Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol 2003; 169: 697-700
20 Sherman JA, Davies HT. Ultracision: the harmonic scalpel and its possible uses in maxillofacial surgery. Br J Oral Maxillofac Surg 2000; 38: 530-532
21 Spivak H, Richardson WS, Hunter JG. The use of bipolar cautery, laparosonic coagulating shears, and vascular clips for hemostasis of small and medium-sized vessels. Surg Endosc 1998; 12: 183-185
22 Loh SA, Carlson GA, Chang EI, Huang E, Palanker D, Gurtner GC. Comparative healing of surgical incisions created by the PEAK PlasmaBlade, conventional electrosurgery, and a scalpel. Plast Reconstr Surg 2009; 124: 1849-1859
23 Ruidiaz ME, Messmer D, Atmodjo DY , et al. Comparative healing of human cutaneous surgical incisions created by the PEAK PlasmaBlade, conventional electrosurgery, and a standard scalpel. Plast Reconstr Surg 2011; 128: 104-111
24 Diamantis T, Kontos M, Arvelakis A , et al. Comparison of monopolar electrocoagulation, bipolar electrocoagulation, Ultracision, and Ligasure. Surg Today 2006; 36: 908-913