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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
1   Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
2   Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan
,
Takashi Saitou
2   Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan
,
Kazuyuki Kubo
2   Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan
,
Takeshi Beppu
3   Department of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan
,
Takashi Yamaki
1   Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
,
Hiroyuki Sakurai
1   Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

14 February 2012

15 May 2012

Publication Date:
21 September 2012 (online)

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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
 

  • References

  • 1 O'Connor JL, Bloom DA, William T. Bovie and electrosurgery. Surgery 1996; 119: 390-396
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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)
    CrossrefPubMedGoogle Scholar
  • 4 Amaral JF. Laparoscopic cholecystectomy in 200 consecutive patients using an ultrasonically activated scalpel. Surg Laparosc Endosc 1995; 5: 255-262
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 14 Emam TA, Cuschieri A. How safe is high-power ultrasonic dissection?. Ann Surg 2003; 237: 186-191
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 24 Diamantis T, Kontos M, Arvelakis A , et al. Comparison of monopolar electrocoagulation, bipolar electrocoagulation, Ultracision, and Ligasure. Surg Today 2006; 36: 908-913
    CrossrefPubMedGoogle Scholar