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Harmonic scalpel versus electrocautery in breast reduction surgery: a randomized controlled trial
Todd E Burdette1, Carolyn L Kerrigan, Karen A Homa
1Lebanon, N.H. From the Division of Plastic and Reconstructive Surgery and the Leadership Preventive Medicine Residency Program, Dartmouth-Hitchcock Medical Center.
Plastic and Reconstructive Surgery
|September 17, 2011
Summary
The Harmonic Scalpel showed no significant clinical advantage over electrocautery in breast reduction surgery. High costs of the Harmonic Scalpel make it a less favorable option for this procedure.
Area of Science:
- Plastic Surgery
- Surgical Technology
Background:
- Bilateral breast reduction surgery is a common procedure.
- Electrocautery is a widely used surgical tool for hemostasis.
- The Harmonic Scalpel is a newer device with potential advantages.
Purpose of the Study:
- To compare the efficacy of the Harmonic Scalpel versus electrocautery in bilateral breast reduction.
- To evaluate operative time, fluid drainage, and postoperative pain.
Main Methods:
- A matched-pair design with 31 patients was used.
- One breast was randomly assigned to the Harmonic Scalpel, the other to electrocautery.
- Key outcomes included resection/hemostasis time, drainage volume, and pain scores.
Main Results:
- A statistically significant but not clinically significant difference in operative time was observed (Harmonic Scalpel: 33 min, electrocautery: 31 min).
- No significant differences were found in drainage volume or postoperative pain scores.
- Complication rates were not statistically significant due to small sample size, but trended higher with the Harmonic Scalpel. The Harmonic device had a higher per-procedure cost.
Conclusions:
- The Harmonic Scalpel is comparable to electrocautery for breast reduction surgery regarding key surgical outcomes.
- The higher cost of the Harmonic Scalpel suggests it may not be cost-effective for this specific procedure.
- Electrocautery remains a suitable and cost-effective option for bilateral breast reduction.
