Ultrasonic Shears Decrease Postoperative Hematomas in Head and Neck Microvascular Reconstruction

Area of Science:

• Microsurgery
• Surgical Oncology
• Head and Neck Surgery

Background:

• Postoperative hematoma is a significant complication in microvascular reconstructions.
• Minimizing bleeding and the need for reoperation is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the impact of ultrasonic shears on postoperative hematoma and takeback rates.
• To determine if ultrasonic shears improve outcomes in head and neck microvascular reconstructions.

Main Methods:

• Retrospective cohort study of 2288 patients undergoing free flap reconstruction.
• Comparison of outcomes between patients dissected with and without ultrasonic shears.

Main Results:

• Overall hematoma rate was 1.3%.
• Hematoma rates were significantly lower with ultrasonic shears (0.63%) compared to conventional methods (2.3%), P=.0015.
• Takeback rates for bleeding were also reduced with ultrasonic shears (0.56% vs 1.61%).

Conclusions:

• Ultrasonic shears are associated with a decreased rate of postoperative hematoma and takeback for bleeding.
• The adoption of ultrasonic shears can reduce perioperative morbidity in head and neck cancer microvascular reconstruction.