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Switching to Tumescent Dissection in Mastectomy.

Emna Bakillah1, Ari D Brooks1, Seye Adekeye2

  • 1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

The Breast Journal
|February 14, 2025
PubMed
Summary
This summary is machine-generated.

Tumescent dissection (TUM) in mastectomies showed fewer overall complications and shorter operative times compared to electrocautery. While TUM had fewer wound healing issues, infection rates were higher in reconstructed cases.

Keywords:
breast surgerymastectomytumescent dissection

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Area of Science:

  • Surgical Oncology
  • Plastic and Reconstructive Surgery

Background:

  • Mastectomy techniques aim to minimize complications and operative time.
  • Tumescent dissection (TUM) utilizes local anesthesia and epinephrine for flap elevation.
  • Electrocautery is a standard method for tissue dissection during surgery.

Purpose of the Study:

  • To compare the complication rates and operative times of tumescent dissection versus standard electrocautery dissection in mastectomy procedures.
  • To evaluate outcomes in both mastectomies with and without immediate reconstruction.

Main Methods:

  • Retrospective cohort study of 242 patients undergoing mastectomy between January 2016 and October 2020.
  • Comparison of complication rates (primary outcome) and operative time (secondary outcome) between TUM and electrocautery groups.
  • Statistical analysis using Chi-squared tests and two-sample t-tests.

Main Results:

  • TUM group (141 patients) had a lower overall complication rate (44.68%) compared to electrocautery (101 patients, 59.41%; p=0.024).
  • Wound healing complications were reduced with TUM in reconstructed cases (6.1% vs. 21%; p=0.005), but infection rates were higher (14.3% vs. 3.2%; p=0.023).
  • Mean operative time was significantly shorter for TUM (216.09 min) versus electrocautery (250.16 min; p=0.016).

Conclusions:

  • Tumescent dissection offers comparable outcomes to electrocautery in mastectomies with reduced overall complication rates.
  • Electrocautery's thermal effect may contribute to skin-related complications, which appear reduced with TUM.
  • Shorter operative times with TUM may decrease risks associated with prolonged general anesthesia.