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Harmonic scalpels compared with electrocautery in reconstructive flap harvesting: A meta-analysis

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Affiliated Author(s)
신영민정운혁
Alternative Author(s)
Shin, Young MinJeong, Woon Hyeok
Journal Title
Microsurgery
ISSN
1098-2752
Issued Date
2022
Abstract
Background:
Numerous studies have compared electrical devices used for flap surgery, but the results are inconsistent. This research was performed to evaluate the efficacy of two different types of electric devices: electrocautery and ultrasonic shears.

Methods:
The PubMed, Embase, and Scopus databases were searched systematically. A total of 505 cases were included in this study, including 209 electrocautery and 296 harmonic scalpel cases. The following information was retrieved from the included studies: the first author of the article, publication year, flap type, flap harvest time, drain volume, bleeding volume and postoperative complications. Hematoma, infection, flap necrosis and wound dehiscence were considered postoperative complications. The Q statistic for heterogeneity and the I2 index were calculated. If I2 < 50%, we used a fixed-effects model; if I2 > 50%, we employed a random-effects model in our meta-analysis.

Results:
A total of eight studies which met the inclusion criteria were included and reviewed systematically for a meta-analysis. The harmonic scalpel yielded a statistically significantly more favorable flap harvest time and drain volume than did electrocautery. The Harmonic scalpel led to a shorter flap harvest time by 26.29 min (95% CI = −39.38 to −13.2; p < .00001) and smaller drain volume by 58.76 ml (95% CI = −105.27 to −12.25; p = .01) on average. However, there were no significant differences in the bleeding volume or incidence rates of infection, flap necrosis and wound dehiscence.

Conclusion:
The Harmonic scalpel method yields better outcomes in terms of the flap harvest time and drain volume than does the conventional electrocautery method. Therefore, the Harmonic scalpel is a better option for cauterization and dissection in flap surgery.
Department
Dept. of Dentistry (치과학)
Dept. of Plastic Surgery (성형외과학)
Publisher
School of Medicine (의과대학)
Citation
Jaehoon Kim et al. (2022). Harmonic scalpels compared with electrocautery in reconstructive flap harvesting: A meta-analysis. Microsurgery, 42(1), 89–96. doi: 10.1002/micr.30831
Type
Article
ISSN
1098-2752
DOI
10.1002/micr.30831
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44052
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Dentistry (치과학)
1. School of Medicine (의과대학) > Dept. of Plastic Surgery (성형외과학)
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