Advantages of a new technique of neck dissection using an ultrasonic scalpel

The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection

“…A previous study indicated that there is a possible link between seroma and thermal trauma from electrocautery dissection [19]. Therefore, use of harmonic scalpel in neck dissection was reported to reduce the incidence of seroma formation in several studies [21,22]. In addition, flapless technique was found to reduce dead space and was reported to decrease the incidence of seroma formation after thyroid surgery [23].…”

Early Modification in Drainage of Interleukin-1β and Tumor Necrosis Factor-α Best Predicts Surgical-Site Infection After Cervical Neck Dissection for Oral Cancer

“…A prospective study of the advantages of the harmonic scalpel for CND surgery concluded that a shorter operative time is associated with less seroma formation and better wound healing in the postoperative period. 26 Patients who underwent a bilateral CND had an increased risk of SSI. In the authors' opinion, this higher risk can be explained by increased surgical time, which is an independent risk factor, and the association in 100% of patients with bilateral CND and tracheostomy, which is another independent risk factor (Table 1).…”

Use of an Ultrasonic Blade Facilitates Muscle Repair After Incision Injury

“…Inadequate hemostasis or unnecessary trauma from attempts to induce hemostasis at excessive temperatures can lead to secondary damage and slow the wound healing process [1][2][3][4][5]. Hence, development of methods and means to control intra-operative bleeding while limiting inflammation and muscle fibrosis are of importance.…”

“…Early reports indicated that the ultrasonically vibrating knife produced less tissue injury resulting in faster cutaneous wound healing compared with electrosurgery [2], and since then numerous studies have confirmed the advantages of this surgical dissection method in various tissues. In comparison to electrosurgery, the Harmonic Blade provided better hemostasis and tissue strength in oral mucosal surgery [5], less bleeding in tonsillectomy [8,11], faster operative times and less bleeding in thyroidectomy [12], less blood loss in hip replacement [13,14] and spinal surgery [15], less postoperative pain, drainage volume and soft tissue injury in hip arthoplasty [16], and less bleeding, shorter operative times, and better wound healing in neck dissection [3].…”

“…Several experiments were performed ex vivo using porcine muscle to investigate the production of surgical plume [17] and lateral thermal spread [18]. In a human clinical study of supraomohyoid neck dissection, the use of the Harmonic Blade led to reduced bleeding, shorter operative time, less seroma formation and better postoperative wound healing compared to electrocoagulation [3]. A recent study by Rubino et al [19] demonstrated that healing of longitudinal incisions in the rabbit tibialis anterior muscle using the Harmonic Blade progressed with less degenerative/necrotic changes and significantly attenuated acute inflammation compared with electrosurgery.…”