Bloodless Pedicle Deepithelialization in Reduction Mammaplasty

Intradermal Infiltration of Local Anesthetic—Rapid and Bloodless Deepithelialization of the Breast Pedicle

“…1 Deepithelialization of the large, inferiorly based pedicle remains the most tedious step of the operation for many plastic surgeons. 2 Some authors have suggested using dermatomes, 3 lasers, 4 electrocautery, 5 and parenchymal tumescence 6 to improve efficiency, whereas some have abandoned deepithelialization altogether in favor of deskinning. 2 We present a novel method of rapid, bloodless deepithelialization using diffuse intradermal infiltration of local anesthetic.…”

Deepithelialization of breast in reduction mammoplasty using cable tie as breast tourniquet

“…[1] Barr et al advocated the use of electrocautery device instead of scalpels for deepithelialization and found it to be quick and safe. [2] Khan described his own technique with scissors [3] as Sinha enhanced deepithelialization with scissors using what he called maze pattern incisions. [4] Simone et al emphasised the use of infiltration solutions to ease this stage.…”

Safety of diathermy for pedicle de-epithelialization in breast reduction surgery in comparison to surgical blade use

“…A similar conclusion was drawn from an earlier study conducted by Demirtas et al (11) Barr et al, however, showed that the diathermy technique was safe to use and safely decreases blood loss, decreases operative time and was easier than de-epithelialization with a scalpel or scissors. (7) Other authors in case studies have reported the use of the Versajet for de-epithelialization and have noted a decrease in operative time. (12) However, similar to the dermatome, the use of the Versajet machine can be costly as the consumables required are very expensive.…”

“…However, it is time-consuming and results in bleeding. (7) It is for these reasons that some authors have attempted different ways of de-epithelialization with the hope of decreasing operative time and blood loss while maintaining reliability, a good blood supply and preservation of nipple sensation. (7) Various attempts have been made over the years to improve on the time taken to perform pedicle de-epithelialization.…”

“…(7) It is for these reasons that some authors have attempted different ways of de-epithelialization with the hope of decreasing operative time and blood loss while maintaining reliability, a good blood supply and preservation of nipple sensation. (7) Various attempts have been made over the years to improve on the time taken to perform pedicle de-epithelialization. Juma et al used an electric dermatome for pedicle de-epithelialization and showed a reduction of the total operative time by up to 40 min.…”