Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) vs conventional electrosurgery in post‐bariatric abdominoplasty: A retrospective randomised clinical study

Schlosshauer, Torsten; Kiehlmann, Marcus; Riener, Marc‐Oliver; Sader, Robert; Rieger, Ulrich M.

doi:10.1111/iwj.13221

Cited by 15 publications

(21 citation statements)

References 31 publications

(70 reference statements)

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“…In the same study, incisions made with PEAK PlasmaBlade showed a less thermal injury depth, when compared with traditional monopolar electrosurgery (38% reduction). In another study of our research group, the use of PEAK PlasmaBlade in post‐bariatric patients undergoing abdominoplasty produced significantly less acute thermal damage than conventional monopolar electrosurgery (40% vs 75%; P = .035) 27 . Also, incisions made with PEAK PlasmaBlade in these patients showed a less thermal injury depth when compared with conventional standard of care (32% reduction).…”

Section: Discussionmentioning

confidence: 86%

“…This special patient population undergoing mastectomy has a relatively high risk of complications, such as hematoma, wound healing problems, and necrosis of the NAC 2‐5 . Based on previous work, 23,24,27 it is likely that wound healing problems can be reduced in female‐to‐male transsexuals undergoing mastectomy by using alternative devices of monopolar electrocautery, such as PEAK PlasmaBlade, which provides scalpel‐like cutting precision, while the blade temperature remains close to body temperature. Therefore, in the present study, we evaluated two dissection techniques, like PEAK PlasmaBlade and monopolar electrosurgery and their effect on postoperative wound healing, in female‐to‐male transgender patients undergoing mastectomy.…”

Section: Discussionmentioning

confidence: 99%

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Effect of low‐thermal dissection device versus conventional electrocautery in mastectomy for female‐to‐male transgender patients

Schlosshauer

Kiehlmann

Riener

et al. 2020

International Wound Journal

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Subcutaneous mastectomy, the first step in sexual reassignment surgery of female‐to‐male transsexuals, is associated with high rates of complication and revision surgery. Also, conventional electrosurgery and the associated thermal tissue damage may compromise outcome. This retrospective randomised clinical study evaluated the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade, Medtronic, Minneapolis, Minnesota) in comparison with conventional electrosurgery. A total of 17 female‐to‐male transsexuals undergoing mastectomy were randomised to PEAK PlasmaBlade on one breast side and to monopolar electrosurgery on the other side of the same patient. Wounds of 17 patients were examined histologically for acute thermal injury. Significantly less total volume of drain output (58.8 ± 37.4 mL vs 98.5 ± 76.4 mL; P = .012) was found on the PEAK PlasmaBlade side compared with the electrosurgery side. Duration of drain was significantly shorter on the PEAK PlasmaBlade side (2.5 ± 0.7 days vs 3.2 ± 0.6 days; P = .010). Furthermore, the PEAK PlasmaBlade side showed fewer thermal damages (41.2% vs 82.4%; P = .039) and thermal injury depth from PEAK PlasmaBlade side was less (3170 vs 4060 μm). PEAK PlasmaBlade appears to be superior to monopolar electrosurgery for mastectomy in female‐to‐male transsexuals, because it demonstrated less thermal tissue damage, less total volume of drain output, and shorter duration of drain, resulting in faster wound healing.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Effect of low‐thermal dissection device versus conventional electrocautery in mastectomy for female‐to‐male transgender patients

Schlosshauer

Kiehlmann

Riener

et al. 2020

International Wound Journal

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“…The PB is a relatively new electrosurgical technology developed to achieve cutting and coagulation effects with a relatively low operating temperature, which reduces thermal damage (6,25). It applies high-frequency RF pulses to generate electrical plasma along the edge of the electrode (26).…”

Section: Discussionmentioning

confidence: 99%

“…It uses high-intensity RF pulses to induce the formation of electrical plasma along the edge of the electrode, limiting this effect on the tissue surface. Thus, PB reduces local operating temperature, creating less thermal damage to adjacent tissues (6)(7)(8). At present, this technology is widely used in surgical procedures abroad (9,10).…”

Section: Introductionmentioning

confidence: 99%

Comparative healing of swine skin following incisions with different surgical devices

et al. 2021

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Background: Electrosurgical technology is widely used in surgical dissection and hemostasis, but the generated heat creates thermal injury to adjacent tissues and delays wound healing. The plasma blade (PB) applies pulsed radiofrequency (RF) to generate electrical plasma along the edge of a thin, flat, insulated electrode, minimizing collateral tissue damage. This study aimed to evaluate wound healing in swine skin following incision with a new surgical system that applies low-temperature plasma (NTS-100), a foreign PB, conventional electrosurgery (ES), and a scalpel blade.Methods: In vitro porcine skin and an in vivo porcine skin model were used in this study. Full-thickness skin incisions 3 cm in length were made on the dorsum of each animal for each of the 5 surgical procedures at 0, 21, 28, 35, and 42 days. The timing of the surgical procedures allowed for wound-healing data points at 1, 2, 3, and 6 weeks accordingly. Local operating temperature and blood loss were quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. Results: Local operating temperature was reduced significantly with NTS-100 (cut mode 83.12±23.55 ℃; coagulation mode 90.07±10.6 ℃) compared with PB (cut mode 94.46±11.48 ℃; coagulation mode 100.23±6.58 ℃, P<0.05) and ES (cut mode 208.99±34.33 ℃, P<0.01; coagulation mode 233.37±28.69 ℃, P<0.01) in vitro. Acute thermal damage from NTS-100 was significantly less than ES incisions (cut mode: 247.345±42.274 versus 495.295±103.525 μm, P<0.01; coagulation mode: 351.419±127.948 versus 584.516±31.708 μm, P<0.05). Bleeding, histological scoring of injury, and wound strength were equivalent for the NTS-100 and PB incisions. Conclusions:The local operating temperature of NTS-100 was lower than PB, and NTS-100 had similarly reliable safety and efficacy.

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“…Furthermore, two randomized studies have since compared the use of electrocautery and plasma-kinetic coagulation methods in abdominoplasty, with the latter showing improved patient outcomes. 14,15…”

Section: Introductionmentioning

confidence: 99%

Dissection Methods in Abdominoplasty: A Systematic Review and Meta-Analysis

2021

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Abdominoplasty is one of the most common cosmetic procedures performed worldwide. Despite recent advances in surgical technique, the risk of complications remains high. The advantages of using various dissection devices as a method of flap elevation in abdominoplasty remains unclear. A systematic search was undertaken to identify studies comparing electrocautery dissection with scalpel dissection and plasma-kinetic energy-based dissection methods in abdominoplasty. A meta-analysis was performed using the selected studies. Seven studies were analyzed. These studies included a total of 1143 patients who underwent abdominoplasty using electrocautery (n = 617), steel scalpel (n = 457), or plasma dissection (n = 69). A meta-analysis was conducted, which showed an overall reduction in incidences of seroma, operative time, and length of hospital stay in the scalpel dissection group compared with the electrocautery group. The plasma dissection group showed a reduction in rate of postoperative wound infection and hematoma, as well as a reduction in drain output and length of hospital stay, compared with the electrocautery group. There are few studies comparing outcomes using different dissection techniques in abdominoplasty. These studies are small and heterogeneous in design. However, using plasma-kinetic energy-based devices or scalpel dissection appears to be associated with reduced complication rates, shorter operative time, lower drain volumes, and a reduction in the length of hospital stay.

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Comparative analysis on the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade) vs conventional electrosurgery in post‐bariatric abdominoplasty: A retrospective randomised clinical study

Cited by 15 publications

References 31 publications

Effect of low‐thermal dissection device versus conventional electrocautery in mastectomy for female‐to‐male transgender patients

Effect of low‐thermal dissection device versus conventional electrocautery in mastectomy for female‐to‐male transgender patients

Comparative healing of swine skin following incisions with different surgical devices

Dissection Methods in Abdominoplasty: A Systematic Review and Meta-Analysis

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