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Modified radical mastectomy: A pilot clinical trial comparing the use of conventional electric scalpel and harmonic scalpel
  • Barretos Cancer Hospital
  • Universidade Estadual Paulista (UNESP)
  • 1743-9191
  • 1743-9159
Background: The aim of this study was to compare the rates of local postoperative complications among women undergoing modified radical mastectomy with an electric scalpel (ES) or a harmonic scalpel (HS). It is thought that HS use has less postoperative complications, mainly seroma formation. Methods: This study was a prospective non-randomised clinical trial (NCT01391988) among consecutive patients, performed in parallel. Patients underwent modified radical mastectomy using an HS or ES. We analysed the following operative variables: time, blood loss and seroma volume drainage. Postoperative complications, including seroma, flap necrosis, haematoma and infection were evaluated on the 7th and 14th days. Results: Forty-six patients underwent a MRM with ES and 49 with HS; no differences were observed between the groups. The rate of local complications was 29% in the HS group and 52% in the ES group (p=0.024). The rates of seroma (16.3% versus 28.3%; p=0.161), necrosis (4.1% vs. 21.7%; p=0.013; OR=0.15), haematoma (2.0% vs. 8.7%; p=0.195) and infection (2.0% vs. 6.5%; p=0.351) were lower in the HS group. Adding the findings of all comparative studies using HSs in MRM to the seroma rates in the current study, the seroma rate, expressed as a categorical variable, did not decrease with HS. Seroma was present in 60/219 cases using an HS and in 69/239 cases utilising an ES (p=0.72). Based on a multivariate analysis, HS decreased the risk of skin necrosis (p=0.015). Conclusions: HSs do not decrease the seroma rate. However, this method may be useful in skin sparing mastectomy because it decreases skin flap necrosis. © 2013 Surgical Associates Ltd.
Issue Date: 
International Journal of Surgery, v. 11, n. 6, p. 496-500, 2013.
Time Duration: 
  • Breast cancer
  • Clinical trial
  • Electric scalpel
  • Harmonic scalpel
  • Modified radical mastectomy
  • Postoperative complications
  • adult
  • aged
  • clinical article
  • clinical trial
  • comparative study
  • female
  • graft necrosis
  • hematoma
  • human
  • mastectomy
  • postoperative infection
  • priority journal
  • prospective study
  • scalpel
  • seroma
  • skin necrosis
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Appears in Collections:Artigos, TCCs, Teses e Dissertações da Unesp

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