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Use of ultrasonic scalpel and monopolar electrocautery for skin incisions in neck dissection: a prospective randomized trial

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Abstract

Purpose

Ultrasonic scalpel (UC) and monopolar electrocautery (ME) are standard equipment for soft tissue surgery. The aim of the present study was to compare intraoperative and postoperative patterns of patients using either UC or ME for skin incisions in neck dissection.

Material and methods

In a prospective randomized study of 30 patients, the thermal effects of UC (n = 15) and ME (n = 15) were examined using real-time infrared thermographic imaging. Additionally, tissue damage was evaluated histopathologically. The other measured variables were operation and bleeding time, postoperative pain score (only neck incision area), in-patient time, and complications.

Results

UC significantly reduces the thermal effects, compared to ME (p < 0.001). The mean depth of tissue damage (i.e., necrosis) was 272.7 μm for UC and 284.7 μm for ME with no significant difference (p = 0.285). From the third postoperative day, patients treated using UC had noticeably less pain in the neck incision area (t3 p = 0.010; t4 p < 0.001; t5 p < 0.005). Cutting time was reduced for ME by 36.1 s (p < 0.001) and the bleeding time was decreased by 40.9 s for UC (p < 0.001). The total preparation time was the same (p = 0.402). When comparing in-patient time (p = 0.723), as well as complications, no significant differences were seen.

Conclusion

UC results in less postoperative pain and less bleeding in the neck incision area. Accordingly, UC is superior to ME for skin incisions in neck dissection.

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Author notes

  1. Daniel Schneider and Kai Goppold contributed equally to this study.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany

    Daniel Schneider, Kai Goppold & Reinhard Bschorer

  2. Department of Oral and Maxillofacial Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany

    Peer W. Kaemmerer

  3. Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

    Gerhard Schoen

  4. Institute of Pathology, Helios Kliniken Schwerin, Schwerin, Germany

    Michael Woehlke

Authors
  1. Daniel Schneider
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  2. Kai Goppold
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  3. Peer W. Kaemmerer
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  4. Gerhard Schoen
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  5. Michael Woehlke
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  6. Reinhard Bschorer
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Corresponding author

Correspondence to Daniel Schneider.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

Ethical approval was obtained from the regional ethics committee of the University Medical Centre in Rostock, Germany.

Patient consent

All included patients signed an informed consent form before participating in this study.

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Schneider, D., Goppold, K., Kaemmerer, P.W. et al. Use of ultrasonic scalpel and monopolar electrocautery for skin incisions in neck dissection: a prospective randomized trial. Oral Maxillofac Surg 22, 169–175 (2018). https://doi.org/10.1007/s10006-018-0686-x

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  • DOI: https://doi.org/10.1007/s10006-018-0686-x

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