gms | German Medical Science

78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2007, München

The use of the ultrasound scalpel (Harmonic®) for the preparation of the pectoralis major or radialis flap

Meeting Abstract

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  • corresponding author Stefan Tesche - Department of Oto-Rhino-Laryngology/Head and Neck-Surgery, University Hospital, Hamburg, Germany
  • author Frank Metternich - Department of Oto-Rhino-Laryngology/Head and Neck-Surgery, University Hospital, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno100

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2007/07hno100.shtml

Veröffentlicht: 8. August 2007

© 2007 Tesche et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The pectoralis- major (PM) and the radialis- (RL) or forearm- flap are useful tools in reconstructive surgery of the head and neck. The accuracy of the preparation strongly influences the results of both flaps. The use of the ultrasound scalpel (US), which allowes tissue dissection with simultaneous coagulation and no muscle contraction, seems to be an improvement.

Methods: We included 15 patients with Head- and Neck Sqamous Cell Carcimomas (T3 and T4) who received a PM- flap (n=10) or a RL- flap (n=5) for reconstruction after tumour resection. We investigated the parameters intra- and postoperative hemostasis, flap`s vitality and postoperative pain. We used ten comparable tumour patients as control group.

Results: In 87% (13/15) we needed no further bipolar coagulation or ligation; in all 5 RL- flaps the US achieved hemostasis alone. There was no postoperative bleeding. The long term results concerning flap`s vitality were in all cases excellent. The postoperative pain was comparable to the control group.

Conclusion: The US offers a very exact tissue dissection with simultaneous hemostasis. This results in an excellent control of the operation field. Because of the mechanical action of the US there are only little thermal effects on neighbouring tissues. This means a lower risk of inducing microthromboses when dissection of the perforating vessels of the radial artery and no muscle contraction when the preparation of pectoralis muscle is performed. Because of our experiences we can recommend the US for the preparation of the pectoralis major or radialis flap.