A comparison of energy-based dissection devices

May 14, 2019

Researchers compare the effectiveness, safety and cost-effectiveness of four energy-based tissue dissection devices.

While four commonly used energy-based tissue dissection devices for abdominoplasty are safe, the Ultracision Harmonic Scalpel (Ethicon) results in significantly higher blood loss than the others, and the PEAK Plasmablade (Medtronic) and Ultracision methods have the highest surgical costs, according to a paper published April 8, 2019 in the Aesthetic Surgery Journal.

Researchers compared the effectiveness, safety and cost-effectiveness of electrocautery (Covidien), Pulsed Electron Avalanche Knife (PEAK) Plasmablade, Ultracision Harmonic Scalpel and argon plasma coagulation (APC, Erbe) in a randomized, open-label study of 57 abdominoplasty patients. Average follow-up was one year.

Researchers found that while surgery duration didn’t differ significantly among the four techniques, electrocautery procedures took the longest at an average 1 hour and 50 minutes and APC the shortest at an average 1 hour and 19 minutes.

Drainage quantity was statistically similar among groups, but there was a trend in the PEAK group for lower drainage volume.

Wound healing complications also did not differ significantly among groups. Of the 19 cases of minor and major wound healing disorders, most, including seromas, occurred in the electrocautery group. 

Where the researchers did find significant variation was in cost-effectiveness and blood loss. The Ultracision Harmonic Scalpel resulted in the most blood loss.

“From an economic standpoint, either electrocautery or APC represent the most cost-effective devices for abdominoplasties,” they write. “Surprisingly, APC was the most cost-efficient device for long-term use. Although initially presenting the second highest acquisition costs, less expensive surgical costs and shorter surgery duration lead to a benefit over time.”

Electrocautery is the least costly method if the surgeon’s case load is low to moderate. PEAK has high acquisition and high intraoperative costs. And Ultracision is inexpensive to buy but has the highest intraoperative costs, according to the paper.

Disclosures:

Study authors reported no relevant disclosures.

References:

Duscher D, Aitzetmüller MM, Shan JJ, et al. Comparison of Energy-Based Tissue Dissection Techniques in Abdominoplasty: A Randomized, Open-Label Study Including Economic Aspects. Aesthet Surg J. 2019;39(5):536-543.