A Prospective Comparison of Scalpel Versus Bipolar Scissors in the Elevation of Radial Forearm Fasciocutaneous Free Flaps

Mark K. Wax, Catherine Winslow, Stella Desyatnikova, Peter E. Andersen, James I. Cohen

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objectives/Hypothesis The radial forearm fasciocutaneous free flap has become the workhorse for reconstruction of head and neck ablative defects. A location distal to the head and neck allows this flap to be elevated concurrent with the ablation. Most commonly, the flap is elevated under tourniquet control. This involves a primary ischemic insult with a certain amount of hemorrhage after the tourniquet is released. Bipolar scissors are a new method of dissection. They may allow for a speedier dissection with a concomitant decrease in ischemic time. Their hemostatic properties may control hemorrhage after use of the tourniquet. Study Design A prospective study of patients undergoing radial forearm free flaps over a 12-month period at a tertiary care referral center was undertaken. Results Forty patients were entered into the study, flaps were elevated with scalpel (20) and with bipolar scissors (20). Mean time under tourniquet was 39 minutes (range, 30-56 min) with scalpel compared with 27 minutes (range, 21-31 min) with bipolar scissors (P <.001). Total mean time of elevation (including control of hemostasis and pedicle dissection) for scalpel elevation was 50 minutes (range, 35-61 min) compared with 32 minutes (range, 20-41 min) for bipolar scissors elevation (P <.001). Mean blood loss was 46 mL (range, 15-110 mL) in the scalpel elevation group compared with 14 mL (range, 0-50 mL) in the bipolar scissors elevation group (P <.001). Complications at the donor site were equal between groups. Conclusions Bipolar scissors are a safe, efficient method for elevating radial forearm free flaps.

Original languageEnglish (US)
Pages (from-to)568-571
Number of pages4
JournalLaryngoscope
Volume111
Issue number4
DOIs
StatePublished - Apr 2001

Keywords

  • Scalpel
  • bipolar scissors
  • free flap
  • radial forearm
  • reconstruction

ASJC Scopus subject areas

  • Otorhinolaryngology

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