A NOVEL TECHNIQUE OF HARMONIC TISSUE DISSECTION REDUCES POSTOPERATIVE HEMATOMA, FLAP NECROSIS, WOUND SEPSIS AFTER MODIFIED RADICAL MASTECTOMY COMPARED TO CONVENTIONAL ELECTROCAUTERY

Abstract

Background: Breast cancer is a serious public health problem with high incidence and prevalence coefficients. This study was undertaken with the intention to evaluate the benefits of harmonic scalpel dissection over electrocautery in MRM.

Methods: This comparative study was conducted in Department of Surgery, IGMC Shimla over a period of one year from 1 July 2015 to 30 June 2016. Histologically proven cases of carcinoma breast presenting in the surgery OPD or admitted in the surgery wards were included in the present study.

Results: Postoperative hematoma occured in 1 patient of Electrocautery Group, which was drained. There were no cases of postoperative hematoma in Harmonic Group. This difference was not found to be statistically significant with P value=.313. Postoperative flap necrosis occurs in 1 (3%) patient of harmonic MRM Group and 4(11.8%) patients of electrocautery MRM Group. This difference was not found to be statistically   significant with P value 0 .1633. Postoperative wound sepsis occurs in 2 (5%) patient of Harmonic MRM Group and 5(14%) patients of Electrocautery MRM Group. This difference was not found to be statistically significant with P value 0.2312.

Conclusion- Harmonic scalpel signi?cantly reduces postoperative overall complications (?ap necrosis, and SSI) in the patient undergoing MRM

Keywords: Flap necrosis, SSI, MRM