Shireen Ramzanali Damani, Sadiqa Haider, Syed Sagheer Hussain Shah.
Comparison of modified radical mastectomy using harmonic scalpel and electrocautery.
J Surg Pak Jan ;18(1):2-6.

Objective: To compare the intraoperative and postoperative outcome of modified radical mastectomy (MRM) using harmonic scalpel versus electrocautery. Study design: Comparative study. Place & Duration of study: Department of Surgery, Jinnah Postgraduate Medical Center (JPMC) Karachi, Surgical ward 26, from December 2010 to June 2012. Methodology: This study included fifty females undergoing modified radical mastectomy. Twenty-five were operated with harmonic scalpel and twenty-five with electrocautery. Operative time, blood loss, total drainage volume (axillary and flap drains) and days for which the drains were placed, pain score, volume of sermoa, hematoma, frequency of flap necrosis and lymphedema were compared. Results: There were no statistical differences between the two groups as regard to operative time (p=0.264), seroma (p=0.247), hematoma (p=0.235), flap necrosis (p=1.000) and lymphedema (p=1.000). Furthermore there was no statistically significant difference in terms of pain relief (p=0.197). There was a highly significant difference (p<0.001) in relation to blood loss, drainage volume of flap drain and duration of placement of flap drain only. Hospital stay was not shortened because all patients were routinely discharged after three days following removal of the drains. Conclusion: Use of harmonic scalpel in mastectomy significantly reduced blood loss, total drainage volume and days but did not lower operative time, seroma formation, postoperative pain and total hospital stay.

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