title: The linear cutting stapler may reduce surgical time and blood loss with muscle transection: a pilot study.
abstract: Because of skeletal muscle's density and vascularity, its transection with standard electrocautery can be tedious. In a pilot study we asked whether a linear cutting stapling device decreased surgical time, blood loss, transfusion rates, and complications in patients undergoing above-knee amputation when compared to traditional electrocautery. We retrospectively reviewed 11 patients with above-knee amputation cases using a linear cutting stapling device over a 10-year period and compared those to 13 patients in whom we used electrocautery. The patients treated with the linear cutting stapling device had an average of 97 minutes of surgical time, 302 cc blood loss, and 1.55 units transfusion, compared to an average 119 minutes, 510 cc, and 2.15 units, respectively, with the electrocautery cases. Despite the trends, these parameters, as well as major complications, were similar in these two small groups. In skeletal muscle transection, we believe the linear cutting stapler is a reasonable and potentially cost-effective technical alternative to electrocautery, possibly resulting in less blood loss and shorter surgical time with similar rates of complications.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Division of Musculoskeletal Oncology, Southern California Permanente Medical Group, 1011 Baldwin Park Boulevard, Baldwin Park, CA, 91706, USA. dallison12@hotmail.com
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Allison
authors.forename: Elke R
authors.initials: ER
authors.lastname: Ahlmann
authors.forename: Anny H
authors.initials: AH
authors.lastname: Xiang
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Menendez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000295:instrumentation* / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D013528:Surgical Staplers; D013848:Thigh / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult