Use of ultrasonic shears in the harvest of the free osteocutaneous fibula flap.
OBJECTIVE
Traditionally, the fibula free flap has been raised by electrocautery and sharp dissection with clipping and tying of vessels. Use of the ultrasonic scalpel has been proposed to be a faster, more hemostatic, and less traumatic method of harvest.


METHODS
We performed a retrospective chart review of 58 patients who underwent fibula free flap reconstruction between 2007 and 2010. The main outcome measures were blood loss, operative time, and flap harvest time.


RESULTS
Use of the ultrasonic shears was not associated with a statistically significant reduction in intraoperative blood loss, operative time, or flap harvest time. However, the flap harvest time did trend toward statistical significance (p = 0.073). Use of distribution-based effect sizes demonstrated a moderate clinically important difference in favor of the ultrasonic shears for both operative time and flap harvest time.


CONCLUSIONS
The use of ultrasonic shears is comparable to traditional methods of fibula free flap harvest and can be considered an alternative method of harvest.
Department of Otolaryngology-Head and Neck Surgery, University of South Florida College of Medicine, USA.
Jon N
JN
Burton
Mark W
MW
El-Deiry
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D033081:Shear Strength; D013524:Surgical Flaps; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014465:Ultrasonics