title: High-volume hydrodissection: increasing the safety and efficiency of perforator dissection.
abstract: BACKGROUND
  Although perforator flaps have advanced the field of reconstructive microsurgery, these flaps increase operative time and difficulty of dissection. A prospective experimental animal study was performed to study the use of high-volume hydrodissection to simultaneously decrease the operative time while increasing the safety of perforator dissection.
  
  
  METHODS
  Sixteen Sprague-Dawley rats underwent bilateral "deep inferior epigastric perforator" flap dissections with hydrodissection used on the study side and a traditional dissection performed on the control side. Primary outcome measurements included dissection time and dissection difficulty score (1-5 in order of increasing difficulty).
  
  
  RESULTS
  The mean (SD) dissection time for the hydrodissected perforators was 9.29 (2.50) minutes versus 13.22 (2.44) minutes for the control perforators (P < 0.001). The mean (SD) dissection difficulty score was 4.44 (0.73) for the dissection of the control side compared with 1.69 (0.87) for the hydrodissected side (P < 0.001).
  
  
  CONCLUSIONS
  The mechanical benefits of hydrodissection of perforators were evident in reduction of perforator dissection time and difficulty.
authors.affiliation: From the *Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, and†Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan; and ‡Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Dhruv
authors.initials: D
authors.lastname: Singhal
authors.forename: Paolo M
authors.initials: PM
authors.lastname: Fanzio
authors.forename: Ethan T
authors.initials: ET
authors.lastname: Lee
authors.forename: Chee J
authors.initials: CJ
authors.lastname: Chang
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
mesh_terms: D000818:Animals; D004210:Dissection / Q000379:methods*; D019074:Epigastric Arteries / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D061525:Perforator Flap / Q000098:blood supply / Q000601:surgery*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014867:Water
chemical_list: D014867:Water