Kos Marcin, Engelke Werner
Department of Maxillofacial Surgery, Klinikum Minden, Germany.
J Craniomaxillofac Surg. 2007 Jan;35(1):10-4. doi: 10.1016/j.jcms.2006.10.007. Epub 2007 Feb 12.
The aim of the study was to see whether a new technique of a neck dissection applying an ultrasonic activated (harmonic) scalpel would improve patient recovery.
A prospective, non-randomized study was undertaken on 40 supraomohyoid neck dissections performed using a harmonic scalpel (20 pts) or electrocoagulation (20 pts). The evaluation included: operation time, intraoperative blood loss, postoperative seroma formation and pattern of wound healing.
The operative time (mean+/-SD) using a harmonic scalpel was significantly shorter (52+/-10 min vs. 86+/-22 min; p<or=0.001) and the blood loss was less (13+/-7 ml vs. 85+/-58 ml; p<or=0.001), neck drainage on the first and second postoperative days were significantly smaller after using the ultrasonic scalpel (30+/-26 ml; 44+/-23 ml vs. 77+/-65 ml; 118+/-66 ml, p<or=0.001). Wound healing complications amounted to only 5% (20% in the control group).
The use of the harmonic scalpel during neck dissection led to diminished bleeding, shorter operative time, lesser seroma formation and better wound healing in the postoperative period.
本研究的目的是观察应用超声激活(谐波)手术刀的颈部清扫新技术是否能改善患者恢复情况。
对40例采用谐波手术刀(20例)或电凝法(20例)进行的肩胛舌骨肌上颈部清扫术进行了前瞻性、非随机研究。评估内容包括:手术时间、术中失血、术后血清肿形成及伤口愈合情况。
使用谐波手术刀的手术时间(均值±标准差)显著更短(52±10分钟对86±22分钟;p≤0.001),失血量更少(13±7毫升对85±58毫升;p≤0.001),使用超声手术刀后术后第1天和第2天的颈部引流量显著更少(30±26毫升;44±23毫升对77±65毫升;118±66毫升,p≤0.001)。伤口愈合并发症仅为5%(对照组为20%)。
在颈部清扫术中使用谐波手术刀可减少出血、缩短手术时间、减少血清肿形成并在术后实现更好的伤口愈合。