Comparison of Energy-Based Tissue Dissection Techniques in Abdominoplasty: A Randomized, Open-Label Study Including Economic Aspects

Abstract

Background

Abdominoplasty is one of the most common procedures in plastic surgery, and energy-based tissue dissection techniques have become the gold standard. Despite its frequency, abdominoplasty is still associated with high complication rates.

Objectives

We compare clinical and economic data of four methods of energy-based tissue dissection in a randomized, open-label study.

Methods

A total of 57 patients were preoperatively randomized into four groups: Electrocautery, Ultracision Harmonic Scalpel, Argon Plasma Coagulation, and PEAK-Plasmablade. Demographic and operational data, as well as information on the postoperative course and complications were collected. For economic analysis, quotes were obtained from the device companies or official suppliers.

Results

We found no significant difference in the duration of surgery, the drainage quantity, or wound healing complications between treatment groups. The Ultracision method caused significantly greater blood loss compared to all other techniques (p<0.01). When comparing surgical costs, we found PEAK and Ultracision devices more expensive compared to APC and Electrocautery.

Conclusions

All methods evaluated can be applied safely and effectively in abdominoplasty procedures. However, our data demonstrate a significantly higher blood loss for the Ultracision Harmonic Scalpel. Considering our clinical data, we are unable to find justification for the higher costs of PEAK and Ultracision methods.