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Modified Radical Mastectomy With Axillary Dissection Using the Electrothermal Bipolar Vessel Sealing System—Invited Critique
David Euhus, MD
Arch Surg. 2008;143(6):581.
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Prolonged axillary drainage and marginal flap necrosis are troubling immediate complications of modified radical mastectomy, and lymphedema is a potentially devastating delayed complication. As surgeons, we compulsively enforce meticulous technique to minimize these complications, and when they occur, we often attribute them to patient and disease variables that are outside of our control. The study by Manouras et al forces us to consider whether readdressing technical factors well within our control could significantly improve outcomes for our patients.
Marginal flap necrosis and associated infections occur in less than 5% of patients, but the risk is increased in smokers and in women with diabetes mellitus, and it seems more common in women with filmy subcutaneous fat that is sparsely invested with narrow-caliber blood vessels. These data by Manouras et al suggest that raising flaps using a bipolar device rather than a knife or monopolar electrocautery eliminates this complication. . . . [Full Text of this Article]
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Modified Radical Mastectomy With Axillary Dissection Using the Electrothermal Bipolar Vessel Sealing System
Andreas Manouras, Haridimos Markogiannakis, Michael Genetzakis, George M. Filippakis, Emmanuel E. Lagoudianakis, Georgia Kafiri, Konstantinos Filis, and George C. Zografos
Arch Surg. 2008;143(6):575-580.
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