Fasiha Munawwar, Atif Ashraf Janjua, Imdad Ahmed, Hassan Shaukat, Kiran Sarfaraz, Abdul Basit Qureshi.
Outcome of Ultra sonic dissection in Modified Radical Mastectomy.
Esculapio J Services Inst Med Sci Jan ;15(3):195-8.

Objectives: The objective of this study was to determine the outcome of ultrasonic dissection in modified radical mastectomy. Method: 90 patients fulfilling the uinclusion criteria were selected for study. Modified radical mastectomy was performed by using the ultrasonic dissector. Flaps were raised using coagulating shears/blades of ultrasonic dissector and dissection of the breast tissue was done with same device. Level II axillary clearance was done in all cases. Coaptive coagulation mode was used to occlude and transect the blood vessels and lymphatic vessels. Two closed suction drains placed. Results: All the patients were females with mean age of 45.81 +- 10.02 years. Mean volume of drainage of pectoral drain was 56 +- 35.45ml, mean volume of drainage of axillary drain was 250 +- 109.07ml, and mean total volume of drainage was 306.39 +- 130ml. The mean duration of drain was 5.87+-1.62 days. There were 4 patients (4.44%) who developed seroma out of total ninety patients at 10th postoperative day while 86 patients (95.56%) had no clinical signs of seroma. None of the patients developed wound infection, flap necrosis, or post-operative hematoma. Conclusion: Modified radical mastectomy with axillary dissection using ultrasonic dissection is safe, feasible and effective. With this technique, there is reduced volume of drainage and duration and incidence of seroma.

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