High-Precision Electrosurgical Scalpel for Scarpa Sparing Abdominoplasty – Pilot Randomized Controlled Trial of Efficacy and Safety

BACKGROUND: The dissection technique can influence abdominoplasty complication rates. New "bovie" tips have been developed to minimize thermal damage and optimize tissue dissection. OBJECTIVES: The purpose of the present study was to perform a randomized controlled trial to evaluate the effect of the dissection technique on several outcomes and complications after a Scarpa-sparing abdominoplasty, comparing a high-precision electrosurgical scalpel (HPES) with the conventional electroscalpel. METHODS: This prospective study was conducted at a single medical facility between June 2020 and February 2022 and enrolled patients who underwent Scarpa-sparing abdominoplasty. Forty female patients were included in the study and randomly assigned to either abdominoplasty performed using the conventional "bovie" tip (Group A) or a similar procedure using the HPES tip (Group B). The following variables were analyzed: patient characteristics, duration of suction drain use, drain output, complications (local and systemic), unscheduled visits, readmissions, and reoperation requirements. RESULTS: Both groups exhibited similar general characteristics, differing only in body mass index. The HPES group showed a 23.6% significant reduction in total drain output and a trend toward lower daily outputs, peaking on day two with a 60.0% reduction in drain output. Local and systemic complications were similar, except for a trend toward lower wound dehiscence in the HPES group. Notably, no systemic complications occurred in either group. CONCLUSION: Our findings support the safety and efficacy of the HPES tip for Scarpa-sparing abdominoplasty. This pilot randomized controlled trial demonstrated the benefits of substantially reducing drain output. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .