High-volume hydrodissection: increasing the safety and efficiency of perforator dissection.

Abstract

Although perforator flaps have advanced the field of reconstructive microsurgery, these flaps increase operative time and difficulty of dissection. A prospective experimental animal study was performed to study the use of high-volume hydrodissection to simultaneously decrease the operative time while increasing the safety of perforator dissection. Sixteen Sprague-Dawley rats underwent bilateral "deep inferior epigastric perforator" flap dissections with hydrodissection used on the study side and a traditional dissection performed on the control side. Primary outcome measurements included dissection time and dissection difficulty score (1-5 in order of increasing difficulty). The mean (SD) dissection time for the hydrodissected perforators was 9.29 (2.50) minutes versus 13.22 (2.44) minutes for the control perforators (P < 0.001). The mean (SD) dissection difficulty score was 4.44 (0.73) for the dissection of the control side compared with 1.69 (0.87) for the hydrodissected side (P < 0.001). The mechanical benefits of hydrodissection of perforators were evident in reduction of perforator dissection time and difficulty.