EP-87 Use of Harmonic Focus Shears in Plastic Surgery. Literature review and future recommendations

Abstract

Abstract Introduction Harmonic Focus Shears (HFS) (Ethicon Endo-Surgery, USA) is an ultrasonic device specifically designed through its curved clips and hand activated trigger system to be precise and minimise the impact on tissues. Initially designed for head and neck dissection and proved to be effective without increasing risk of complications in thyroidectomy procedure it is surprisingly rarely mentioned in the field of plastic surgery. We performed a literature search to established current uses of ultrasonic devices in plastic surgery and determine its effectiveness, and future uses. Methods Literature search was performed in accordance to guidelines for Preferred Reporting Items for Systemic Reviews and Metanalysis. Discussion Use of ultrasonic devices as harmonic prove to be a useful tool in precise large tissue dissection surgery including pedicled flap and free flap dissection. Described benefits embrace upgraded operative time, blood loss, tissue discharge and morbidity. Initially described to be superior to traditional electrocauthery in facelift procedure, ultrasonic devices then evolved to be advantageous when considering outcomes in breast reduction surgery, implant based breast reconstruction and capsulectomy. HFS as a novel and improved ultrasonic device allows for focused forceps dissection, haemostasis and tissue coagulation without the need to swap instruments that is safe to the surrounding tissues. Learning curve is expected and pitfalls include additional staff training, multiple wire device setup, single use and possible overheating. On balance however improved timings and therefore operative efficiency, low risks of complications and optimal patient outcomes make this method of tissue handling a favourable tool to introduce to common plastic surgical practice.