The Effects of an Antistick Phospholipid Solution on Bipolar Electrocautery Efficacy in Rhytidectomy

Abstract

Ensuring adequate intraoperative hemostasis is crucial in avoiding serious complications of rhytidectomy surgery such as hematoma formation and skin flap necrosis. Charring of bipolar electrocautery arms can lead to ineffective hemostasis, frequent wiping to ensure hemostatic efficacy and prolonged operative time. We investigate the impact of a commercially available antistick coating solution (Electro Lube) on intraoperative wiping frequency of bipolar electrocautery arms and operative time for rhytidectomy procedures. Fifty patients undergoing rhytidectomy were prospectively enrolled in a randomized, split-face study. All patients enrolled were seen and evaluated in a private facial plastic and reconstructive surgery practice, and were operated on by a single surgeon in either an accredited ambulatory surgical center under deep, intravenous sedation or in a monitored office setting under light, oral sedation. Electro Lube was utilized to coat bipolar electrocautery arms for one side of the rhytidectomy procedure on each patient, letting the contralateral side serve as control. Total number of wipes to clean the cauterizing arms of the bipolar cautery per procedure was counted, and operative time, from skin incision to skin trimming, was measured. Total wipe count in the intervention group (n = 50) was 13 (0.26 wipes/procedure) versus 47 in the control group (n = 50) (0.94 wipes/procedure), a difference that was found to be statistically significant ( P = .0013). Average operative time in the intervention group was 27.52 minutes versus 28.35 minutes in the control group. This difference was also found to be statistically significant ( P = .043). The use of Electro Lube to coat bipolar electrocautery arms may have clinical utility to simplify and reduce intraoperative wiping and shorten operative time in rhytidectomy procedures and other cosmetic or reconstructive procedures where frequent use of bipolar electrocautery to maintain intraoperative hemostasis is crucial.