{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:36:52Z","timestamp":1786988212495,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["NRF\u20102022R1F1A1076330"],"award-info":[{"award-number":["NRF\u20102022R1F1A1076330"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Donor\u2010site morbidity, particularly prolonged drainage and seroma formation, remains a persistent challenge in latissimus dorsi myocutaneous (LDMC) flap surgery. Although the Harmonic scalpel allows simultaneous cutting and coagulation and has demonstrated advantages in other surgical settings, its potential to mitigate drainage\u2010related morbidity during full\u2010muscle LDMC flap harvest has not been fully characterized. This study evaluated its impact on donor\u2010site outcomes in free LDMC flap reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed of patients who underwent free LDMC flap reconstruction for lower extremity defects (from 2015 to 2025). Patients were grouped by dissection method: Harmonic versus conventional electrocautery. Outcomes included total drain volume, mean daily drainage, drainage duration, and seroma. Group comparisons and multivariable regression were used to assess predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010nine patients were analyzed (Harmonic,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921; Conventional,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928). Flap elevation time was significantly shorter in the Harmonic group (74.8\u2009\u00b1\u200914.7 vs. 120.2\u2009\u00b1\u200932.8\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Seroma occurred in six patients (21.4%) in the Conventional group but in none in the Harmonic group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.075). Mean total drainage volume was lower with Harmonic dissection (437.3\u2009\u00b1\u2009242.0 vs. 610.7\u2009\u00b1\u2009379.7\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), whereas mean daily drainage was similar (57.2\u2009\u00b1\u200921.5 vs. 54.8\u2009\u00b1\u200929.1\u2009mL\/day,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.167). Drainage duration was significantly shorter in the Harmonic group (7.5\u2009\u00b1\u20092.4 vs. 10.9\u2009\u00b1\u20093.4\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). On multivariable analysis, flap size independently predicted total drainage volume (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.77, 95% CI 0.23\u20131.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and Harmonic use independently reduced drainage duration by 3.3\u2009days (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22123.32, 95% CI \u22125.54 to \u22121.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Harmonic dissection in free LDMC flap harvest shortened elevation time, reduced drainage duration, and eliminated seroma. These findings support its role in minimizing donor\u2010site morbidity and improving efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70246","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T04:26:23Z","timestamp":1779510383000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Ultrasonic Dissection on Donor\u2010Site Morbidity and Drainage in Latissimus Dorsi Free Flaps"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4612-6672","authenticated-orcid":false,"given":"Bo Young","family":"Park","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, School of Medicine Ewha Womans University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d0ab4d"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001077"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318216b65c"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103330"},{"key":"e_1_2_12_6_1","first-page":"125","article-title":"A Systematic Review and Meta\u2010Analysis of Harmonic Technology Compared With Conventional Techniques in Mastectomy and Breast\u2010Conserving Surgery With Lymphadenectomy for Breast Cancer","volume":"8","author":"Cheng H.","year":"2016","journal-title":"Breast Cancer (Dove Med Press)"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/397260"},{"key":"e_1_2_12_8_1","first-page":"1714","article-title":"Function\u2010Sparing Free Split Latissimus Dorsi Flap for Lower\u2010Extremity Reconstruction: Five\u2010Year Consecutive Single\u2010Surgeon Series","volume":"102","author":"Chim H.","year":"2020","journal-title":"Journal of Bone and Joint Surgery (American Volume)"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2012.05.006"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5434"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-016-0850-x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.03.032"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12498"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142271"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30831"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-023-02057-9"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2016.05.017"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.70001"},{"key":"e_1_2_12_19_1","first-page":"181","article-title":"Functional Morbidity Following Latissimus Dorsi Flap Breast Reconstruction","volume":"5","author":"Smith S. L.","year":"2014","journal-title":"Journal of the Advanced Practitioner in Oncology"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2007.03.019"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002545"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.25270\/wnds\/22055"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70246","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70246","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:21:23Z","timestamp":1786987283000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/micr.70246"],"URL":"https:\/\/doi.org\/10.1002\/micr.70246","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70246"}}