{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:46:27Z","timestamp":1791963987449,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reduction mammoplasty for symptomatic macromastia provides meaningful relief from musculoskeletal pain, postural strain, and functional limitations. A critical step in the procedure is pedicle de\u2010epithelialization, traditionally performed using a scalpel. Although effective, scalpel de\u2010epithelialization can be time\u2010intensive, prompting evaluation of alternative techniques such as monopolar electrocautery. Other sharp techniques include curved\u2010scissor de\u2010epithelialization, en bloc removal, and pedicle deskinning. Monopolar techniques utilize either a conventional blade electrode or a Colorado needle tip. This study compares surgical outcomes between scalpel and monopolar electrocautery de\u2010epithelialization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective, intra\u2010patient comparative study was conducted at the Department of Surgery, Alexandria Faculty of Medicine, between October 2023 and April 2025. Patients with symptomatic macromastia undergoing bilateral reduction mammoplasty received scalpel de\u2010epithelialization on the right breast and monopolar electrocautery on the left. Follow\u2010up assessments occurred at 1\u00a0week, 2\u00a0weeks, 1\u00a0month, and monthly thereafter for up to 12\u00a0months. The primary outcome was de\u2010epithelialization time. Secondary outcomes were intraoperative blood loss and pain both postoperatively and at 6\u00a0months. Statistical analyses included paired\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, Wilcoxon signed\u2010rank tests, and McNemar's tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty patients undergoing bilateral reduction mammoplasty were included. Monopolar electrocautery demonstrated a significantly shorter mean de\u2010epithelialization time compared to the scalpel (5.07\u00a0\u00b1\u00a00.88\u00a0minutes vs. 10.87\u00a0\u00b1\u00a01.93\u00a0minutes;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Intraoperative blood loss was also significantly lower with monopolar electrocautery (139.1\u00a0\u00b1\u00a020.64\u00a0mL vs. 176.7\u00a0\u00b1\u00a016.06\u00a0mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). At 6\u00a0months, BREAST\u2010Q breast pain scores were modestly lower with the monopolar technique (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.046). Rates of postoperative complications and patient satisfaction were comparable between techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Monopolar electrocautery significantly reduced de\u2010epithelialization time, the primary outcome of this study. It was also associated with lower intraoperative blood loss. Although modestly lower breast pain scores were observed at 6\u00a0months, the difference was small, and its clinical importance remains uncertain. The study was not powered to evaluate postoperative complication rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70574","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:15:08Z","timestamp":1789539308000},"page":"2809-2816","source":"Crossref","is-referenced-by-count":0,"title":["De\u2010Epithelialization Using Scalpel Versus Monopolar Electrocautery Cutting in Reduction Mammoplasty: A Prospective Comparative Study"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3626-1331","authenticated-orcid":false,"given":"Khaled E.","family":"Barakat","sequence":"first","affiliation":[{"name":"Surgical Oncology Unit Surgery Department Faculty of Medicine Alexandria University  Alexandria Egypt"},{"name":"New Borg Al Arab Hospital Directorate of Health Affairs in Alexandria Ministry of Health and Population  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed F.","family":"Asal","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Surgery Department Faculty of Medicine Alexandria University  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Abdelkader","sequence":"additional","affiliation":[{"name":"Surgical Oncology Unit Surgery Department Faculty of Medicine Alexandria University  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa K.","family":"Abuhasan","sequence":"additional","affiliation":[{"name":"Medical Education Department Faculty of Medicine Alexandria University  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7388-0688","authenticated-orcid":false,"given":"Anas","family":"Bakdalieh","sequence":"additional","affiliation":[{"name":"College of Medicine Northeast Ohio Medical University  Rootstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annaliisa","family":"Cordova","sequence":"additional","affiliation":[{"name":"College of Medicine Northeast Ohio Medical University  Rootstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Nusair","sequence":"additional","affiliation":[{"name":"College of Medicine Northeast Ohio Medical University  Rootstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Adham R.","family":"Elsayed","sequence":"additional","affiliation":[{"name":"College of Medicine Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Surgery Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Biomedical Sciences Northeast Ohio Medical University  Rootstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-2789","authenticated-orcid":false,"given":"Marc D.","family":"Basson","sequence":"additional","affiliation":[{"name":"College of Medicine Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Surgery Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Biomedical Sciences Northeast Ohio Medical University  Rootstown Ohio 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