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Pulsed Electron Avalanche Knife (PEAK) PlasmaBlade versus Traditional Electrocautery for Surgery: A Review of Clinical Effectiveness and Cost-Effectiveness

Last updated: August 9, 2019
Project Number: RC1162-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of Pulsed Electron Avalanche Knife (PEAK) PlasmaBlade soft tissue dissection device versus traditional electrocautery for surgery?
  2. What is the cost-effectiveness of PEAK PlasmaBlade soft tissue dissection device for surgery?

Key Message

Limited evidence suggested that surgery with PEAK PlasmaBlade (PPB) resulted in significantly better outcomes than traditional electrocautery (EC) as indicated by shorter time to wound healing, duration of post-operative hospital stay, pain-free swallowing, and length of time for which drains remained in place. Patient satisfaction was also significantly higher, whereas damage to device leads during generator replacement surgery, and thermal damage to tissues in the area of incision were substantially lower with PPB than EC. However, there were inconsistencies in evidence about the comparative effectiveness of two instruments concerning the length of procedure time, drainage volume, and post-operative infection rates, with some studies reporting significantly shorter times for PPB or EC, or not finding a significant difference between the two modalities. It was unclear if the inconsistencies might be due to the differences in processes involved in surgeries for the different indications. Limited evidence from one retrospective study suggested that the use of PPB for latissimus dorsi flap reconstruction resulted in a significantly lower incidence of seroma than using EC. However, one randomized controlled trial found no significant difference in the rates of seroma between PPB and EC among patients who underwent abdominoplasty. Overall, the evidence from the studies included in this report was limited and insufficient to determine the comparative clinical effectiveness PPB versus EC for surgery in general though it suggests that outcomes may differ depending on the type of surgery. Sources of uncertainty included low methodological quality that suggested a high potential risk of bias, and inconsistencies in evidence, with some studies reporting better results with PPB while others found better outcomes in favor of traditional EC, while others found no difference between the two modalities. No relevant evidence regarding the cost-effectiveness of PEAK PlasmaBlade for surgery was identified.