■ The skin flap is best dissected by pulling it upward with two four's pronged retractors. During this procedure the assistant should ensure that the retractors are pulled forward gently. At the same time the assistant can carry out hemostasis with bipolar tweezers. As a result of the tumescence infiltration, the surgical area is clearly visible and not covered with blood. This enables dissection from the fascia of the upper arm to be carried out quickly. The surgeon can do this with either scissors or a scalpel.
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