To compare the superiority of electrocautery over the traditional scalpel for skin incisions

Abstract

Background. This study was designed to assess whether electrocautery can be used for incising skin in various abdominal operations. To date, many trials have been conducted to this regard, but drew inconclusive. Methods. A prospective analysis of 60 patients was done. The age of the patients included in the trial ranged from age 15 to 60 years. The patients were randomized into two groups, namely “incision by scalpel” and “incision by electrocautery.” These populations were further subgrouped into those receiving Flank incisions, those receiving Kocher’s incisions, and those receiving Midline incisions. The parameters used to compare the two primary groups were pain (on the visual analog scale), blood loss from the incision, time taken to make the incision, incidence of postoperative wound infection, and finally the cosmetic appeal upon follow-up. Results. The results showed significantly less blood loss as well as less pain scores associated with electrocautery incisions over scalpel incisions. The electrocautery incisions also took less time to make. Although the time taken and the blood loss did not attain statistical significance in the Midline abdominal incisions, the results still favored use of electrocautery in midline as well as other incisions. Postoperatively, the rates of wound infection were comparable in both techniques (3 in scalpel and 2 in cautery incision.). The cosmetic appeal was superior in the incisions that employed use of electrocautery. Conclusions. The method of electrosurgical incision is seen to be an easily learned, safe, highly effective technique associated with lesser complications. Comparing the three incisions, less pain and less bleed was noted with use of electrocautery. Additionally, there was no incidence of postoperative hematomas, no delay in healing of wounds incised by diathermy and the aesthetic results obtained were superior with minimal scarring. The difference in the incidence of wound infections was not significant. We concluded that use of electrocautery is a suitable method of skin incision; especially when employed for Kocher’s abdominal incision and abdominal flank incisions, although its use in Midline abdominal incisions did not show significant superiority.