World Journal of Surgery

, Volume 33, Issue 8, pp 1594–1599 | Cite as

Diathermy vs. Scalpel Skin Incisions in General Surgery: Double-Blind, Randomized, Clinical Trial

Article

Abstract

Objective

This prospective, double-blind, randomized, controlled trial was designed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery.

Methods

A total of 369 patients who underwent diathermy incision (group A: 185 patients) or scalpel incision (group B: 184 patients) were analyzed. Variables analyzed were: surgical wound classification, length and depth of incision, incision time, duration of operation, incisional blood loss, postoperative pain, duration of hospital stay, duration of healing, and postoperative complications. The inclusion criteria were all patients who underwent elective or emergency general surgery. The exclusion criteria were only cases with incomplete patients’ data and patients who were lost to follow-up. This study was conducted at Fatima Hospital-Baqai Medical University and Shamsi Hospital (Karachi), from January 2006 to December 2007.

Results

Incision time was significantly longer for patients in group B (p = 0.001). Incisional blood loss also was more for patients in group B (p = 0.000). Pain perception was found to be markedly reduced during the first 48 h in group A (p = 0.000). Total period of hospital stay (p = 0.129) and time for complete wound healing (p = 0.683) were almost the same for both groups. Postoperative complication rate by wound classification did not differ markedly between the two groups (p = 0.002 vs. p = 0.000).

Conclusions

Diathermy incision has significant advantages compared with the scalpel because of reduced incision time, less blood loss, & reduced early postoperative pain.

References

  1. 1.
    Johnson CD, Serpell JW (1990) Wound infection after abdominal incision with scalpel or diathermy. Br J Surg 77:626–627PubMedCrossRefGoogle Scholar
  2. 2.
    Ji GW, Wu YZ, Wang X, Pan HX, Li P, Du WY, Qi Z, Huang A, Zhang LW, Zhang L, Chen W, Liu GH, Xu H, Li Q, Yuan AH, He XP, Mei GH (2006) Experimental and clinical study of influence of high-frequency electric surgical knives on healing of abdominal incision. World J Gastroenterol 12:4082–4085PubMedGoogle Scholar
  3. 3.
    Dixon AR, Watkin DF (1990) Electrosurgical skin incision versus conventional scalpel: a prospective trial. J R Coll Surg Edinb 35:299–301PubMedGoogle Scholar
  4. 4.
    Sebben JE (1988) Electrosurgery principles: cutting current and cutaneous surgery–part I. J Dermatol Surg Oncol 14:29–31PubMedGoogle Scholar
  5. 5.
    Chrysos E, Athanasakis E, Antonakakis S, Xynos E, Zoras O (2005) A prospective study comparing diathermy and scalpel incisions in tension-free inguinal hernioplasty. Am Surg 71:326–329PubMedGoogle Scholar
  6. 6.
    Kearns SR, Connolly EM, McNally S, McNamara DA, Deasy J (2001) Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. Br J Surg 88:41–44PubMedCrossRefGoogle Scholar
  7. 7.
    Miller E, Paull DE, Morrissey K, Cortese A, Nowak E (1988) Scalpel versus electrocautery in modified radical mastectomy. Am Surg 54:284–286PubMedGoogle Scholar
  8. 8.
    Ozgun H, Tuncyurek P, Boylu S, Erpek H, Yenisey C, Kose H, Culhaci N (2007) The right method for midline laparotomy: what is the best choice for wound healing? Acta Chir Belg 107:682–686PubMedGoogle Scholar
  9. 9.
    Garcia A, Nascimento JE, Darold EM, Pimentel RE, Curvo EA, Daud FO (2007) Healing of abdominal wall aponeurosis of rats after incision with either cold scalpel or electrocautery. Acta Cir Bras 22(Suppl 1):12–15PubMedGoogle Scholar
  10. 10.
    Duxbury MS, Blake SM, Dashfield A, Lambert AW (2003) A randomised trial of knife versus diathermy in pilonidal disease. Ann R Coll Surg Engl 85:405–407PubMedCrossRefGoogle Scholar
  11. 11.
    Sheikh B (2004) Safety and efficacy of electrocautery scalpel utilization for skin opening in neurosurgery. Br J Neurosurg 18:268–272PubMedCrossRefGoogle Scholar
  12. 12.
    Pearlman NW, Stiegmann GV, Vance V, Norton LW, Bell RC, Staerkel R, Van-Way CW, Bartle EJ (1991) A prospective study of incisional time, blood loss, pain, and healing with carbon dioxide laser, scalpel, and electrosurgery. Arch Surg 126:1018–1020PubMedGoogle Scholar
  13. 13.
    Stolz AJ, Schutzner J, Lischke R, Simonek J, Pafko P (2004) Is a scalpel required to perform a thoracotomy? Rozhl Chir 83:185–188PubMedGoogle Scholar
  14. 14.
    Franchi M, Ghezzi F, Benedetti-Panici PL, Melpignano M, Fallo L, Tateo S, Maggi R, Scambia G, Mangili G, Buttarelli M (2001) A multicentre collaborative study on the use of cold scalpel and electrocautery for midline abdominal incision. Am J Surg 181:128–132PubMedCrossRefGoogle Scholar
  15. 15.
    Groot G, Chappell EW (1994) Electrocautery used to create incisions does not increase wound infection rates. Am J Surg 167:601–603PubMedCrossRefGoogle Scholar
  16. 16.
    Peterson A (1982) The use of electrosurgery in reconstructive and cosmetic maxillofacial surgery. Dent Clin North Am 26:799–823PubMedGoogle Scholar
  17. 17.
    Kaspar TA, Wagner RF Jr (1991) Percutaneous injury during dermatologic surgery. J Am Acad Dermatol 24:756–759PubMedCrossRefGoogle Scholar
  18. 18.
    Ippolito G, Italiano-Rischio O (1996) Scalpel injury and HIV infection in a surgeon. Lancet 347(9007):1042PubMedCrossRefGoogle Scholar
  19. 19.
    Tapias L, Tapias-Vargas LF, Tapias-Vargas L (2008) Primary cutaneous inoculation tuberculosis in a healthcare worker as a result of a surgical accident. Int J Dermatol 47:833–835PubMedCrossRefGoogle Scholar
  20. 20.
    Tsude K, Fujiyama S, Sato S, Kawano S, Taura Y, Yoshida K, Sato T (1992) Two cases of accidental transmission of hepatitis C to medical staff. Hepatogastroenterology 39:73–75PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  1. 1.Department of SurgeryFatima Hospital and Baqai Medical UniversityKarachiPakistan

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