Randomised Controlled Clinical Trial of Scalpel Versus Diathermy for Abdominal Skin Incisions

Abstract

Since the early twentieth century, diathermy has been increasingly used for tissue dissection and haemostasis, but the surgeons, however, are reluctant to use surgical diathermy for making skin incisions. This reluctance is now being challenged by multiple studies suggesting diathermy to be a safer option. This was a randomised, clinical study conducted in the department of General and Gastrointestinal Surgery at Calcutta Medical Research Institute, Kolkata in 2017. The study was done to evaluate the diathermy as an effective alternative to scalpel blade in making skin incisions in elective abdominal surgeries. A total of 72 patients undergoing abdominal surgeries were included and randomly divided into diathermy and scalpel groups. Both groups were compared based on incisional blood loss, early postoperative pain, wound complication rates, and cosmetic outcome of scar by Patient-Observer Scar Assessment Scale. After exclusion, a total of 72 patients, 36 each from the two groups, were analysed based on the above mentioned parameters. We found that the incisional blood loss is significantly lesser in the diathermy group in comparison to that of the scalpel group (p < 0.001). Also, the early postoperative pain was significantly lesser in the diathermy group (p < 0.001). Postoperative wound complication rates were comparable between the two groups, and postoperative scar cosmesis is significantly better with the use of diathermy (p < 0.001). In our study, we found that the diathermy is an effective and safe alternative to the steel scalpel blade for making abdominal skin incisions in elective procedures.