Comparative Evaluation of Wound Outcome between Electrocautery and Scalpel Incision

Evaluation of Wound Outcome between Electrocautery and Scalpel Incision

  • Shri Krishna Ranjan Associate Professor, Department of Surgery, Anugrah Narayan Magadh Medical College and Hospital,Gaya
  • Santosh Kumar Assisstant Professor, Department of Surgery, Anugrah Narayan Magadh Medical College and Hospital, Gaya
Keywords: Surgical incision, Scalpel, Cutting electrocautery, Inguinalhernioplasty

Abstract

Background: The  use  of  cutting  electrocautery  instead  of  scalpel  for  skin  incision  is  still  suboptimal  worldwide. There  are many  studies which  include  its  use  in  general  surgical  operations  but without  use  of  prothetic material.Aim:The objective  of this study was to evaluate whether the  application of extreme heat by cutting electrocautery may result in significant postoperative pain and poor wound healing  with  increased  risk  of  wound  infection  in  presence  of  underlying  prosthetic  material  and  poor  cosmesis because  of  excessive  tissue  damage  and  scarring  respectively  as  per  previous  hypothesis  or  it’s  safe  and  effective instead.Subjects and Methods:A total of 196 Patients were allocated consecutively to either electrocautery (n=98) or scalpel (n=98) groups. The duration used in making the skin incision; the incisional blood loss and the  ensuing  length  and  depth  of  the  wound  were  noted.  Postoperative pain; duration of  wound  healing  and  the occurrence of surgical site infection and cosmetic outcome were also noted.Results:The ages ranged from 16 to 73 years. The demography, case distribution and body mass index were similar in both groups.  The incision time was shorter in the electrocautery group (P <0.001). The blood loss was less with the electrocautery compared to the scalpel (6.53±3.84 ml vs. 18.16±7.36 ml, P<0.001). The cumulative numerical rating scale score for pain was 12.65 (standard deviation SD 8.06) and 17.12 (SD 9.49) in the diathermy and scalpel groups respectively (P<0.001).  There  was  no  statistically  significant  difference  in  wound  infection  and  wound  closure (epithelialization time) (P=0.206).Conclusion: The  use  of  cutting  electrocautery  in making  skin  incision  during  inguinal  hernioplasty  is  as  safe  as scalpel  in  terms of wound healing and cosmesis and  is also associated with  reduced  incision  time,  incisional blood loss, and postoperative pain.

Published
2019-12-16
Section
Articles