Comparison of Electrocautery and Scalpel Incision in Midline Abdominal Surgery
Article Sidebar
Main Article Content
Abstract
Background: With the advancement of surgical techniques, the comparison of electrocautery and scalpel incisions in midline abdominal surgeries has become an essential area of study. Traditional scalpel incisions have been known for their precision but carry risks of excessive blood loss and sharp injuries. Electrocautery, offering a potentially safer and more efficient alternative, has been gaining attention in surgical practices.
Objective: The primary objective of this study was to compare the effectiveness, safety, and outcomes of electrocautery versus scalpel incisions in midline abdominal surgeries, with a focus on incision time, blood loss, wound infection, and postoperative pain.
Methods: A randomized controlled trial was conducted at the Military Hospital, Rawalpindi, over 12 months from June 2021 to June 2022. A total of 150 patients, split evenly into electrocautery and scalpel groups, were evaluated. Patients aged 20-75 years, undergoing midline abdominal surgery, were included. The main parameters measured were incision time, blood loss, wound infection, and postoperative pain. Data were analyzed using SPSS version 25.0, employing independent samples t-tests and chi-square tests.
Results: The electrocautery group exhibited a significantly shorter incision time (13.73 ± 2.45 seconds) compared to the scalpel group (18.67 ± 3.02 seconds, p < 0.001). Blood loss was also lower in the electrocautery group (11.47 ± 2.49 ml) than in the scalpel group (27.27 ± 4.13 ml, p < 0.001). Wound infection rates were 6.7% for electrocautery and 13.3% for scalpel, though this was not statistically significant (p = 0.174). Remarkably, 100% of the electrocautery group reported postoperative pain, in contrast to none in the scalpel group (p = 0.000).
Conclusion: The study concluded that electrocautery is more effective than scalpel incision in terms of incision time and blood loss, making it a preferable method for midline abdominal surgeries. However, the higher incidence of postoperative pain in the electrocautery group warrants further investigation.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Hempel S, Kalauch A, Oehme F, Wolk S, Welsch T, Weitz J, et al. Wound complications after primary and repeated midline, transverse and modified Makuuchi incision: A single-center experience in 696 patients. Medicine. 2021;100(20):e25989.
Heger P, Pianka F, Diener MK, Mihaljevic AL. [Current standards of abdominal wall closure techniques : Conventional suture techniques]. Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen. 2016;87(9):737-43.
Mizell JS. Complications of abdominal surgical incisions. Up To Date Accessed on. 2016;31.
Zabaglo M, Sharman T. Postoperative Wound Infection. StatPearls. Treasure Island (FL): StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.; 2022.
Azoury S, Farrow N, Hu Q, Soares K, Hicks C, Azar F, et al. Postoperative abdominal wound infection-epidemiology, risk factors, identification, and management. Chron Wound Care Manage Res. 2015;2:137-48.
Yadav A, Agarwal L, Jain SA, Kumawat S, Sharma S. Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study. International Surgery Journal. 2021;8(5):1507-11.
Kalawar RS, Khanal G, Chaudhary P, Rijal R, Maharjan R, Paneru S, et al. Comparative study of safety and efficacy of electrocautery blade with cold scalpel blade for skin opening during fixation of fracture of forearm bone with plate and screws. Health Renaissance. 2015;13(2):43-9.
Prakash LD, Balaji N, Kumar SS, Kate V. Comparison of electrocautery incision with scalpel incision in midline abdominal surgery - A double blind randomized controlled trial. International journal of surgery (London, England). 2015;19:78-82.
Prakash LD, Balaji N, Kumar SS, Kate V. Comparison of electrocautery incision with scalpel incision in midline abdominal surgery–a double blind randomized controlled trial. International Journal of Surgery. 2015;19:78-82.
Sharma N, Chauhan A, Sharma V, Gupta A, Pathania S. Harmonic scalpel, the tool for new age laparoscopic cholecystectomy. International Surgery Journal. 2018;5(6):2327-30.
Shih J, Jeschke MG. Electrical Burn Injuries. In: Jeschke MG, Kamolz L-P, Sjöberg F, Wolf SE, editors. Handbook of Burns Volume 1: Acute Burn Care. Cham: Springer International Publishing; 2020. p. 505-10.
Shahmoradi MK, Mehri J, Taheri HR. Comparison of hemorrhoidectomy using harmonic scalpel and electrocautery: A randomized controlled trial. International Journal of Surgery Open. 2020;27:39-42.
Zimrin AB, Bai Y, Holcomb JB, Hess JR. 40 - Hemorrhage Control and Thrombosis Following Severe Injury. In: Kitchens CS, Kessler CM, Konkle BA, Streiff MB, Garcia DA, editors. Consultative Hemostasis and Thrombosis (Fourth Edition). Philadelphia: Elsevier; 2019. p. 811-8.
Vahabi S, Veiskarami P, Roozbahani M, Lashani S, Farzan B. Cross-sectional study on hearing loss and auditory reaction time before and after spinal anesthesia with marcaine 0.5% in patients undergoing elective surgery. Annals of Medicine and Surgery. 2020;60:236-40.
Vahabi S, Karimi A, Beiranvand S, Moradkhani M, Hassanvand K. Comparison of the effect of different dosages of celecoxib on reducing pain after cystocele and rectocele repair surgery. The Open Anesthesia Journal. 2020;14(1).
Ismail A, Abushouk AI, Elmaraezy A, Menshawy A, Menshawy E, Ismail M, et al. Cutting electrocautery versus scalpel for surgical incisions: a systematic review and meta-analysis. Journal of Surgical Research. 2017;220:147-63.
Sinha UK, Gallagher LA. Effects of steel scalpel, ultrasonic scalpel, CO2 laser, and monopolar and bipolar electrosurgery on wound healing in guinea pig oral mucosa. The Laryngoscope. 2003;113(2):228-36.
Kearns S, Connolly E, McNally S, McNamara D, Deasy J. Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. British journal of surgery. 2001;88(1):41-4.
Zarei F, Shahmoradi MK. Scalpel versus electrocautery for herniorrhaphy incision: a randomized controlled trail. International Journal of Surgery Open. 2021;28:33-6.
Gupta S, Mehta A, Gupta V. A comparative study between electrocautery and steel scalpel in making abdominal wall incision in caesarean section. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(6):2328- 31.
V. RK, S. M, Mathad S. Outcome of skin incision by cautery versus steel scalpel in hernia surgery: a prospective cohort study at a tertiary medical college hospital in South India. Int Surg J. 2017;4(5):4.
Charoenkwan K, Iheozor‐Ejiofor Z, Rerkasem K, Matovinovic E. Scalpel versus electrosurgery for major abdominal incisions. Cochrane Database of Systematic Reviews. 2017(6).