Comparison Of Midline Abdominal Surgery Using Scalpel Versus Electrocautery Incision in Rural Indian Population

Authors

  • Dr. Mohammed Raziya Sultana Begum  Junior Resident General Surgery, Great Eastern Medical School and Hospital, Srikakulam, India
  • Dr. Punnana Swathi  Junior Resident General Surgery, Great Eastern Medical School and Hospital, Srikakulam, India
  • Dr. Kanna Chandra Varma  Junior Resident General Surgery, Great Eastern Medical School and Hospital, Srikakulam, India
  • Dr. Didla Satya Rajakumari  Junior Resident General Surgery, Great Eastern Medical School and Hospital, Srikakulam, India
  • Dr. Rapaka Ashok Reddy  Head of Department of General Surgery, Great Eastern Medical School and Hospital, Srikakulam, India

DOI:

https://doi.org/10.32628/IJSRST229698

Keywords:

Midline Abdominal Surgery, Scalpel, Electrocautery, Incision

Abstract

The scalpel was considered a gold standard for making skin incisions until the inception of diathermy. Nowadays, electrodes used in making diathermy incisions generate a pure sinusoidal current which produces cleavage in the tissue planes without creating damage to surrounding areas, thus leading to minimal burn-related wound complications.4 Hence, this study was carried out to determine whether electrocautery is safe and effective for making skin incisions as compared to a scalpel for midline abdominal surgery. OBJECTIVE: The object of the study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection. The objective was to determine whether electrocautery is safe and effective for making skin incisions as compared to a scalpel for midline abdominal surgery. Methodology: Patients scheduled for midline abdominal surgeries and willing to participate in the study were randomized into two groups- group A (electrocautery group) and group B (scalpel group). Results: In this study, 52 patients were included and divided into two groups, of which 26 were in group A and 26 were in group B. Intraoperative blood loss and incision time are less while using electrocautery as compared to a scalpel. In terms of postoperative pain and wound complications, there was no discernible variance between the two groups. Conclusion: The use of electrocautery for making skin incisions in midline abdominal surgery was associated with less intraoperative blood loss and less incision time as compared to a scalpel. There was no variance in postoperative pain and wound complications between the two groups. With the above advantages of electrocautery, we conclude that electrocautery is a safe and effective alternative to a scalpel in making skin incisions in midline laparotomy.

References

  1. Centres for disease control and prevention, workbook for designing, implementing, and evaluating a sharps injury prevention program, 2010.
  2. Perry J, Parker G, Jagger J. Percutaneous injury rates. Adv expos prevent. 2005;7:42-5.
  3. Mumtaz S, Rehman M, Muzaffar M, Hassam M, Iqbal W. Frequency of seropositive blood donors for hepatitis B, C and HIV viruses in railway hospital, Rawalpindi. Pak J Med Res. 2001;41:51-3.
  4. Ayandipo OO, Afuwape OO, Irabor D, Oluwatosin OM, Odigie V. Diathermy versus scalpel incision in a heterogenous cohort of general surgery patients in a Nigerian teaching hospital. Niger J Surg. 2015;21;43-7.
  5. Siraj A, Farooqdar M, Gilani AAS, Raziq S. A study on comparison of diathermy and scalpel incisions in elective midline laparotomy. Prof Med J. 2011;18:106-11.
  6. Allan SN, Spitz L, Noort R, Black MM. A comparative study of scalpel and electrosurgical incision on subsequent wound healing, J Pediatr Surg. 1982;17:52-4.
  7. Aird LN, Brown CJ. Systematic review and meta analysis of electrocautery versus scalpel for surgical skin incisions. Am J Surg. 2012; 204:216-21.
  8. Sowa DE, Masterson BJ, Nealon N, Fraunhofer JA. Effects of thermal knives on wound healing. Obstet Gynecol. 1985;66:436-9.
  9. Johnson MA, Gadacz TR, Pfeifer ER. Comparison of CO2 laser, electrocautery and scalpel incisions on acute phase reactants in rat skin. Am Surg. 1997;63:13-6.
  10. 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. Laryngoscope. 2003;113:228-36.
  11. Ozgiin H, Tuncyurek P, Boylu S. The right method for midline laparotomy: what is the best choice for wound healing? Acta Chir Belg. 2007;107:682-6.
  12. Franchi M, Ghezzi F, Panici PL. Multicentre collaborative study on the use of cold scalpel and electrocautery for midline abdominal incisions. Am J Surg. 2001;181:128-32.
  13. Papay FA, Stein J, Luciano M, Zins JE. The microdissection cautery needle versus the cold scalpel in bicoronal incisions. J Craniofac Surg. 1998;9:344-7.
  14. Ozdogan M, Yilmaz KB, Ozaslan C. Scalpel versus electrocautery dissections: the effect on wound complications and pro-inflammatory cytokine levels in wound fluid. Turk J Med Sci. 2008;38:111-6.
  15. Chrysos E, Athanasakis E, Antonakakis S. A prospective study comparing diathermy and scalpel incisions in tension-free inguinal hernioplasty. Am Surg. 2005;71:326-9.
  16. Johnson CD, Serpell JW. Wound infection after abdominal incision with scalpel or diathermy. Br J Surg. 1990;77:626-7.
  17. Kearns SR, Connolly EM, McNally S. Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. Br J Surg. 2001;88:41-4.
  18. Rappaport WD, Hunter GC, Allen R. Effect of electrocautery on wound healing in midline laparotomy incisions. Am J Surg. 1990;160:618-20.
  19. Kumagai SG, Rosales RF, Hunter GC. Effects of electrocautery on midline laparotomy wound infection. Am J Surg. 1991;162:620-3.
  20. Shafighi M, Huemer GM, Meirer R, Katzer HP. Comparison of epigastric skin flap survival in sharp versus electrocautery dissection in a rat model. Plast Reconstr Surg. 2003;112:1503-4.
  21. Soballe PW, Nimbkar NV, Hayward I. Electric cautery lowers the contamination threshold for infection of laparotomies, Am J Surg. 1998;175:263-6.

International Journal of Scientific Research in Science and Technology

Downloads

Published

2023-01-05

Issue

Volume 10, Issue 1, January-February-2023

Section

Research Articles

License

Copyright (c) IJSRST

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

[1]
Dr. Mohammed Raziya Sultana Begum, Dr. Punnana Swathi, Dr. Kanna Chandra Varma, Dr. Didla Satya Rajakumari, Dr. Rapaka Ashok Reddy "Comparison Of Midline Abdominal Surgery Using Scalpel Versus Electrocautery Incision in Rural Indian Population" International Journal of Scientific Research in Science and Technology(IJSRST), Online ISSN : 2395-602X, Print ISSN : 2395-6011,Volume 10, Issue 1, pp.18-21, January-February-2023. Available at doi : https://doi.org/10.32628/IJSRST229698