Comparison of cutting diathermy with cold scalpel incision in midline abdomen surgery

Abstract

Introduction: The role of electrosurgery has gradually evolved over the last century. Widespread concerns regarding application of electrosurgery remain with regard to wound infection and pain due to thermal burns continue to persist in surgical circles. Such concerns have been proven baseless in studies conducted around the world, which have come in support of using electrocautery in view of better outcomes related to hemostasis and pain and equivocal outcomes in terms of wound infection risk. We sought in this study to establish the validity of these results in the setting of a government teaching hospital. Objectives: To analyze and compare the midline laparotomy incision made using cutting diathermy and cold scalpel with respect to post-operative pain and wound infection rates. Methods: A prospective study comprising of patients undergoing midline laparotomy in the General Surgery Department chosen by purposive sampling were divided into 2 groups of 50 each depending on whether they underwent skin incision by diathermy or cold scalpel. They were observed daily for ten days in the post-operative period. Results: Patients who underwent cautery incision had lower mean NRS value of 5.64 ±2.22 as compared to those who underwent cold scalpel incision with a higher mean NRS of 6.18 ± 2.18. There was an incidence of 30% purulent infections in scalpel incisions compared to 14% of cautery incisions. These differences were not statistically significant. Conclusion: There is no contraindication for the use of cutting cautery in midline laparotomy.