This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. BJS 2001; 88: 41-44.
Published: 6th December 2002
Authors: S. R. Kearns, E. M. Connolly, S. McNally, D. A. McNamara, J. Deasy
Background
Electrocautery is used increasingly for tissue dissection, although fears of excessive scarring and poor wound healing have curtailed its widespread use for skin incision. This study compared electrosurgical incision with traditional scalpel incision.
Method
One hundred patients requiring elective midline laparotomy were randomized prospectively to either scalpel or diathermy incision. Parameters measured included incision time, wound size, wound blood loss, total intraoperative blood loss and postoperative wound pain. All wound complications were recorded.
Results
The two groups did not differ significantly in relation to patient or wound characteristics. Laparotomy incisions using diathermy were significantly quicker than scalpel incisions (mean(s.e.m.) 6·1(0·4) versus 7·5(0·5) s/cm2; P < 0·04). There was significantly less blood loss in the diathermy group compared with the scalpel group (0·8(0·1) versus 1·7(0·3) ml/cm2; P = 0·002). Postoperative pain scores were significantly lower in the diathermy group for the first 48 h after operation (P < 0·05). Morphine requirements were also significantly lower over the first 5 postoperative days in the diathermy incision group (P < 0·04). There was no difference between groups in wound complications before discharge and at the 1‐month follow‐up.
Conclusion
Electrosurgical midline incision in elective surgery has significant advantages over scalpel use on the basis of incision time, blood loss, early postoperative pain and analgesia requirements. © 2001 British Journal of Surgery Society Ltd
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