Efficacy of Electrocautery Skin Incision over Scalpel Incision - A Comparative Study

Background The anecdotal fear of using cautery for surgical incisions is still common in surgical practice despite recent evidences. The aim of this study is to compare the results of electrocautery and the scalpel in skin incisions. Materials and Methods This is a prospective randomized double blind study conducted in the Department of Surgery, of JSS Hospital, Mysuru. Patients were randomized to have either scalpel or electrocautery incisions. 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 were also noted. Results There were 193 patients consisting of the scalpel group (n = 100) and the electrocautery group (n = 93). The ages ranged from 16 to 73 years. The demography, case distribution and body mass index were similar in both groups. The mode of presentation was predominantly elective. The incision time was shorter in the electrocautery group. The blood loss was less with the diathermy compared to the scalpel. Postoperative pain is more in scalpel incision as compared to cautery. There was no statistically significant difference in wound infection and wound closure (epithelialization time) (P = 0.237). Conclusion - The method of electrosurgical incision can be easily learned, safe, highly effective technique associated with lesser complications. Comparatively less pain and less bleeding were noted with use of electrocautery and no delay in healing of wounds incised by diathermy was noted with good acceptable scar. Concluding that use of electrocautery is a suitable method of skin incision