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A Comparative Study of Cutting Electrocautery Versus Scalpel for Surgical Incisions
Mahim Koshariya1, A K Ashish1, Sanjay Sisodiya1
1Department of General Surgery, Gandhi Medical College, Bhopal, Bhopal, IND.
Introduction:
The usage of scalpels for surgery started well before the Industrial Revolution, starting from crude instruments to precise and long-lasting instruments. The conventional teaching advocates the usage of scalpels over electrocautery in most teaching hospitals. This was based on a semantic school of thought that existed at that time, which was wary of burn injury to skin, hampered healing, or increased postoperative pain, rather than clinically driven conclusions. Usage of both these instruments is being studied extensively for placement of incisions. Materials and methods: This study was done in a prospective comparative observational manner among patients on whom an incision was placed with either a scalpel or cutting electrocautery. Patients undergoing surgery in our institution aged 18 to 65 years without any external factors hampering wound healing were included in this study. Patients outside the age group have been excluded. Surgical incisions were placed using a scalpel and cautery and data were recorded. Data were collected using a semi-open questionnaire and interviews and analysis was done using Excel (Microsoft, Redmond, WA, USA).
Results:
One hundred twenty-four patients were enrolled, with an average age of 43 years. Cautery was used on 60 patients and a scalpel on 64 patients. Blood loss was significantly higher in the scalpel group (p<0.01). Postoperative pain was measured by visual analogue scoring (VAS) system and it was found that the scalpel group had significantly higher VAS scores on postoperative days three, seven, and 30 (P<0.05). Speed of incision and postoperative wound complication were comparable in both groups. Outcomes of incisions were better with the use of cautery (p<0.05).
Conclusion:
Cutting electrocautery may serve as a viable alternative to the traditional scalpel. It is associated with reduced intraoperative blood loss, shorter operative times, and a postoperative course characterized by primary intention healing and a low complication profile.