Clinical Outcomes Following Diathermy Versus Scalpel Intraoral Incisions in Mandibular Fracture Surgery: A Randomized...

Mandibular fracture surgery requires intraoral incisions, and the choice between scalpel and diathermy may affect operative efficiency, blood loss, pain, and healing. Aim To compare and evaluate the outcome of intraoral incisions with the use of diathermy and a scalpel in the treatment of mandibular fractures. Settings and design Prospective randomized comparative study conducted at a single tertiary care center. Methodology Thirty patients with mandibular fractures were enrolled and randomized into two groups (15 per group). Group A underwent incision with a scalpel, and Group B underwent incision with diathermy. Incision time, blood loss, total operating time, postoperative pain, and wound healing were evaluated at 24 hours and on postoperative days three, seven, and 10. Statistical analysis Data were analyzed using SPSS version 21.0 (IBM Corp., Armonk, USA). Normality of continuous variables (age, incision time, blood loss, total operating time, postoperative pain scores, and wound healing scores) was assessed using the Shapiro-Wilk test; normally distributed variables were compared using an unpaired t-test and non-normally distributed variables using the Mann-Whitney U test. Categorical variables were compared using the chi-square or Fisher's exact test, as appropriate. A p value < 0.05 was considered statistically significant. Sample size was based on convenience sampling without a priori power calculation. Results Thirty patients with mandibular fractures were enrolled and randomized into two groups. The mean age was 25.87 ± 10.63 years in the scalpel group and 26.80 ± 8.00 years in the diathermy group, with no significant difference between groups. Male patients comprised 14/15 (93.3%) in each group. The mean incision time was 239.5 ± 37.95 seconds in the diathermy group and 248.0 ± 32.72 seconds in the scalpel group. Mean blood loss was 6.2 ± 5.88 mL and 8.5 ± 6.4 mL, respectively. Total operating time was 94.47 ± 37.35 minutes in the diathermy group and 80.47 ± 30.33 minutes in the scalpel group. Postoperative pain was significantly higher with diathermy at the early follow-up visits, whereas wound healing outcomes were comparable in both groups at all time points. Conclusions In mandibular fracture surgery, diathermy may modestly reduce incision-related bleeding and time, though this study was underpowered to confirm these trends; scalpel incisions were associated with significantly less early postoperative pain, with comparable wound healing outcomes between techniques. Larger, adequately powered trials are needed to confirm the hemostatic and efficiency trends observed.