Randomized Clinical Trial
Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy
Article first published online: 6 DEC 2002
© 2001 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 88, Issue 1, pages 41–44, January 2001
How to Cite
Kearns, S. R., Connolly, E. M., McNally, S., McNamara, D. A. and Deasy, J. (2001), Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. Br J Surg, 88: 41–44. doi: 10.1046/j.1365-2168.2001.01625.x
- Issue published online: 6 DEC 2002
- Article first published online: 6 DEC 2002
- Manuscript Accepted: 12 JUL 2000
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.
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.
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.
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