A comparative study of scalpel and surgical diathermy incision in elective operations of head and neck cancer

Kumar, Vikas; Tewari, Mallika; Shukla, H. S.

doi:10.4103/0019-509x.82904

Cited by 29 publications

(12 citation statements)

References 19 publications

(19 reference statements)

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“…The majority of the reports have focused on differences in incision time, blood loss, postsurgical pain, and wound complications as a function of different incision methods. 5 – 7 The few reports that describe the cosmetic appearances of surgical wounds made with electrosurgical devices versus those made with CSS either did not involve full-thickness cutaneous incisions with both devices, 8 included assessment of scar appearance by the operating surgeon and not by a blinded observer(s) or patients, 9 or evaluated a relatively small number of subjects. 10…”

Section: Discussionmentioning

confidence: 99%

Advanced Cutting Effect System versus Cold Steel Scalpel

Lee¹,

Marks

Smith³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Background:Use of electrosurgery for skin incisions has been controversial due to concerns of delayed healing, excessive scarring, and increased infection. Recent studies using modern electrosurgical generators that produce pure sinusoidal “CUT” waveforms have shown reductions in thermal damage along incisions made with these devices compared with their predecessors. This study compares scar formation in incisions made using a cold steel scalpel (CSS) or the ACE Blade and Mega Power Generator (ACE system, Megadyne Medical Products, Draper, Utah) from patient and blinded observer perspectives.Methods:Subjects seeking plastic surgery were enrolled in the study. Incisions on one side of each subject’s body were made with a CSS while equivalent incisions on the contralateral side were made with the ACE system. Differences between incision methods were evaluated by assessment of scar formation by observers and assessment of patient satisfaction relating to scar formation at 120 days postsurgery.Results:Observers rated incision vascularization, pigmentation, thickness, and relief. The mean observer score (± SD) of incisions made with the ACE system was 11.1 ± 4.4 while that of incisions made with the CSS was 10.8 ± 3.7 (P < 0.0001). Patients rated incision pain, itching, discoloration, stiffness, thickness, and irregularity. The mean patient score of incisions made with the ACE system was 9.4 ± 9.2 while that of incisions made with the CSS was 9.3 ± 8.5 (P < 0.0001).Conclusions:Results showed noninferior wound healing/scar formation in skin incisions made with the ACE system compared with incisions made with a CSS.

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Section: Discussionmentioning

confidence: 99%

Advanced Cutting Effect System versus Cold Steel Scalpel

Lee¹,

Marks

Smith³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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“…Chau et al [17], in another study of 19 patients undergoing neck incisions, found no difference in subjective or objective cosmetic outcome, or in patient satisfaction scores between cutting diathermy and scalpel group after 6 months. A further recent retrospective study by Kumar et al [18] investigated the cosmetic outcome of diathermy versus scalpel skin incision in head and neck surgery; no difference in cosmetic outcome between the two groups was found after 1 month.…”

Section: Fig 1 Boxplots Of Sbses By Incision Mode X-axis Showing Mode Of Incision and Y-axis Showing Stony Brooke Evaluation Scale (Sbsesmentioning

confidence: 97%

Comparison of the Outcome of Diathermy Versus Scalpel Skin Incision in Surgical Cases

Pattnaik¹,

Prasad²,

Dey

et al. 2017

Indian J Surg

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The objective of this study was to compare the outcome of cutting diathermy incisions versus surgical scalpel incisions in three different sites of elective surgery. This study was a prospective observational study conducted at a tertiary care teaching hospital in Pune, India, over a period of 2 years from June 2014 to June 2016 including a 1-year follow-up period. Inclusion criteria were patients of both sexes who were admitted for elective surgeries of the thyroid, breast, and abdomen. Data including demographic details, infection rate, and cosmetic appearance were recorded in both groups to compare the final surgical outcome. A total of 135 patients were finally analyzed in the study. A total of 68 patients (group A) underwent operation via diathermy skin incision and 67 patients (group B) underwent operation via scalpel skin incision. In diathermy (group A), a total 18% (n = 12) patients developed complications and in scalpel (group B), a total 21% (n = 14) patients developed complications (chi-square = 2.386, p value = 0.801). In diathermy (group A), 56 cases (82%) had excellent scar, 12 cases (17%) had fair scar, and 1 case (1.5%) had poor scar. In scalpel group (group B), 53 cases (79%) had excellent scar, 12 cases (18%) had fair scar, and 2 cases (3%) developed poor scar (f = 2.56, p = 0.112). No significant difference was noted in wound healing and the rate of wound complication in skin incision made by cutting diathermy as compared to the conventional scalpel skin incision in our present study. We also conclude that there is no difference in cosmetic outcome in both groups after 1 year of follow-up.

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“…Although electrocautery has the advantages of less bleeding, faster speed, complete haemostasis and less sharp injury to operators,3–8 it is currently mainly reserved for incision and separation of subcutaneous tissue and deeper layers as well as haemostasis, while rarely used by surgeons to cut skin for fear that the heat generated by electrocautery may damage the skin tissue and appendages around the incision, resulting in poor incision healing, excessive scarring and devitalised tissue may also become a focus of infection 9 10. Nonetheless, scalpels have other inherent disadvantages, including unclear anatomical hierarchy due to bleeding wounds, the need to ligate blood vessels with sutures, leaving sutures as foreign bodies remaining in the body which may lead to wound infection or foreign body reactions, sharp injuries which may lead to infection of blood-borne infectious diseases and unintentionally damaging surrounding vital organs and structures during procedures 11 12. On the other hand, there has been some literature on abdominal incisions showing that there is no statistical difference in postoperative complications between incisions made with conventional scalpel and electrocautery 4–7 13–16.…”

Section: Introductionmentioning

confidence: 99%

Needle-tip electrocautery versus steel scalpel incision in neurosurgery: study protocol for a prospective single-centre randomised controlled double-blind trial

Xu,

Fang,

Wang

et al. 2023

BMJ Open

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IntroductionElectrocautery is used widely in surgical procedures, but making skin incision has routinely been performed with scalpel rather than electrocautery, for fear that electrocautery may cause poor incision healing, excessive scarring and increased wound complication rates. More and more studies on general surgery support the use of electrocautery for skin incision, but research comparing the two modalities for scalp incision in neurosurgery remains inadequate. This trial aims to evaluate the safety and efficacy of needle-tip monopolar for scalp incision in supratentorial neurosurgery compared with steel scalpel.Methods and analysisIn this prospective, randomised, double-blind trial, 120 eligible patients who are planned to undergo supratentorial neurosurgery will be enrolled. Patients will be randomly assigned to two groups. In controlled group scalp incision will be made with a scalpel from the epidermis to the galea aponeurotica, while in intervention group scalp will be first incised with a steel scalpel from the epidermis to the dermis, and then the subcutaneous tissue and galea aponeurotica will be incised with needle-tip monopolar on cutting mode. The primary outcomes are scar score (at 90 days). The secondary outcomes include incision pain (at 1 day, on discharge, at 90 days) and alopecia around the incision (at 90 days), incision blood loss and incision-related operation time (during operation), incision infection and incision healing (on discharge, at 2 weeks, 90 days).Ethics and disseminationThis trial will be performed according to the principles of Declaration of Helsinki and good clinical practice guidelines. This study has been validated by the ethics committee of West China Hospital. Informed consent will be obtained from each included patient and/or their designated representative. Final results from this trial will be promulgated through publications.Trial registration numberChiCTR2200063243.

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A comparative study of scalpel and surgical diathermy incision in elective operations of head and neck cancer

Abstract: There is no change in wound complication rate and scar formation even after application of heat during use of surgical diathermy. Therefore, surgical diathermy is safe and as effective as scalpel during elective skin incision of head and neck cancer.

Cited by 29 publications

References 19 publications

Advanced Cutting Effect System versus Cold Steel Scalpel

Advanced Cutting Effect System versus Cold Steel Scalpel

Comparison of the Outcome of Diathermy Versus Scalpel Skin Incision in Surgical Cases

Needle-tip electrocautery versus steel scalpel incision in neurosurgery: study protocol for a prospective single-centre randomised controlled double-blind trial

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