Abdominal Wound Problem after Hysterectomy using Scalpel Versus Electrocautery for Skin and Subcutaneous Dissection

Abstract

Objective: To evaluate the postoperative abdominal wound problem after hysterectomy with scalpel versus electrocautery for skin and subcutaneous dissection. Material and Methods: A total of 516 post-menopausal women having age 40 to 65 years who were planned for elective hysterectomy were included in this study. Patients having only benign disorders were included. In group E (N=258); Skin incision and tissue dissection was done using electrocautery by setting the electrocautery machine at cutting mode at 30 to 50 watts’ power. In group S (N=258); conventional scalpel was used for skin incision. Scalpel number 23 was used for skin and subcutaneous tissue dissection. Post-operative wound complications such as seroma, hematoma, wound dehiscence and wound infections were primary study endpoints. Results: Mean age was 48.6±6.9 years in electrocautery and 49.2±6.3 years in scalpel group (p-value 0.30). Seroma formation was diagnosed in 98 (37.98%) patients in electrocautery group and in 52 (20.1%) patients in scalpel group (p-value <0.0001). Wound infections were diagnosed in 50 (19.3%) patients in electrocautery group versus in 87 (33.7%) patients in scalpel group (p-value 0.0002). Hematoma was diagnosed in 10 (3.87%) patients in electrocautery group and in 19 (7.4%) in scalpel group (p-value 0.08). Conclusion: The use of electrocautery is associated with lower rate of post-operative wound infections and hematoma formation. The present study advocates the use of electrocautery for skin and subcutaneous tissue dissection in patients undergoing abdominal hysterectomy. Keywords: Abdominal hysterectomy, electrocautery, scalpel, wound complications.