title: A comparison between scalpel and electrocautery in modified radical mastectomy.
abstract: OBJECTIVE
  To compare the effects of a conventional cold scalpel and electrocautery in modified radical mastectomy.
  
  
  METHODS
  A non-randomised controlled trial.
  
  
  METHODS
  Teaching hospital in Southern Taiwan.
  
  
  METHODS
  101 consecutive patients with primary breast cancer who underwent modified radical mastectomy between July 1987 and June 1989.
  
  
  METHODS
  The 44 patients during the first year were allocated to have skin flaps fashioned conventionally with a cold scalpel and the 57 patients during the second year, by electrocautery.
  
  
  METHODS
  Morbidity and mortality among the 101 patients who underwent modified radical mastectomy.
  
  
  RESULTS
  The groups were comparable in regard to age, menopause, cancer stage, weight of specimen and histological type of cancer. The mean blood loss was 567 ml when scalpel was used and 150 ml when electrocautery was used (p < 0.001). The postoperative fall in packed cell volume was significantly greater in the scalpel group (0.75 [0.26] compared with 0.28 [0.15], p < 0.001) and more patients in this group required transfusion (9 compared with 0, p < 0.01). There were no deaths in either group. There were no significant differences in operation time, total post-operative Hemovac drainage, postoperative hospital stay, the number of lymph nodes removed, the number of metastatic lymph nodes, and postoperative complications between the groups.
  
  
  CONCLUSIONS
  Electrocautery is a safe, convenient and rational method for constructing skin flaps in modified radical mastectomy, and patients do not need blood transfusions.
authors.affiliation: Department of Surgery, Chang-Gung Memorial Hospital at Kaohsiung, Taiwan, R.O.C.
authors.forename: S M
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: F F
authors.initials: FF
authors.lastname: Chou
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery*; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010144:Paget's Disease, Mammary / Q000601:surgery; D013524:Surgical Flaps; D065227:Transfusion Reaction