Electrocautery for cutaneous flap creation during thyroidectomy: a randomised, controlled study.
BACKGROUND
Although electrocautery has been used widely in surgery, the fear of delayed wound healing and infection persists. We aimed to evaluate the risk factors for wound complications and the rate of wound complications, comparing the use of electrocautery or scissors in cutaneous flap creation during thyroidectomy.


METHODS
The study group comprised 239 consecutive patients scheduled for thyroidectomy.


METHODS
Patients were randomly assigned to cutaneous flap dissection by either electrocautery (group one, n = 126) or scissors (group two, n = 113). Age, gender, body mass index, American Society of Anesthesiology score, tissue weight, operating time, incision length, cutaneous tissue depth, thyroid function and surgeon experience were recorded and compared with the rate of post-operative wound complications in both groups.


RESULTS
There were no significant differences between the overall rate of post-operative wound complications, comparing groups one and two (7.9 vs 10.6 per cent, respectively; p = 0.74). Significant positive correlations were found between wound complication and age (Spearman's rank coefficient (rs) = 0.135, p = 0.036), body mass index (rs = 0.379, p = 0.0001), cutaneous tissue depth (rs = 0.677, p = 0.0001) and tissue weight (rs = 0.643, p = 0.0001). According to logistic regression analysis, a body mass index of more than 27.5 kg/m2 was associated with a 13.7-fold increased rate of post-operative wound complications.


CONCLUSIONS
When creating cutaneous flaps during thyroidectomy, the use of electrocautery is as safe as the use of scissors. Such electrocautery does not increase the risk of wound complications in thyroid surgery.
Barbaros
U
U
Department of General Surgery, Istanbul University, Turkey.
Erbil
Y
Y
Aksakal
N
N
Citlak
G
G
Işsever
H
H
Bozbora
A
A
Ozarmağan
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013525:Surgical Instruments; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult