title: Wound complications and clinical results of electrocautery versus a scalpel to create a cutaneous flap in thyroidectomy: a prospective randomized trial.
abstract: OBJECTIVE
  The use of electrocautery for tissue dissection is becoming increasingly popular, despite the associated risk of poor wound healing and excessive scarring. We conducted this study to compare the wound complications and early and late clinical results resulting from electrocautery versus the scalpel to create a cutaneous flap during thyroidectomy.
  
  
  METHODS
  The subjects of this study were 100 patients, randomized prospectively to either a scalpel group (group S, n = 50) or an electrocautery group (group E, n = 50).
  
  
  RESULTS
  Thickness of tissue damage, postoperative thickness of the flap, discomfort in the neck 7 days after surgery, and hypoesthesia and paresthesia in the neck 3 months after surgery were significantly higher in group E than in group S. There were no significant differences in overall postoperative wound complications, postoperative pain, satisfaction with the cosmetic result, or overall outcome of the operation between the groups. Although the incidence of seroma was higher in group E (20%) than in group S (8%), the difference was not significant.
  
  
  CONCLUSIONS
  Although electrocautery was associated with increased histological tissue damage, postoperative flap edema, discomfort, and other complications in the early stage, the clinical and cosmetic results of flaps made using electrocautery or a scalpel were similar and satisfactory 6 months after surgery.
authors.affiliation: Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uludag
authors.forename: Gurkan
authors.initials: G
authors.lastname: Yetkin
authors.forename: Alper
authors.initials: A
authors.lastname: Ozel
authors.forename: M Banu Yilmaz
authors.initials: MB
authors.lastname: Ozguven
authors.forename: Senay
authors.initials: S
authors.lastname: Yener
authors.forename: Adnan
authors.initials: A
authors.lastname: Isgor
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004210:Dissection / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D004564:Electrocoagulation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013524:Surgical Flaps / Q000009:adverse effects*; D013959:Thyroid Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D016896:Treatment Outcome