title: Surgical site infection: an observer-blind, randomized trial comparing electrocautery and conventional scalpel.
abstract: OBJECTIVE
  To evaluate the incidence of surgical site infection (SSI) based on the type of scalpel used for incisions in the skin and in subcutaneous tissues.
  
  
  METHODS
  Observer-blind, randomized equivalence clinical trial with two arms (electrocautery versus conventional scalpel) which evaluated 133 women undergoing elective abdominal gynecologic oncology surgery. A simple randomization stratified by body mass index (BMI: 30 kg/m(2)) was carried out. Women were evaluated at 14 and 30 days following the operation. A multivariate analysis was performed in order to check whether the type of scalpel would be a risk factor for SSI.
  
  
  RESULTS
  Group arms were balanced for all variables, excepted for surgical time, which was significantly higher in the electrocautery group (mean: 161.1 versus 203.5 min, P = 0.029). The rates of SSI were 7.4% and 9.7%, respectively, for the conventional scalpel and electrocautery groups (P = 0.756). The exploratory multivariate model identified body mass index ≥30 kg/m(2) (OR = 24.2, 95% CI: 2.8-212.1) and transverse surgical incision (OR = 8.1, 95% CI: 1.5-42.6) as independent risk factors for SSI. The type of scalpel used in surgery, when adjusted for these variables and the surgery time, was not a risk factor for SSI.
  
  
  CONCLUSIONS
  This study showed that the SSI rates for conventional scalpel and electrocautery were not significantly different. These results were consistent with others reported in the literature and would not allow a surgeon to justify scalpel choice based on SSI.
  
  
  BACKGROUND
  NCT01410175 (Clinical Trials - NIH).
authors.affiliation: Infection Control Commission, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Regiane Ladislau
authors.initials: RL
authors.lastname: Rongetti
authors.affiliation: Infection Control Commission, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Paulo de Tarso
authors.initials: Pde T
authors.lastname: Oliveira e Castro
authors.affiliation: Breast Surgery Department, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Renê Aloisio da Costa
authors.initials: RA
authors.lastname: Vieira
authors.affiliation: Medical Oncology Department, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Sérgio Vicente
authors.initials: SV
authors.lastname: Serrano
authors.affiliation: Gynecologic Oncology Department, Barretos Cancer Hospital, Barretos, Brazil.
authors.forename: Mariana Fabro
authors.initials: MF
authors.lastname: Mengatto
authors.affiliation: Gynecologic Oncology Department, Barretos Cancer Hospital, Barretos, Brazil; Teaching and Research Institute, Barretos Cancer Hospital, Barretos, Brazil. Electronic address: mdfregnani@terra.com.br.
authors.forename: José Humberto Tavares Guerreiro
authors.initials: JH
authors.lastname: Fregnani
mesh_terms: D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D013525:Surgical Instruments / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology*
keywords: Body mass index; Clinical trial; Electrocoagulation; Gynecological surgical procedure; Surgical wound infection