title: Diathermy versus Scalpel Incision in a Heterogeneous Cohort of General Surgery Patients in a Nigerian Teaching Hospital.
abstract: BACKGROUND
  The anecdotal fear of using cautery for surgical incisions is still common in surgical practice despite recent evidences. The aim of this study is to compare the results of electrocautery and the scalpel in skin incisions.
  
  
  METHODS
  This is a prospective randomized double blind study conducted in the Department of Surgery, of a teaching hospital in Ibadan. Patients were randomized to have either scalpel or electrocautery incisions. The duration used in making the skin incision; the incisional blood loss and the ensuing length and depth of the wound were noted. Postoperative pain; duration of wound healing and the occurrence of surgical site infection were also noted.
  
  
  RESULTS
  There were 197 patients consisting of the scalpel group (n = 98) and the electrocautery group (n = 99). The ages ranged from 16 to 73 years. The demography, case distribution and body mass index were similar in both groups. The mode of presentation was predominantly elective. The incision time was shorter in the electrocautery group (P < 0.001). The blood loss was less with the diathermy compared to the scalpel (6.53 ± 3.84 ml vs. 18.16 ± 7.36 ml, P < 0.001). The cumulative numerical rating scale score for pain was 12.65 (standard deviation [SD] 8.06) and 17.12 (SD 9.49) in the diathermy and scalpel groups respectively (P < 0.001). There was no statistically significant difference in wound infection and wound closure (epithelialization time) (P = 0.206).
  
  
  CONCLUSIONS
  The use of electrocautery in making skin incision is associated with reduced incision time, incisional blood loss, and postoperative pain.
authors.affiliation: Department of Surgery, College of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: Omobolaji O
authors.initials: OO
authors.lastname: Ayandipo
authors.affiliation: Department of Surgery, College of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: Oludolapo O
authors.initials: OO
authors.lastname: Afuwape
authors.affiliation: Department of Surgery, College of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: David
authors.initials: D
authors.lastname: Irabor
authors.affiliation: Department of Surgery, College of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: Odunayo M
authors.initials: OM
authors.lastname: Oluwatosin
authors.affiliation: Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
authors.forename: Vincent
authors.initials: V
authors.lastname: Odigie
keywords: Diathermy; electrocautery; general surgery; surgical incision
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