title: Randomized, clinical trial on diathermy and scalpel incisions in elective general surgery.
abstract: BACKGROUND
  Since a long time skin incisions have routinely been made with scalpels. Now a day there is a shift in trend from this method to electrosurgical skin incisions. However, fear of bad scars and improper wound healing has prevented its wide spread use. This Study aimed to compare both methods of skin incisions for different variables.
  
  
  OBJECTIVE
  The aim of this study was to examine incisional time, blood loss during incision and postoperative wound complications and pain with both methods of skin incision.
  
  
  METHODS
  A prospective, comparative and randomized study was conducted at different hospitals of Hyderabad and Nawabshah, Pakistan from 1(st) of December 2009 to 30(th) of November 2011. The study included patients of either sex above the age of five years with general surgical pathology who were to undergo surgery. these candidates were randomly put into two groups. In Group A patients incision was made with a scalpel and in group B with diathermy. Data was analyzed for age, sex, comorbid illness, incisional time, blood loss during incision making and postoperative pain and wound complications.
  
  
  RESULTS
  A total of 283 patients completed the follow-up and were included in the final analysis. Group A comprised of 143 (50.53%) patients; 83 (58%) males and 60 (42%) females with a mean age of 36.03 years. Amongst the 140 patients of group B, there were 85 (60.7%) males and 55 (39.3%) females with a mean age of 36.52 years. Twenty-five (17.48%) patients of group A and 27 (19.28%) of group B had comorbid illnesses. Mean incision time was 8.9025-sec/cm(2) for group A and 7.3057 sec/cm(2) for group B patients. Mean blood loss during incision making was 1.8262 mL/cm(2) and 1.1346 mL/cm(2) for group A and B patients, respectively. Pain was 5.2957 for group A patients on day one and 3.1181 for group B patients. Pain score was 2.1049 and 1.6206 on day two and 0.8191 and 0.7192 on day five, for group A and B patients, respectively. Postoperative wound complications were noticed in 26 (18.18%) patients of group A and 22 (15.71%) patients of group B.
  
  
  CONCLUSIONS
  Diathermy incision is a safe and expedient technique. It takes less time than scalpel incision and loss of blood is also lower during incision. Diathermy is associated with lesser post-operative pain and complications than the scalpel incision. Diathermy should be method of choice in general elective surgery.
authors.affiliation: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
authors.forename: Altaf Ahmed
authors.initials: AA
authors.lastname: Talpur
authors.affiliation: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
authors.forename: Abdul Basir
authors.initials: AB
authors.lastname: Khaskheli
authors.affiliation: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
authors.forename: Nandlal
authors.initials: N
authors.lastname: Kella
authors.affiliation: Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
authors.forename: Akmal
authors.initials: A
authors.lastname: Jamal
keywords: Complications; Diathermy; Pain, Postoperative; Scalpel
references.citation: Am J Surg. 2012 Aug;204(2):216-21
references.pmid: 22537473
references.citation: Acta Chir Belg. 2010 Jul-Aug;110(4):451-6
references.pmid: 20919668
references.citation: Br J Neurosurg. 2004 Jun;18(3):268-72
references.pmid: 15327229
references.citation: World J Surg. 2009 Aug;33(8):1594-9
references.pmid: 19418093
references.citation: Indian J Cancer. 2011 Apr-Jun;48(2):216-9
references.pmid: 21768669
references.citation: J Dermatol Surg Oncol. 1988 Jan;14(1):29-31
references.pmid: 3275701
references.citation: Br J Surg. 1988 Dec;75(12):1179-80
references.pmid: 2976607
references.citation: Am Surg. 2005 Apr;71(4):326-9
references.pmid: 15943407
references.citation: Br J Surg. 1990 Jun;77(6):626-7
references.pmid: 2143426
references.citation: Eur J Orthop Surg Traumatol. 2007 Jul 25;:
references.pmid: 23412144
references.citation: Am J Surg. 2001 Feb;181(2):128-32
references.pmid: 11425052
references.citation: Br J Surg. 2012 May;99(5):613-20
references.pmid: 22367850
references.citation: J R Coll Surg Edinb. 1990 Oct;35(5):299-301
references.pmid: 2283608
references.citation: Acta Chir Belg. 2007 Nov-Dec;107(6):682-6
references.pmid: 18274184
references.citation: Am J Surg. 1994 Jun;167(6):601-3
references.pmid: 8209936
references.citation: Dent Clin North Am. 1982 Oct;26(4):799-823
references.pmid: 6958599
references.citation: Br J Surg. 2001 Jan;88(1):41-4
references.pmid: 11136307
references.citation: Am J Surg. 1970 Mar;119(3):222-4
references.pmid: 5443922