title: Comparison of electrocautery incision with scalpel incision in midline abdominal surgery - A double blind randomized controlled trial.
abstract: To compare the electrocautery incision with scalpel incision in patients undergoing abdominal surgery using a midline incision with respect to incision time, blood loss during incision, postoperative incision site pain and wound infection.
  
  
  METHODS
  Patients undergoing midline abdominal surgery were randomized into electrocautery and scalpel groups. The incision dimensions, incision time and blood loss during incision were noted intraoperatively. Postoperative pain and wound infection were recorded on every postoperative day for one week.
  
  
  RESULTS
  41 patients in each of the two groups were analyzed. Gender and age distribution was similar in both the groups. The mean incision time per unit wound area in the electrocautery group and scalpel group was 9.40 ± 3.37 s/cm(2) and 9.07 ± 3.40 s/cm(2) (p = 0.87) respectively. The mean blood loss per unit wound area was significantly lower in the electrocautery group at 6.46 ± 3.94 ml when compared to that of 23.40 ± 15.28 ml in the scalpel group (p= < 0.0001, CI = 11.97-21.89). There was no significant difference in pain on any of the postoperative days between the two groups and there was no significant difference in the wound infection rates between the electrocautery and scalpel groups (14.63% vs. 12.19%; p = 0.347).
  
  
  CONCLUSIONS
  With a comparable Postoperative incision site pain, wound infection rate and significantly lower blood loss with the equal time taken for the incision, electrocautery can be considered safe and effective in making skin incision in midline laparotomy compared to scalpel incision.
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India. Electronic address: doraiprakash@gmail.com.
authors.forename: Lalgudi Dorairajan
authors.initials: LD
authors.lastname: Prakash
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India. Electronic address: nitesh.pagadala@gmail.com.
authors.forename: Nitesh
authors.initials: N
authors.lastname: Balaji
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India. Electronic address: drsureshkumar08@yahoo.com.
authors.forename: Sathasivam Suresh
authors.initials: SS
authors.lastname: Kumar
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry 605006, India. Electronic address: drvikramkate@gmail.com.
authors.forename: Vikram
authors.initials: V
authors.lastname: Kate
mesh_terms: D000005:Abdomen / Q000601:surgery*; D004311:Double-Blind Method; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013525:Surgical Instruments
keywords: Electrocautery incision; Electrosurgery; Midline laparotomy; Scalpel incision