A multicentre collaborative study on the use of cold scalpel and electrocautery for midline abdominal incision

• Published in: The American journal of surgery Vol. 181; no. 2; pp. 128 - 132
• Main Authors: Franchi, Massimo, Ghezzi, Fabio, Benedetti-Panici, Pier Luigi, Melpignano, Mauro, Fallo, Luca, Tateo, Saverio, Maggi, Renato, Scambia, Giovanni, Mangili, Giorgia, Buttarelli, Marco
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2001; Elsevier; Elsevier Limited
• Subjects: Abdomen; Age; Biological and medical sciences; Body mass; Body mass index; Body size; Coagulation; Cold; Cold scalpel; Complications; Cross-Sectional Studies; Diabetes; Diathermy; Electrocautery; Electrocoagulation; Fallopian Tubes - surgery; Female; Humans; Hysterectomy - methods; Infections; Laparotomy - methods; Logistic Models; Malignancy; Medical sciences; Ovariectomy; Regression analysis; Skin; Statistical analysis; Steroids; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Instruments; Surgical Wound Dehiscence - epidemiology; Surgical Wound Dehiscence - prevention & control; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Uterine cancer; Wound healing; Wound incision; Wound infection; Wound infection; Diathermy; Cold scalpel; Wound incision; Electrocautery; Human; Surgical incision; Scalpel; Multicenter study; Electric; Median; Cauterization; Abdomen; Time lag; Result; Treatment; Surgery; Technique; Cicatrization; Comparative study
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(00)00561-4

Background: Although studies in animals demonstrated a better wound healing after abdominal incision with cold scalpel than with electrocautery, clinical experiences did not confirm these findings. The purpose of this study was to compare early and late wound complications between diathermy and scalpel in gynecologic oncologic patients undergoing midline abdominal incision. Methods: Patients undergoing midline abdominal incision for uterine malignancies were divided into two groups according to the method used to perform the abdominal midline incision: cold scalpel and diathermy in coagulation mode. Early and late complications were compared. Logistic regressions were used for statistical analysis. Results: Nine hundred sixty-four patients were included, of whom 531 were in the scalpel group and 433 in the electrocautery group. Both groups were similar with respect to demographic, operative, and postoperative characteristics. Univariate analysis revealed a higher incidence of severe wound complications in the scalpel group than in the electrocautery group (8 of 531 versus 1 of 433, P <0.05). After adjustment for confounding variables (eg, age, body mass index) no differences were found between groups. Conclusions: Scalpel and diathermy are similar in terms of early and late wound complications when used to perform midline abdominal incisions. Therefore the choice of which method to use remains only a matter of surgeon preference.