Title: Comparison of Various Incision Techniques in Abdominal Surgery

Authors: Dr Nisar Ahmad Ansari, Dr Osman Musa Hingora, Dr R P Singh

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i5.165

Abstract

Surgical incisions are usually made with scalpel but usually results in skin bleeding which obscure the operating field. Other alternative in making surgical incision is diathermy. Usually skin incision by diathermy is avoided due to fear of deep burn and scarring when compared with scalpel incision, which create a clean incised wound with minimal tissue destruction. But diathermy in skin incisions decreases bleeding with less incision time. This study compared the complication and effectiveness of various techniques of making skin incisions in an abdominal surgical procedure in 105 patients in age group of 20-60 years. Patients were divided into 3 groups: A: Incision by sharp needle electrode only. B: Incision to reticular dermis with scalpel blade then further incision deep to the peritoneum with sharp needle electrode. C: Incision by conventional scalpel only.

Result: There was no difference between group A, group B and group C regarding age, sex and weight (p>0.05). The incision bleeding was less in group A (statistically non-significant, p>0.05). There were more inflamed wounds in group A on 3rd day as compared to group B and group C (statistically significant p<0.05). The postoperative complications and hospital stay were less in group C compared to group A and group B (statistically non significant p>0.05). There was no difference in group A, group B and group C regarding cosmetic appearance after three months.

Conclusion: Study suggested that scalpel blade is superior to electro diathermy for making surgical incisions.

Keywords: Diathermy, Incision.

References

  1. Glover JL, Bendick PJ, Link WJ. The use of thermal knives in surgery: electro surgery, lasers, plasma scalpel. Current Problems in Surgery 1978; 15: 1-78
  2. Soderstrom R. Principles of electrosurgery as applied to gynaecology. In: Rock JA, Jones HW III editor(s). TeLinde’s Operative Gynecology. 9th Ed. Philadelphia: Lippincott Williams & Wilkins; 2003:291-308
  3. Dixon AR and Watkin DFL. Electrosurgical skin incision versus conventional scalpel: a prospective trial. JR Coll Surg Edimb 1990;35: 299-301.
  4. Ayandipo OO, Afuwape OO, Irabor D, Oluwatosin OM, Odigie V. Diathermy versus Scalpel Incision in a Heterogeneous Cohort of General Surgery Patients in a Nigerian Teaching Hospital. Nigerian Journal of Surgery : Official Publication of the Nigerian Surgical Research Society. 2015;21(1):43-47. doi:10.4103/1117-6806.153193.
  5. Chalya PL, Mchembe MD, Mabula JB, Gilyoma JM. Diathermy versus scalpel incision in elective midline laparotomy: A prospective randomized controlled clinical study. East and Cent. Afr JSurg 2013;18:71–7
  6. Arsalan S, Muhammad F, Athar AS, Sohail R. Elective midline laparotomy; comparison of diathermy and scalpel incisions. Prof Med J. 2011;18:106–11.
  7. Kearns SR, Connoly EM, McNally S, McNamara DA, Deasy J. Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. Br J Surg 2001;88:41-4.
  8. Amin Mir, M. Nadeem Khan, Iqbal Aziz, Anis Ismail. Randomized comparative study of electro surgical and conventional scalpel incisions in general surgery. Surgery. 2010;20(25):15-22.
  9. Ly J, Mittal A, Windsor J. Systematic review and meta-analysis of cutting diathermy versus scalpel for skin incision. Br J Surg. 2012;99(5):613-20.
  10. Abul Nagah G, Tarek EF, Lotfy H, Shehab W, Tarek A. Comparative study between using harmonic scalpel and electrocautery in modified radical mastectomy. Egyptian Journal of Surgery 2007;26:176-80.
  11. Patil VB, Mule VD, Raval RM, Kulkarni AA. Observational study of scalpel versus electrocautery for subcutaneous incision in elective gynaecological surgeries.Int J Reprod Contracept Obstet Gynecol 2017;6:950-4.
  12. Keven B, Lawrenson and Fredericro Stephen’s. The use of electrocuting and electrocoagulation in surger. Aust NZ J Surg 1970; 39: 417-421.
  13. Nisar AH Chowdri, Nazir AH Wani, Akhtar AH Ganie, Sameer Hassan Naqash, GH Qadir Peer, Khursheed Alam Wani. Prospective randomized comparative study of electro surgical and conventinal scalpel incisions in general surgery. IJS 2001; 63(4): 308-311.

Corresponding Author

Dr Osman Musa Hingora

Professor & Head, Eras Lucknow medical College & Hospital, Sarfarazganj, Lucknow, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.