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Analysis Study Research Paper | Surgery | India | Volume 12 Issue 3, March 2023 | Popularity: 5.2 / 10

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Comparison of Tissue Selective Use of Electrocautery Cum Steel Scalpel Versus Conventional Steel Scalpel Alone in Abdominal Incisions - A Prospective Randomized Study of 100 Cases

Baldev Singh, Sugandh Gumber, Sumitoj Singh, Gagandeep Gupta

Abstract: Background: Surgeons have been in constant debate to identify the best method for abdominal incisions. Nowadays, there is a shift in trend from steel scalpel to electrosurgical incisions. However, the use of electrocautery is still limited due to concerns regarding poor wound healing and inadvertent injury to deeper structures. The present study was focused on combined use of electrocautery and steel scalpel in a tissue selective approach for abdominal incisions and compare the post - operative wound infection rate and early post operative complications with those of steel scalpel incisions for better patient outcome. Aims and objectives: This prospective study aimed to compare the outcome of abdominal incisions using tissue selective combination of electrocautery cum steel scalpel versus conventional use of steel scalpel alone with regards to incision time, total blood loss, early post - operative pain, wound healing, scar formation and hematoma/Seroma formation. Materials and method: Patients were randomly divided into two groups of 50 each. Inone group, abdominal incision was given using tissue selective combination of electrocautery and steel scalpeland in second group, abdominal incision was given using conventional Steel scalpel only. Both groups were compared with regards to incision time, total blood loss, post - operative pain, post - operative wound infection rate and wound healing. Results: On comparison, the difference in time required to complete the incision between both the groups was highly significant (p=0.001) with mean incision time in group A at 683+95 secs and group B at 871+68 secs. A highly significant difference (p=.000) was observed in the amount of blood loss between the two groups (20.20?6.773 ml in group A vs.42.22?7.778 ml in group B). The mean duration of hospital stay in cautery group was 6.26?2.73 days and in scalpel group was 8.08?3.56 days (p=0.001). No significant intergroup difference was found in VAP score at Post - op Day 1 (p=0.137), at week 1 (p=0.741), week 3 (p=0.631) and week 4 (p =0.757). However, statistically significant intergroup differencein VAP score was seen on Post - op Day 2 (p = 0.002), Post - op Day 3 (p=0.000). However, no difference in terms of wound characteristics and complications was noted between the two groups. Conclusion: The study results revealed that the tissue selective use of combination of electrocautery and scalpel is superior in terms of incision time, duration of post operative hospital stay and amount of blood lost during the incision. Since no difference in wound characteristics was noted between the two groups, tissue selective use of electrocautery is a safe alternative to scalpel for gaining access to the abdominal cavity.

Keywords: Electrocautery, Scalpel, Abdominal incisions, incision time, wound healing

Edition: Volume 12 Issue 3, March 2023

Pages: 1211 - 1214

DOI: https://www.doi.org/10.21275/SR23317110147

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