The Right Method for Midline Laparotomy: What is the Best Choice for Wound Healing ?

Özgün, Hedef; Tuncyurek, Pars; Boylu, Şükrü; Erpek, Hakan; Yenisey, Çiğdem; Kose, Hayrullah; Çulhacı, Nil

doi:10.1080/00015458.2007.11680146

Cited by 12 publications

(7 citation statements)

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“…However, it is still infrequently used for making skin incisions. The reluctance in the use of skin incision is due to the fear that electro surgical instruments create increased amounts of necrotic tissue within the wound which may increase the chances of wound infection leading to delayed wound healing and excessive scarring ( 2 , 8 - 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the recent years, many studies have been conducted on both methods of skin incision, which showed less operating time, diminished loss of blood, and reduced early pain and fewer requirements of analgesic drugs after surgery using the diathermy method of skin incision when compared to scalpel incision ( 2 ). In one experimental study, conducted on rats, it was shown that wound incisions made with a cold scalpel had more rapid tensile strengths as compared to diathermy or harmonic scalpels ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

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Randomized, Clinical Trial on Diathermy and Scalpel Incisions in Elective General Surgery

Talpur¹,

Khaskheli²,

Kella³

et al. 2015

Iran Red Crescent Med J

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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.Objectives: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.Patients and Methods:A prospective, comparative and randomized study was conducted at different hospitals of Hyderabad and Nawabshah, Pakistan from 1st of December 2009 to 30th 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/cm2 for group A and 7.3057 sec/cm2 for group B patients. Mean blood loss during incision making was 1.8262 mL/cm2 and 1.1346 mL/cm2 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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Randomized, Clinical Trial on Diathermy and Scalpel Incisions in Elective General Surgery

Talpur¹,

Khaskheli²,

Kella³

et al. 2015

Iran Red Crescent Med J

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“…The entity of tissue damage and the nature of the energy and the time of its application on tissues could impair the regeneration events and growth process; in particular thermal energy, as diathermy, used to incision and tissue dissection seems to be associated with more cellular damage and soft tissue devastation. Have been shown faster operating times, reduced blood loss and early post-operative pain and lower analgesia using diathermy for skin incision if compared with cold blade [18,19], but this is a “speedy procedure” for a linear and regular cutting with short and “constant moving” energy application and quickly heat dispersion and rapid return of cut tissues to normal body temperature. In this use the damage and the heat burn is limited to the section line and short in time, with no involvement and spreading to the close tissues.…”

Section: Discussionmentioning

confidence: 99%

Pilonidal sinus disease: Preliminary case-control study on heat-related wound dehiscence

Frazzetta

Silvia

Patrizia³

et al. 2019

Annals of Medicine and Surgery

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BackgroundPilonidal disease is a morbid condition of the young population, that could impair quality of life with a high cost for the health care system. No consensus exists on optimal surgical treatment, even if several techniques have been proposed. In this preliminary case-control study we compared excision by knife and diathermy to investigate if wound dehiscence could be related to heat spreading during excision of the sinus.Materials and methodBetween January 2017 and February 2018, 29 patients underwent to sinus excision.16 patients underwent sinus excision by diathermy (named “Hot” group, case-group) while 13 patients underwent excision by the knife as the control group (named “Cold” group). The temperature data were recorded for both groups. Were considered primary and secondary outcomes.Resultsthe cold group has worse outcomes in operative time and blood loss, but better results in post-operative pain at first day and first control, number of weekly and total dressings until healing, time for full wound recovery, days to return to work, patient feeling feedback and scar aspect. Wounds healed within 8–12 days were 84.6% in the Cold group and 18.8% in the Hot one. I° Dindo-Clavien complications were respectively 15.4% and 100.0% for the Cold and Hot group. No differences were recorded for II° Dindo-Clavien complications and in days of hospitalization.Conclusioncold excision of the sinus pilonidalis has better results both in terms of precarious healing and quality of life, probably because the tissues are not subjected to diathermocoagulation damage and therefore the healing occurs more quickly. (United States National Institutes of Health, www.clinicaltrial.gov, number NCT 03764657, www.researchregistry.com UIN 5003).

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“…Patients with co-morbids conditions like diabetes mellitus and hypertension were the included in this study to observe that weather the diseases have an effect on wound healing, but no significant difference was found; complication rates were similar as in other studies that had patients without co-morbids. 8,9 The most compelling reason for the routine use of cutting diathermy for skin incisions, therefore, is removal of the scalpel from the operating theatre and elimination of an important cause of injury. We did not find any difference in the rate of wound complications between cutting diathermy and scalpel in our study.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of diathermy versus scalpel skin incision in abdominal surgery

2019

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Background: Various methods of skin incision have been identified in the recent past. Traditional skin incisions were made with stainless steel scalpel but recently electrocautery instruments like harmonic scalpel are also in use. With rise of seropositive cases, we aimed to evaluate whether the electrocautery can replace scalpel in operation theater, to avoid unfortunate injury to surgeons with scalpel. So we compared the usefulness of diathermy skin incision vs. scalpel skin incision in general surgical patients.Methods: This prospective study designed to include 120 patients admitted in the Department of General Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar and who were undergoing elective abdominal surgical procedures namely cholecystectomy, appendectomy and inguinal hernia repair etc. Patients were randomly allocated into 2 groups of 60 patients each. In Group A, incision were made with electrocautery on cut mode and power set to 60-70. In group B, skin incisions were made with scalpel.Results: No statistical difference was found between group A and group B with regard to time of administration of pain killer injection, seroma formation, discharge being noticed from wound in both groups. Moreover the results were statistically non-significant for vascularity, pigmentation and pliability of wound observed.Conclusions: We concluded that electrocautery can effectively and efficiently replace scalpel in operation theater.

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The Right Method for Midline Laparotomy: What is the Best Choice for Wound Healing ?

Cited by 12 publications

References 0 publications

Randomized, Clinical Trial on Diathermy and Scalpel Incisions in Elective General Surgery

Randomized, Clinical Trial on Diathermy and Scalpel Incisions in Elective General Surgery

Pilonidal sinus disease: Preliminary case-control study on heat-related wound dehiscence

A prospective study of diathermy versus scalpel skin incision in abdominal surgery

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