Comparative analysis of scalpel versus diathermy incisions in midline laparotomy

Shahab ul Huddah; Shahzad Hussain Waqar; Isbah Rashid

Abstract
Objective: To compare diathermy versus scalpel incisions for midline laparotomy in terms of mean blood loss, mean incision related time, frequency of postoperative wound infection, and mean postoperative pain.
Methodology: This randomized clinical trial was carried out at Department of General Surgery at Pakistan Institute of Medical Sciences, Islamabad and included 176 patients who underwent midline laparotomy. Patients were randomized to two groups; those who received incision with diathermy were placed in group A, and those who received incision with scalpel in group B. Variables analyzed were mean blood loss, mean incision related time, frequency of postoperative wound infection, and mean postoperative pain.
Results: Each group had 88 patients with mean age was 39.8±12.4 years and 41.9±10.5 years in group A and B, respectively. Majority of the patients in both groups were male. Postoperative infection was comparable in both groups. Mean incision related time in group A was 6.3±0.9 seconds and 7.2±2.1 seconds in group B (p<0.001). Mean blood loss in group A was 1.3±0.3 mL and in group B 1.4±0.3 mL (p=0.006). Mean pain score was significantly lesser in group A than group B. There was no statistically significant difference in postoperative wound infection in short term post operatively.
Conclusion: Diathermy incision is a safe and expedient technique as it takes lesser time, lesser blood loss and reduced postoperative pain as compared to scalpel. Diathermy should be used an alternative method for incision in midline laparotomy.

Key words: Diathermy incision, laparotomy, scalpel.

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