DIATHERMY INCISIONS V/S SURGICAL SCALPEL INCISIONS

OUTCOME IN GENERAL SURGERY

Abstract

Objectives: The objective of this study was to compare the outcome of diathermy
incisions v/s surgical scalpel incisions in general surgery. Study Design: Cross sectional study.
Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. Lyari
General Hospital and Dow University of Health Sciences between January to December 2009.
Methodology: 100 consecutive patients for elective general surgery were randomly assigned
to either group A incision with cutting diathermy (n=50) or group B cold steel scalpel (n=50).
Data including demographic details, hospital stay, infection rate and non-infective complications
like swelling, bleeding, dehiscence and seroma formation were recorded in both groups to
compare the final surgical outcome compared. Results: A total of 80 patients were included in
the study, placed alternatively into two groups of 40 patients each with majority being male (n =
61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of Group A
was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basis
of Gender for the two groups, the positive predictive value for male patients of Group A and B
was 90.09% and 89.28% respectively, but for females the positive predictive value of Group A
and B was 100% and 50% respectively. In Diathermy (Group A) total 20% patients developed
complications and these were seroma formation (n=4, 8%), wound dehiscence (n=3, 6%) and
wound infection (n=3, 6%). In Scalpel (Group B) total 26% patients developed complications
(P-value=0.370) in which seromas was noted (n=5, 10%) then wound infection (n=4, 8%), then
wound bleeding (n=3, 6%) and lastly seroma formation (n=1, 2%). Hospital stays were also
almost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group.
No remarkable difference in demographics, characteristics and in other variables of patients
was noted. Conclusion: We conclude that no significant difference in surgical outcome of
both groups (cutting diathermy Vs. steel scalpel). Therefore, use of either technique to create
surgical wound merely depends upon preference of surgeon.