Cold knife versus monopolar electrosurgery for abdominal incisions (clinical trial) | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 6, Volume 26, Issue 2, May 2022, Page 40-48 PDF (2.32 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2022.237728 | ||||
 View on SCiNiTO | ||||
| Author | ||||
| Shaimaa I. Borhamy | ||||
| Desouk General Hospital , Egyptian Ministry of Health, Kafr Elsheikh, Egypt. | ||||
| Abstract | ||||
| Abstract Background: Scalpel incisions cause low injury to surrounding tissues. Electrosurgery has been used extensively for hemostasis, but the risk of producing huge scars and poor tissue recovery has kept it from being used in skin incisions for the time being. Aim: In patients with benign gynaecological disorders receiving abdominal incisions, to evaluate early postoperative and late term wound complications among scalpel and electrosurgery. Patient and method: Within a 20-month period, a randomised controlled trial (parallel group study with 1:1 randomization) was undertaken at the gynaecology department of Alzhraa University Hospital in Cairo, Egypt. We included 120 women in the trial after determining their eligibility. 16 of them were disqualified for failing to satisfy the inclusion criteria and refusing to participate. During follow-up, 14 patients were lost because they did not attend their second appointment or did not provide their incision photo to the first author (Shaimaa Ismail). Analysis was done on 90 participants, 45 in each group. Cases randomly assigned at the operation day into two groups. Group A: scalpel used for anterior abdominal wall incision and simple compression or stitch for hemostasis , Group B: electrosurgery used for same incision and hemostasis ( CUT and COAG ). Primary outcomes: wound incision time/seconds and wound related blood loss/grams). Secondary outcomes: postoperative pain by VAS score, analgesia needed in first 12 hours postoperative in number of doses, wound infection and ugly scar formation at day 40. Results: the electrosurgery group had a significantly low wound related blood loss (7.39 g ± 5.5 g vs. 24.72 g ± 9.75 g; U = 137; P < 0.001) and lesser incision time (2.16±0.09 min vs. 3.9±1.58 min; U= 303; P < 0.001; Mann-Whitney test) compared to scalpel group. Electrosurgery significantly decrease postoperative pain in both subjective and objective methods. There was no statistical difference found between the groups regard to wound infection (P = 0.3; Fisher exact test ). Conclusion: The proper use of electrosurgery for abdominal wall incision could be a good alternative for scalpel. We registered our study protocol at www.clinicaltrials.gov . ClinicalTrials.gov Identifier: NCT04236401 | ||||
| Keywords | ||||
| Keywords: electrosurgery; scalpel; abdominal incision | ||||
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