International Surgery Journal | January 2019 | Vol 6 | Issue 1 Page 28 International Surgery Journal Vadodariya BP et al. Int Surg J. 2019 Jan;6(1):28-32 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Comparative randomized controlled clinical trial of diathermy versus scalpel incision in midline laparotomy Bhavin P. Vadodariya*, Nimish J. Shah, Mrudul Patel INTRODUCTION Laparotomy skin incisions are made by scalpels with disposable knives, these incisions are associated with more blood loss and pain. 1 Surgical diathermy was introduced at the beginning of the 20 th century to preclude the integral drawbacks of steel scalpel. 2-4 It is well thought out to be competent mode of dissection being hemostatic and suitable. 4-6 With the introduction of recent electrosurgical units accomplished of distributing pure sinusoidal current, this technique is now exceptionally popular because of rapid haemostasis, faster dissection and reduced overall operative blood loss. 7-9 In diathermy, a potential gradient dependent current is passed through the tissue at high frequency (greater than 100000Hz) to excite tissue molecules such as water resulting in precise tissue lyses, which can be used for employed to coagulate (modulated mode) or to cut (sinusoidal mode) the tissue. This principle permits the use of diathermy electrode without causing adjacent ABSTRACT Background: Laparotomy incisions have traditionally been made using a scalpel. Diathermy, a latest technique, is thought to increase the risk of infection, impair healing and decrease cosmesis. Recent studies suggest that diathermy may offer likely advantages with respect to blood loss, incision time and postoperative pain. The aim of this study was to compare the efficacy and safety of surgical diathermy incisions versus conventional scalpel incisions for midline laparotomy in our hospital with an aim to evaluate diathermy as an operational alternative to scalpel incision. Methods: This was a prospective randomized clinical study which was conducted in the surgical wards of Medical College & SSG hospital, Vadodara, between December 2013 and December 2014. Patients were randomly assigned to two groups i.e. Group A (scalpel group) and Group B (diathermy group). Results: A total of 148 patients were enrolled in the study. Of these, 74 patients were randomized to Group A (scalpel group) and 74 patients to Group B (diathermy group). The two groups did not vary significantly in relation to age and sex (p>0.001). Laparotomy skin incisions using diathermy were significantly quicker than scalpel incisions (p=0.624). There was significantly less blood loss in the diathermy group compared with the scalpel group (P=0.15). The mean visual analogue scale was significantly reduced more in the diathermy group than in scalpel group patients on postoperative day 1 (p=0.81), day 3 (p=0.71) and day 5 (p=0.79) respectively. Postoperative complication rates did not differ significantly between the scalpel and diathermy groups (p=0.624). Conclusions: We concluded that diathermy incision in midline laparotomy has significant advantages compared with the scalpel because of reduced incision time, less blood loss, reduced early postoperative pain and postoperative wound infection. Keywords: Diathermy, Incision, Mid line laparotomy, Scalpel Department of General Surgery, Medical College, Vadodara, Gujarat, India Received: 27 September 2018 Accepted: 04 December 2018 *Correspondence: Dr. Bhavin P. Vadodariya, E-mail: imoncosx24@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20185110