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Mansour J, Asarkar A, Pang J, Nathan CAO. Can electrocautery replace the scalpel for surgical skin incision? Laryngoscope 2022; 132:2299-2300. [PMID: 35353385 DOI: 10.1002/lary.30114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022]
Affiliation(s)
- Jobran Mansour
- Dept of Otolaryngology/Head Neck Surgery, LSU Health, Shreveport, Louisiana, USA
| | - Ameya Asarkar
- Dept of Otolaryngology/Head Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks VA Medical Center, Shreveport, Louisiana, USA
| | - John Pang
- Dept of Otolaryngology/Head Neck Surgery, LSU Health, Shreveport, Louisiana, USA
| | - Cherie-Ann O Nathan
- Dept of Otolaryngology/Head Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks VA Medical Center, Shreveport, Louisiana, USA
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Li Z, Mu D, Xu B, Wang C, Cheng H, Li S, Qi J. Drainage Collection After Endoscopic-Assisted Transaxillary Dual-Plane Augmentation Mammaplasty Using Cold or Electrosurgical Separation of Interpectoral Space. Plast Surg (Oakv) 2020; 28:19-28. [PMID: 32110642 PMCID: PMC7016391 DOI: 10.1177/2292550319880913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Endoscopic transaxillary augmentation mammaplasty breast augmentation offers several advantages over other augmentation methods. Nonetheless, this procedure is fraught with some problems, including greater surgical trauma due to the longer separation area. We hypothesized that cold separation of the interpectoral space could reduce surgical injury in comparison to the electrosurgical method. This study aimed to compare the outcomes of endoscopic-assisted transaxillary augmentation mammaplasty using cold separation versus electrosurgical separation of the interpectoral space. METHODS In this prospective clinical trial, cold and electrosurgical separation of the interpectoral space were achieved using a separation shovel and monopolar electrotome, respectively. A total of 20 patients who visited our department in Beijing, China, for primary breast augmentation surgeries from October 1, 2017, and May 31, 2018, were included. The primary outcome was total postoperative drainage volume. The secondary outcomes were operative time, daily drainage volume, daily pain as assessed using the visual analogue scale (VAS), and reoperation rate. Quantitative data were compared using independent-samples t test. Chi-square test was used to compare 2 classified indexes. RESULTS The total drainage volume was significantly lower in the cold separation group than in the electrosurgical separation group (170.45 ± 75.40 mL vs 281.05 ± 148.43 mL; P = .005). The VAS score on the first postoperative day was significantly lower in the cold separation group than in the electrosurgical separation group (6.45 ± 1.93 vs 7.55 ± 1.43; P = .048). Two (20%) reoperations owing to postoperative pain or implant stiffness were performed in the electrosurgical separation group. CONCLUSIONS Cold separation is more conducive to reducing drainage, relieving postoperative pain, and causing less damage than the electrosurgical method in endoscopic-assisted transaxillary dual-plane augmentation mammaplasty.
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Affiliation(s)
- Zifei Li
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Dali Mu
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Boyang Xu
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Chenglong Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Hao Cheng
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Shangshan Li
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Jun Qi
- Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
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AbdElaal NK, Ellakwa HE, Elhalaby AF, Shaheen AE, Aish AH. Scalpel versus diathermy skin incision in Caesarean section. J OBSTET GYNAECOL 2019; 39:340-344. [DOI: 10.1080/01443615.2018.1527298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nasser K. AbdElaal
- Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Mansoura, Egypt
| | - Hamed E. Ellakwa
- Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Mansoura, Egypt
| | - AllaaEldin F. Elhalaby
- Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Mansoura, Egypt
| | - AbdElhameed E. Shaheen
- Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Mansoura, Egypt
| | - Ahmed H. Aish
- Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Mansoura, Egypt
- Resident of Obstetrics and Gynecology at the Ministry of Health, Shoubra General Hospital, Cairo, Egypt
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Evaluation of Pain Following the Use of Scalpel Versus Electrosurgery for Skin Incisions in the Facial Regions. ACTA ACUST UNITED AC 2018; 39:107-112. [PMID: 30864361 DOI: 10.2478/prilozi-2018-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Postoperative pain presents a significant medical problem. It can create a considerable discomfort in the immediate postoperative period and thus increase patient's morbidity. Multiple mechanisms are involved in its' etiology, one of them being the method of tissue incision. The aim of this study is to compare the early postoperative pain following incision with two different methods, scalpel and electrosurgery in the facial regions. MATERIAL AND METHODS Eighty patients with both benign and malignant skin lesions in the facial regions undergoing surgery were enrolled in this study. Patients were randomized in two groups. In group A, comprising 40 patients, cold steel surgical scalpel №15 was used for the surgical procedure. Electrosurgical microneedle with 0.06mm tip radius and generator unit KLS Martin Electrosurgical Unit ME MB 2 set on cutting mode, power 12 W was used for performing the surgery in group B including the same number of patients. After the surgery patients were given analgesics on their demand. The total number of on demand analgesics requirements was calculated. The patients were also asked to note the oral analgesics they were taking after being released from the hospital. RESULTS Results of this study showed a statistically significant difference between the groups in the analgesics demand on the day of the operation (p=0.041). On the day of the operation 52.5% patients in the scalpel group and only 30% of the patents of the electrosurgery group received analgesics on demand. In all other analysed time points, the patients in the scalpel group received analgesics more often than the patients in the microneedle group, but with no statistically confirmed difference between the groups (p>0.05). Even more significant is the fact that patients treated with electrosurgery that needed analgesics, had significantly bigger excision area median 471 (rank 283-589) compared to the patients treated with the conventional method 289 (rank 177-432) (p=0.016). CONCLUSION In accordance with previous studies our results suggested a significantly reduced postoperative pain in the electrosurgery group.
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Ismail A, Abushouk AI, Elmaraezy A, Menshawy A, Menshawy E, Ismail M, Samir E, Khaled A, Zakarya H, El-Tonoby A, Ghanem E. Cutting electrocautery versus scalpel for surgical incisions: a systematic review and meta-analysis. J Surg Res 2017; 220:147-163. [PMID: 29180177 DOI: 10.1016/j.jss.2017.06.093] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/12/2017] [Accepted: 06/29/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although cutting electrocautery can be superior to the scalpel in reducing blood loss and incisional time, several reports associated electrocautery with higher rates of wound infection, impaired healing, and worse cosmesis. We performed this systematic review and meta-analysis to compare cutting electrocautery versus scalpel for surgical incisions. MATERIALS AND METHODS We conducted a computerized literature search of five electronic databases and included all published original studies comparing cutting electrocautery and scalpel surgical incisions. Relevant data were extracted from eligible studies and pooled as odds ratios (ORs) or standardized mean difference (SMD) values in a meta-analysis model, using RevMan and Comprehensive Meta-analysis software. RESULTS Forty-one studies (36 randomized trials, four observational, and one quasirandom study) were included in the pooled analysis (6422 participants). Compared with the scalpel incision, cutting electrocautery resulted in significantly less blood loss (SMD = -1.16, 95% CI [-1.60 to -0.72]), shorter incisional (SMD = -0.63, 95% CI [-0.96 to -0.29]) and operative times (SMD = -0.59, 95% CI [-1.12 to -0.05]), and lower pain scores (SMD = -0.91, 95% CI [-1.27 to -0.55]) with no significant differences in terms of wound infection rates (OR = 0.92, 95% CI [0.74-1.15]) or overall subjective scar score (SMD = -0.49, 95% CI [-1.72 to 0.75]). CONCLUSIONS Surgical incision using electrocautery can be quicker with less blood loss and postoperative pain scores than the scalpel incision. No statistically significant difference was found between both techniques in terms of postoperative wound complications, hospital stay duration, and wound cosmetic characteristics. Therefore, we recommend routine use of cutting electrocautery for surgical incisions.
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Affiliation(s)
- Ammar Ismail
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt; NovaMed Medical Research Association, Cairo, Egypt
| | | | - Ahmed Elmaraezy
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt; NovaMed Medical Research Association, Cairo, Egypt.
| | - Amr Menshawy
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt
| | - Esraa Menshawy
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt
| | - Mahmoud Ismail
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt
| | - Esraa Samir
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Anas Khaled
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, New Damietta, Egypt
| | - Hagar Zakarya
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdelrahman El-Tonoby
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Al-Azhar Medical Students' Association, Cairo, Egypt
| | - Esraa Ghanem
- Al-Azhar Research Network, Cairo, Egypt; Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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