A multicentre collaborative study on the use of cold scalpel and electrocautery for midline abdominal incision

Background: Although studies in animals demonstrated a better wound healing after abdominal incision with cold scalpel than with electrocautery, clini cal experiences did not confirm these findings. The purpose of this study w as to compare early and late wound complications between diathermy and scal pel in gynecologic oncologic patients undergoing midline abdominal incision . Methods: Patients undergoing midline abdominal incision for uterine maligna ncies were divided into two groups according to the method used to perform the abdominal midline incision: cold scalpel and diathermy in coagulation m ode. Early and late complications were compared. Logistic regressions were used for statistical analysis. Results: Nine hundred sixty-four patients were included. of whom 531 were i n the scalpel group and 433 in the electrocautery group. Both groups were s imilar with respect to demographic, operative, and postoperative characteri stics. Univariate analysis revealed a higher incidence of severe wound comp lications in the scalpel group than in the electrocautery group (8 of 531 v ersus 1 of 433, P <0.05). After adjustment for confounding variables (eg, a ge, body mass index) no differences were found between groups. Conclusions: Scalpel and diathermy are similar in terms of early and late w ound complications when used to perform midline abdominal incisions. Theref ore the choice of which method to use remains only a matter of surgeon pref erence. (C) 2001 Excerpta Medica, Inc. All rights reserved.