Surgical site infection rates in scalp incisions for cranial surgeries; a comparison of scalpel and cutting electrocautery

Background: Traditionally, the scalpel, has been the device used to make incisions on the skin. It is readily available, cheap and makes precise cuts on the skin. However, there may be increased operation time with its use because of the time spent in trying to secure haemostasis. The cutting electrocautery has the advantages of being faster with securing haemostasis and reducing blood loss. One of the concerns with the use of cutting electrocautery is that it may increase the risk of surgical site infection. This study compares the surgical site infection rates between the use of electrocautery and the scalpel in patients undergoing cranial surgeries. Methods: This prospective randomized study reviewed 64 patients undergoing cranial surgeries (craniotomy and craniectomy) for various indications. The patients were randomized into 2 groups: the diathermy and scalpel groups. The diathermy group had their incisions made with cutting electrocautery set at 30-40W, blend. The scalpel group had their incisions made with size 20 scalpel after standard skin preparation. The wounds were subsequently assessed for surgical site infection using the CDC criteria, at 3,14 and 30 days after surgery. The difference in infection rate was assessed using fisher’s exact test Results: At least some biodata of the patients showed that both groups were matched. Two patients in each of the groups developed surgical site infection giving rise to an incidence of 6.3%. There was no statistical difference between the two groups in terms of surgical site infection rate. Conclusion. This study did not find any difference in the surgical site infection rate in cranial surgeries when scalp incision was made with either scalpel or cutting electrocautery.