Comparison of Electrocautery and Scalpel Incision in Midline Abdominal Surgery

Background: With the advancement of surgical techniques, the comparison of electrocautery and scalpel incisions in midline abdominal surgeries has become an essential area of study. Traditional scalpel incisions have been known for their precision but carry risks of excessive blood loss and sharp injuries. Electrocautery, offering a potentially safer and more efficient alternative, has been gaining attention in surgical practices. Objective: The primary objective of this study was to compare the effectiveness, safety, and outcomes of electrocautery versus scalpel incisions in midline abdominal surgeries, with a focus on incision time, blood loss, wound infection, and postoperative pain. Methods: A randomized controlled trial was conducted at the Military Hospital, Rawalpindi, over 12 months from June 2021 to June 2022. A total of 150 patients, split evenly into electrocautery and scalpel groups, were evaluated. Patients aged 20-75 years, undergoing midline abdominal surgery, were included. The main parameters measured were incision time, blood loss, wound infection, and postoperative pain. Data were analyzed using SPSS version 25.0, employing independent samples t-tests and chi-square tests. Results: The electrocautery group exhibited a significantly shorter incision time (13.73 ± 2.45 seconds) compared to the scalpel group (18.67 ± 3.02 seconds, p < 0.001). Blood loss was also lower in the electrocautery group (11.47 ± 2.49 ml) than in the scalpel group (27.27 ± 4.13 ml, p < 0.001). Wound infection rates were 6.7% for electrocautery and 13.3% for scalpel, though this was not statistically significant (p = 0.174). Remarkably, 100% of the electrocautery group reported postoperative pain, in contrast to none in the scalpel group (p = 0.000). Conclusion: The study concluded that electrocautery is more effective than scalpel incision in terms of incision time and blood loss, making it a preferable method for midline abdominal surgeries. However, the higher incidence of postoperative pain in the electrocautery group warrants further investigation.