Kearns S R, Connolly E M, McNally S, McNamara D A, Deasy J
Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
Br J Surg. 2001 Jan;88(1):41-4. doi: 10.1046/j.1365-2168.2001.01625.x.
Electrocautery is used increasingly for tissue dissection, although fears of excessive scarring and poor wound healing have curtailed its widespread use for skin incision. This study compared electrosurgical incision with traditional scalpel incision.
One hundred patients requiring elective midline laparotomy were randomized prospectively to either scalpel or diathermy incision. Parameters measured included incision time, wound size, wound blood loss, total intraoperative blood loss and postoperative wound pain. All wound complications were recorded.
The two groups did not differ significantly in relation to patient or wound characteristics. Laparotomy incisions using diathermy were significantly quicker than scalpel incisions (mean(s. e.m.) 6.1(0.4) versus 7.5(0.5) s/cm2; P < 0.04). There was significantly less blood loss in the diathermy group compared with the scalpel group (0.8(0.1) versus 1.7(0.3) ml/cm2; P = 0.002). Postoperative pain scores were significantly lower in the diathermy group for the first 48 h after operation (P < 0.05). Morphine requirements were also significantly lower over the first 5 postoperative days in the diathermy incision group (P < 0.04). There was no difference between groups in wound complications before discharge and at the 1-month follow-up.
Electrosurgical midline incision in elective surgery has significant advantages over scalpel use on the basis of incision time, blood loss, early postoperative pain and analgesia requirements.
电灼术越来越多地用于组织解剖，尽管对过度瘢痕形成和伤口愈合不良的担忧限制了其在皮肤切口方面的广泛应用。本研究比较了电外科切口与传统手术刀切口。
100例需要择期正中剖腹术的患者被前瞻性随机分为手术刀组或透热疗法组。测量的参数包括切口时间、伤口大小、伤口失血量、术中总失血量和术后伤口疼痛。记录所有伤口并发症。
两组在患者或伤口特征方面无显著差异。使用透热疗法的剖腹术切口明显比手术刀切口快（平均值（标准误）6.1（0.4）对7.5（0.5）秒/平方厘米；P<0.04）。与手术刀组相比，透热疗法组的失血量明显更少（0.8（0.1）对1.7（0.3）毫升/平方厘米；P = 0.002）。术后第1个48小时内，透热疗法组的术后疼痛评分明显更低（P<0.05）。在术后的前5天，透热疗法切口组的吗啡需求量也明显更低（P<0.04）。两组在出院前和1个月随访时的伤口并发症方面无差异。
在择期手术中，电外科正中切口在切口时间、失血量、术后早期疼痛和镇痛需求方面比使用手术刀具有显著优势。
