Barbaros U, Erbil Y, Aksakal N, Citlak G, Işsever H, Bozbora A, Ozarmağan S
Department of General Surgery, Istanbul University, Turkey.
J Laryngol Otol. 2008 Dec;122(12):1343-8. doi: 10.1017/S0022215108001734. Epub 2008 Mar 3.
Although electrocautery has been used widely in surgery, the fear of delayed wound healing and infection persists. We aimed to evaluate the risk factors for wound complications and the rate of wound complications, comparing the use of electrocautery or scissors in cutaneous flap creation during thyroidectomy.
The study group comprised 239 consecutive patients scheduled for thyroidectomy.
Patients were randomly assigned to cutaneous flap dissection by either electrocautery (group one, n = 126) or scissors (group two, n = 113). Age, gender, body mass index, American Society of Anesthesiology score, tissue weight, operating time, incision length, cutaneous tissue depth, thyroid function and surgeon experience were recorded and compared with the rate of post-operative wound complications in both groups.
There were no significant differences between the overall rate of post-operative wound complications, comparing groups one and two (7.9 vs 10.6 per cent, respectively; p = 0.74). Significant positive correlations were found between wound complication and age (Spearman's rank coefficient (rs) = 0.135, p = 0.036), body mass index (rs = 0.379, p = 0.0001), cutaneous tissue depth (rs = 0.677, p = 0.0001) and tissue weight (rs = 0.643, p = 0.0001). According to logistic regression analysis, a body mass index of more than 27.5 kg/m2 was associated with a 13.7-fold increased rate of post-operative wound complications.
When creating cutaneous flaps during thyroidectomy, the use of electrocautery is as safe as the use of scissors. Such electrocautery does not increase the risk of wound complications in thyroid surgery.
尽管电灼术在外科手术中已被广泛应用，但人们对伤口延迟愈合和感染的担忧依然存在。我们旨在评估伤口并发症的风险因素及伤口并发症发生率，比较甲状腺切除术中使用电灼术或剪刀进行皮瓣制作的情况。
研究组包括239例连续接受甲状腺切除术的患者。
患者被随机分为两组，一组（n = 126）用电灼术进行皮瓣剥离，另一组（n = 113）用剪刀进行皮瓣剥离。记录患者的年龄、性别、体重指数、美国麻醉医师协会评分、组织重量、手术时间、切口长度、皮肤组织深度、甲状腺功能及外科医生经验，并与两组术后伤口并发症发生率进行比较。
比较两组，术后伤口并发症的总体发生率无显著差异（分别为7.9%和10.6%；p = 0.74）。发现伤口并发症与年龄（斯皮尔曼等级系数（rs）= 0.135，p = 0.036）、体重指数（rs = 0.379，p = 0.0001）、皮肤组织深度（rs = 0.677，p = 0.0001）和组织重量（rs = 0.643，p = 0.0001）之间存在显著正相关。根据逻辑回归分析，体重指数超过27.5 kg/m²与术后伤口并发症发生率增加13.7倍相关。
在甲状腺切除术中制作皮瓣时，使用电灼术与使用剪刀一样安全。这种电灼术不会增加甲状腺手术中伤口并发症的风险。
