Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
Surg Today. 2011 Aug;41(8):1041-8. doi: 10.1007/s00595-010-4435-5. Epub 2011 Jul 20.
The use of electrocautery for tissue dissection is becoming increasingly popular, despite the associated risk of poor wound healing and excessive scarring. We conducted this study to compare the wound complications and early and late clinical results resulting from electrocautery versus the scalpel to create a cutaneous flap during thyroidectomy.
The subjects of this study were 100 patients, randomized prospectively to either a scalpel group (group S, n = 50) or an electrocautery group (group E, n = 50).
Thickness of tissue damage, postoperative thickness of the flap, discomfort in the neck 7 days after surgery, and hypoesthesia and paresthesia in the neck 3 months after surgery were significantly higher in group E than in group S. There were no significant differences in overall postoperative wound complications, postoperative pain, satisfaction with the cosmetic result, or overall outcome of the operation between the groups. Although the incidence of seroma was higher in group E (20%) than in group S (8%), the difference was not significant.
Although electrocautery was associated with increased histological tissue damage, postoperative flap edema, discomfort, and other complications in the early stage, the clinical and cosmetic results of flaps made using electrocautery or a scalpel were similar and satisfactory 6 months after surgery.
尽管电灼可能导致伤口愈合不良和过度瘢痕形成，但因其在组织解剖中的应用日益普及，我们进行这项研究旨在比较电灼与手术刀在甲状腺切除术中创建皮瓣时的伤口并发症、早期和晚期临床结果。
本研究的受试者为 100 例患者，前瞻性随机分为手术刀组（S 组，n = 50）和电灼组（E 组，n = 50）。
E 组组织损伤厚度、术后皮瓣厚度、术后 7 天颈部不适以及术后 3 个月颈部感觉减退和感觉异常均显著高于 S 组。两组间总术后伤口并发症、术后疼痛、对美容结果的满意度以及手术整体结局均无显著差异。虽然 E 组（20%）血清肿的发生率高于 S 组（8%），但差异无统计学意义。
尽管电灼会导致组织学上的组织损伤增加、术后皮瓣水肿、早期不适和其他并发症，但电灼或手术刀制作的皮瓣 6 个月后的临床和美容效果相似且令人满意。
