Wood Jeyhan S, Kittinger Benjamin J, Perry Victor L, Adenola Adeyemi, van Aalst John A
From the *Division of Plastic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; †Division of Plastic Surgery, Texas A&M-Scott & White, Temple, Texas; and ‡Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
J Craniofac Surg. 2014 Jul;25(4):1256-9. doi: 10.1097/SCS.0000000000000932.
There is an ongoing debate regarding the optimal instrument for scalp incisions: the scalpel or electrocautery. The argument generally focuses on improved healing after an incision made with a knife and decreased bleeding when using electrocautery. This study compares the use of scalpel and electrocautery in making coronal incisions for patients undergoing surgical correction of craniosynostosis. The outcome metric used is wound healing within 6 months after surgery. All patients presenting to the University of North Carolina Children's Hospital with craniosynostosis between July 1, 2007 and January 1, 2010 requiring a coronal incision for surgical correction were prospectively enrolled. In all of these patients, half of the coronal incision was made with knife; the other half, with needle tip cautery. Side of the incision was specified at the time of surgery in the operative report. Patients were excluded from the study if the instrument for incision was not specified or if only 1 modality was used for the entire incision. Sixty-eight patients underwent cranial vault reconstruction, of which 58 met inclusion criteria. Of the 58 matched pairs, 55 were analyzed statistically. The 3 excluded cases were those who had midline complications. There were 17 wound complications (15%): 8 in the knife group, 6 in the cautery group, and 3 at midline (with indeterminate side for the problem). We found no statistically significant difference in wound healing between incisions made with a knife or with electrocautery.
手术刀还是电灼器。争论通常集中在用刀切口后愈合改善以及使用电灼器时出血减少。本研究比较了手术刀和电灼器在为接受颅缝早闭手术矫正的患者制作冠状切口时的使用情况。所使用的结果指标是术后6个月内的伤口愈合情况。2007年7月1日至2010年1月1日期间，所有到北卡罗来纳大学儿童医院就诊、患有颅缝早闭且需要冠状切口进行手术矫正的患者均被前瞻性纳入研究。在所有这些患者中，冠状切口的一半用刀制作；另一半用针尖电灼器制作。切口的一侧在手术报告中手术时指定。如果切口器械未明确指定或整个切口仅使用1种方式，则将患者排除在研究之外。68例患者接受了颅骨重建，其中58例符合纳入标准。在58对匹配病例中，55例进行了统计学分析。3例排除病例是那些有中线并发症的患者。共有17例伤口并发症（15%）：刀组8例，电灼组6例，中线3例（问题侧不确定）。我们发现用刀切口和用电灼器切口在伤口愈合方面没有统计学上的显著差异。
