择期普通外科手术中透热疗法与手术刀切口的随机临床试验。

Randomized, clinical trial on diathermy and scalpel incisions in elective general surgery.

作者信息

Talpur Altaf Ahmed, Khaskheli Abdul Basir, Kella Nandlal, Jamal Akmal

机构信息

Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.

出版信息

Iran Red Crescent Med J. 2015 Feb 21;17(2):e14078. doi: 10.5812/ircmj.14078. eCollection 2015 Feb.

DOI:10.5812/ircmj.14078

PMID:25834739

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4376978/

Abstract

BACKGROUND

Since a long time skin incisions have routinely been made with scalpels. Now a day there is a shift in trend from this method to electrosurgical skin incisions. However, fear of bad scars and improper wound healing has prevented its wide spread use. This Study aimed to compare both methods of skin incisions for different variables.

OBJECTIVES

The aim of this study was to examine incisional time, blood loss during incision and postoperative wound complications and pain with both methods of skin incision.

PATIENTS AND METHODS

A prospective, comparative and randomized study was conducted at different hospitals of Hyderabad and Nawabshah, Pakistan from 1(st) of December 2009 to 30(th) of November 2011. The study included patients of either sex above the age of five years with general surgical pathology who were to undergo surgery. these candidates were randomly put into two groups. In Group A patients incision was made with a scalpel and in group B with diathermy. Data was analyzed for age, sex, comorbid illness, incisional time, blood loss during incision making and postoperative pain and wound complications.

RESULTS

A total of 283 patients completed the follow-up and were included in the final analysis. Group A comprised of 143 (50.53%) patients; 83 (58%) males and 60 (42%) females with a mean age of 36.03 years. Amongst the 140 patients of group B, there were 85 (60.7%) males and 55 (39.3%) females with a mean age of 36.52 years. Twenty-five (17.48%) patients of group A and 27 (19.28%) of group B had comorbid illnesses. Mean incision time was 8.9025-sec/cm(2) for group A and 7.3057 sec/cm(2) for group B patients. Mean blood loss during incision making was 1.8262 mL/cm(2) and 1.1346 mL/cm(2) for group A and B patients, respectively. Pain was 5.2957 for group A patients on day one and 3.1181 for group B patients. Pain score was 2.1049 and 1.6206 on day two and 0.8191 and 0.7192 on day five, for group A and B patients, respectively. Postoperative wound complications were noticed in 26 (18.18%) patients of group A and 22 (15.71%) patients of group B.

CONCLUSIONS

Diathermy incision is a safe and expedient technique. It takes less time than scalpel incision and loss of blood is also lower during incision. Diathermy is associated with lesser post-operative pain and complications than the scalpel incision. Diathermy should be method of choice in general elective surgery.

摘要

背景

长期以来，皮肤切口一直常规使用手术刀进行。如今，趋势已从这种方法转向电外科皮肤切口。然而，对瘢痕不佳和伤口愈合不良的担忧阻碍了其广泛应用。本研究旨在比较两种皮肤切口方法的不同变量。

目的

本研究的目的是检查两种皮肤切口方法的切开时间、切开过程中的失血量、术后伤口并发症及疼痛情况。

患者与方法

2009年12月1日至2011年11月30日在巴基斯坦海得拉巴德和瑙沃布沙赫的不同医院进行了一项前瞻性、对比性和随机研究。该研究纳入了年龄在5岁以上、因普通外科病理情况需接受手术的男女患者。这些受试者被随机分为两组。A组患者用手术刀进行切口，B组患者用电刀进行切口。对年龄、性别、合并疾病、切开时间、切开过程中的失血量以及术后疼痛和伤口并发症的数据进行了分析。

结果

共有283例患者完成随访并纳入最终分析。A组包括143例（50.53%）患者；其中男性83例（58%），女性60例（42%），平均年龄36.03岁。B组的140例患者中，男性85例（60.7%），女性55例（39.3%），平均年龄36.52岁。A组25例（17.48%）患者和B组27例（19.28%）患者有合并疾病。A组患者的平均切开时间为8.9025秒/平方厘米，B组患者为7.3057秒/平方厘米。A组和B组患者切开过程中的平均失血量分别为1.8262毫升/平方厘米和1.1346毫升/平方厘米。A组患者术后第一天疼痛评分为5.2957，B组患者为3.1181。术后第二天，A组和B组患者的疼痛评分分别为2.1049和1.6206，术后第五天分别为0.8191和0.7192。A组26例（18.18%）患者和B组22例（15.71%）患者出现术后伤口并发症。