Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Lower Eyelid Blepharoplasty Incision: A Randomized Controlled Trial.

BACKGROUND

Lower eyelid blepharoplasty is one of the most popular aesthetic procedures. Electrocautery provides a hemostatic benefit for skin incision; however, its effect on scar cosmesis remains unclear, particularly in Asian skin types. We compared the Colorado needle electrocautery (pure-cutting mode) versus the traditional scalpel in terms of efficacy, complications, and cosmetic outcomes.

METHODS

A prospective intraindividual randomized controlled trial was conducted to compare the efficacy of Colorado needle electrocautery and scalpel in lower blepharoplasty. The study outcomes were scar quality at different times until 1 year postoperatively, bleeding during incision, and postoperative ecchymosis. Scar quality was evaluated using 3 standard scar ratings: the Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, and Hollander wound evaluation scale.

RESULTS

The study included 25 patients, and the electrocautery side had less blood loss during incision than the scalpel side (2.6 ± 0.65 versus 5.28 ± 0.68 sticks;  < 0.001). The electrocautery side had less postoperative ecchymosis ( < 0.001); however, 1-year scar quality was not statistically significant between the groups.

CONCLUSIONS

Colorado needle electrocautery pure-cutting mode can be an alternative to the traditional scalpel for lower eyelid blepharoplasty skin incision because of long-term scar quality. Electrocautery also has hemostatic benefits, leading to a decrease in intraoperative and postoperative bleeding.