Steel Scalpel versus Electrocautery Blade: Comparison of Cosmetic and Patient Satisfaction Outcomes of Different Incision Methods

Objective: To determine which method of skin incision has superior cosmetic and patient satisfaction outcomes. Methods: Consenting patients undergoing bilateral neck dissection who met the inclusion criteria were prospectively enrolled. Each side of the neck was randomly assigned into one of the following two groups: scalpel incision and electrocautery incision. Cosmetic and patient satisfaction outcomes were collected prospectively with patients and outcome assessors blinded to group assignment. Validated self-report questionnaires and objective scar measures were used. Results: Nineteen patients met the criteria for inclusion. Analysis revealed no significant differences between groups in terms of cosmetic or satisfaction outcomes. Use of the steel scalpel was found to result in significantly greater incision-related blood loss compared with use of the electrocautery blade. Conclusion: Steel scalpel or electrocautery may be used to incise the skin of patients undergoing bilateral neck dissection with no difference in cosmetic or patient satisfaction outcome. The steel scalpel yields greater incision-related blood loss compared with the electrocautery blade.