Diathermy versus scalpel in transverse abdominal incision in women undergoing repeated cesarean section: A randomized controlled trial

AimThe aim of this study was to evaluate the volume of blood loss, wound incision time and wound complication according to use of scalpel or electrosurgery during the creation of transverse abdominal incisions during repeated cesarean section (CS). Material and MethodsA randomized controlled trial was carried out at Ain Shams University Maternity Hospital. We recruited 130 women with a history of one previous CS at the time of their planned lower-segment CS. Participants were randomized to anterior abdominal wall opening from subcutaneous tissue till the peritoneum by either the use of scalpel with disposable blade (No. 22) or diathermy using the standard diathermy pen electrode. The main outcome measures were the volume of blood loss from skin incision to the end of the peritoneal incision, the operative time and wound complication. ResultsWe observed a highly significant difference between the two groups in blood loss (median [interquartile range],11 [8-15.25]g for the diathermy group vs 20 [18-23] g for the scalpel group, P<0.001) and skin-to-peritoneum incision time (median [interquartile range],7 [5-7.25] min for the diathermy group vs 10 [7-11] min for the scalpel group, P<0.001). The postoperative pain was less in the diathermy group but wound complications showed no statistical difference. ConclusionThe use of diathermy in the opening of anterior abdominal wall during CS decreases blood loss and operative time but has no impact on postoperative pain or wound complications.