Diathermy v. scalpel Pfannenstiel incision in repeated caesarean sections: A randomised controlled trial

Background. Most surgeons do not choose diathermy over scalpel skin incision, as they speculate that the thermal effect produced owing to tissue resistance to electrical current may lead to postoperative pain, delayed wound healing and wound complications. Objective. To compare the use of cutting diathermy skin incision with scalpel skin incision with regard to incision time, haemostasis, postoperative pain, wound healing and wound complications. Methods. A randomised controlled trial was performed on 476 women who underwent caesarean sections. They were randomised into two groups: group 1 (women scheduled for conventional scalpel skin incision) and group 2 (women scheduled for cutting diathermy skin incision). Results. The incision time, blood loss, visual analogue scale (VAS) pain score and doses needed for analgesia were significantly lower in group 2 than in group 1 (p<0.001). The groups did not show any significant difference regarding wound complications. Wound healing in both groups was by primary intention. Conclusions. Diathermy skin incision is superior to scalpel skin incision, with no postoperative pain and good wound healing.