Comparison of Cutting Diathermy and Scalpel in Terms of Delay in Wound Healing and Scar Appearance in Skin Incision: A Prospective Observational Study

Introduction: Traditionally, a scalpel is used for surgical incisions. The aim of this study was to compare cutting diathermy and scalpel in terms of wound healing or cosmetic appearance in skin incision. Methods: The study was performed in patients with Pfannenstiel incision in a gynecology and obstetrics clinic. Half of the skin incision of the same patient was made with cautery and the other half was made with scalpel. The part of the incision made with cautery was compared with the incision made with scalpel in terms of wound healing and cosmetic appearance. The assessments were based on the observer scale of the "The Patient and Observer Scar Assessment scale" (POSAS). Evaluations were performed as single blind (observer-blinded, but not surgeon) in the short term (postoperative 15th day) and long term (45th day). Results: A total of 73 women with Pfannenstiel incision were evaluated. The median age of the patients was 33 (21-52) years. The total POSAS scores of the parts opened with scalpel were not statistically different from those opened with cautery both at the 15th and 45th days (27.3 +/- 5.2 vs 27.0 +/- 5.1, p=0.88 for 15th day; 11.8 +/- 3.2 vs 11.0 +/- 4.1, p=0.56 for 45th day). Conclusion: The study showed that using cautery in cutting mode had no effect on poor wound healing and cosmetic appearance in Pfannenstiel incisions compared to the use of scalpel. This result encourages surgeons to make a skin incision with cautery.