Comparison Of Skin Incision With Electro Surgical Cautery Vs Scalpel In Elective Inguinal Hernia Surgery: A Randomized Control Study

Abstract

Surgical incisions are usually made with scalpel. Since its introduction in 1929, Electro surgery has been used extensively and has now become an indispensable tool in every operating room. The present study was designed to evaluate the use of electro surgery for making skin incisions in elective inguinal hernia surgery by comparing postoperative pain and cosmetic outcome. Materials and methods This one year randomized controlled trail was done in Department of General Surgery, KLES Dr.Prabhakar Kore hospital, Belagavi from January 2016 to December 2016. A total of 40 patients were divided into two groups of 20 each. Group A skin incision was made with electrosurgical cautery and Group B skin incision was made with scalpel. Results In the present study all the participants were males. In this study the commonest age group was 55 – 64 years in group A (40 %) and in group B (37.5%). The mean age of the participants in group A is 50.95 ±11.75 and the mean age of the participants in group B is 52.2 ± 11.443(p value of 0.0.741) In the present study the postoperative pain between the two groups is compared at 24 hrs, 48 hrs and 72 hrs. The pain was assessed by Visual Analogue Scale on a scale of 1 to 10. In the present study the mean pain scores at 24 hrs for group A is 3.7 ± 0.71 and that of group B is 4.85 ± 0.82 ( p value 0.0004). The mean pain scores measured at 48 hrs for group A is 2.9 ± 0.62 and for group B is 3.55 ± 0.589 (p value 0.009). In the present study, the pain scores at 72 hrs between the two groups was not statistically significant (p value 0.262) group A mean is 2.2 ± 0.74 and group B mean is 2.55 ± 0.73. The post operative pain scores are less when incision is made with electrosurgical cautery at 24 hrs and 48 hrs The cosmetic outcome between the two groups was compared using Patient and Observer Scar assessment Scale (POSAS) , the scale has patient scale (60) and observer scale (60) and the total score (120) is assessed. The mean scar score of group A is 37.4 ± 4.96 and that of group B is 36.05 ± 5.14 and there is no statistical difference between the two groups, p value = 0.415. The incision length between the two groups was also compared, In group A the mean length of incision is 9.75 cm ± 0.825, in group B the mean length of incision is 9.811 cm ± 0.719 with a p value of 0.722, there is no statistically significant difference between the two groups. Conclusion Electro surgical cautery can be safely and effectively used for making skin incisions in surgical procedures and has the advantage of less postoperative pain when compared with incision made with scalpel.