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September 2022BACKGROUND
The scalpel is considered the gold standard for surgical incisions. Its ease of use and accuracy are some of its advantages. Scalpel injuries are the second most common source of intraoperative injuries to the surgical staff following suture needle injuries, however; thus, restriction of scalpel use is desirable. Electrocautery’s ability to seal off blood vessels during skin incision provides enhanced hemostasis and can minimize blood loss; however, concerns of worse cosmetic outcome, increased postoperative pain, and possible damage to adjacent structures limit its adoption in skin incisions.
A great focus is placed nowadays on value and efficiency in surgery. Previous studies associated cautery use in skin incision with shorter incision time and less blood loss. The aim of this review is to compare cutting electrocautery versus the scalpel for surgical incisions in terms of wound complication rate, incisional time, incision-related blood loss, and cosmetic outcomes.
BEST PRACTICE
Surgical incision using electrocautery can be quicker, with less blood loss and better postoperative pain scores, than the scalpel incision while being cosmetically noninferior and indistinguishable from scalpel incision. The choice of electrocautery tip, energy level and mode, incision speed and technique, and suturing practices may affect scar formation and should be taken into consideration.