Abdominal Wound Problem after Hysterectomy using Scalpel Versus Electrocautery for Skin and Subcutaneous Dissection

2021 ◽  
Vol 15 (9) ◽  
pp. 2870-2872
Author(s):  
Erum Memon ◽  
Kiran Batool ◽  
Mubashra Samina ◽  
Sana Ashfaq ◽  
Kaniz Zehra Naqvi
Keyword(s):  
Subcutaneous Tissue ◽  
Abdominal Hysterectomy ◽  
Skin Incision ◽  
Wound Complications ◽  
P Value ◽  
Abdominal Wound ◽  
Wound Infections ◽  
Tissue Dissection ◽  
Wound Problem ◽  
Operative Wound

Objective: To evaluate the postoperative abdominal wound problem after hysterectomy with scalpel versus electrocautery for skin and subcutaneous dissection. Material and Methods: A total of 516 post-menopausal women having age 40 to 65 years who were planned for elective hysterectomy were included in this study. Patients having only benign disorders were included. In group E (N=258); Skin incision and tissue dissection was done using electrocautery by setting the electrocautery machine at cutting mode at 30 to 50 watts’ power. In group S (N=258); conventional scalpel was used for skin incision. Scalpel number 23 was used for skin and subcutaneous tissue dissection. Post-operative wound complications such as seroma, hematoma, wound dehiscence and wound infections were primary study endpoints. Results: Mean age was 48.6±6.9 years in electrocautery and 49.2±6.3 years in scalpel group (p-value 0.30). Seroma formation was diagnosed in 98 (37.98%) patients in electrocautery group and in 52 (20.1%) patients in scalpel group (p-value <0.0001). Wound infections were diagnosed in 50 (19.3%) patients in electrocautery group versus in 87 (33.7%) patients in scalpel group (p-value 0.0002). Hematoma was diagnosed in 10 (3.87%) patients in electrocautery group and in 19 (7.4%) in scalpel group (p-value 0.08). Conclusion: The use of electrocautery is associated with lower rate of post-operative wound infections and hematoma formation. The present study advocates the use of electrocautery for skin and subcutaneous tissue dissection in patients undergoing abdominal hysterectomy. Keywords: Abdominal hysterectomy, electrocautery, scalpel, wound complications.

scholarly journals Observational study of scalpel versus electrocautery for subcutaneous incision in elective gynaecological surgeries

2017 ◽  
Vol 6 (3) ◽  
pp. 950 ◽  
Author(s):  
Vaibhav B. Patil ◽  
Vidya D. Mule ◽  
Ravi M. Raval ◽  
Abhishek A. Kulkarni
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Subcutaneous Tissue ◽  
Wound Complications ◽  
P Value ◽  
Abdominal Incision ◽  
Postoperative Wound ◽  
Tertiary Teaching ◽  
Group A ◽  
Group B

Background: Considering higher rate of postoperative wound complications in Government set up hospitals, this study was an attempt to compare incision time, incisional blood loss, hospital stay, post-operative pain and postoperative wound complications when subcutaneous tissue is opened with either scalpel or electrocautery in elective gynaecological surgeries after keeping all other clinical and surgical variables same i.e. age, BMI, haemoglobin, incision depth and hospital stay.Methods: This was a prospective observational comparative study conducted in one of the tertiary teaching hospital in Western Maharashtra, India over 12 months. All patients (n=100) were divided into 2 groups. Group A in which skin and subcutaneous tissue was dissected by using scalpel and Group B in which after skin, anterior abdominal wall was opened by using electrocautery. Data analyzed for indication, incisional blood loss, incision time, postoperative pain, wound complications and hospital stay.Results: There were no significant association between preoperative diagnosis and the development of a post-operative wound complications. Mean incision blood loss was found to be significantly higher in group A compared to group B patients. Postoperative pain was significantly higher in group A (P value <0.05). Among wound complications, no statistically significant differences were seen regarding wound complications for the two groups.Conclusions: Electrosurgical dissection for abdominal incision is safe, less time consuming and with less blood loss during subcutaneous incision and produces less postoperative pain. We conclude that the method of subcutaneous tissue incision was unrelated to the development of postoperative abdominal incision problems.

scholarly journals A Comparative Study of Electrocautery Versus Cold Scalpel For Skin Incision In Inguinal Hernia Repair

2017 ◽  
Vol 14 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Meraj Alam Ansari ◽  
S. M. Mishra ◽  
B. D. Baskota
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
College Teaching ◽  
Skin Incision ◽  
Skin Wound ◽  
Wound Complications ◽  
P Value ◽  
Post Operative Pain

Introduction: Electrocautery has been widely used except for the skin incisions; this is because of the fear of scarring of skin, post operative pain, poor wound healing and wound infection in view of devitalisation of tissues. Although still not very popular, yet the use of diathermy instead of scalpel for making skin incision and underlying tissue dissection is gradually gaining wide acceptance. The purpose of this study was to compare the scalpel incision with electrocautery incision over skin in patients undergoing hernia repair.Aims and Objectives: To compare the skin wound made by the diathermy and scalpel with a view in; intraoperative incision time, post operative pain, requirement of analgesia and the quality of wound healing.Material and Methods: This is hospital based comparative study, undergone elective inguinal hernia repair in the department of general surgery at Nepalgunj medical college teaching hospital, Kohalpur from the period of July 2015 to January 2016. Group A, contained 30 patients who underwent skin incision with scalpel and Group B, also contained 30 patients who underwent skin incision with electrocautery. These groups were compared and statistical analysis using SPSS (version 20) was done and p value 0.05 was taken as significant.Results: Compared with a scalpel incision, cutting diathermy resulted in significantly shorter incision time (p <0.002). The two groups did not differ in relation to post operative pain and the post operative analgesics requirements. The postoperative complications viz, seroma and purulent collections were in both the groups though the hematoma collection was seen more in scalpel skin incision.Conclusion: Skin incision made by cutting diathermy was less time taking and there was no appreciable differences in postoperative pain, the requirements of analgesia and the rate of wound complications like seroma, and purulent collection, though the hematoma was seen more in scalpel skin incision. So the use of diathermy for making skin incision is as safe as the use of scalpel in patients undergoing inguinal hernia repair.  JNGMC Vol. 14 No. 1 July 2016, Page: 14-17 

scholarly journals Minimum alveolar concentration of isoflurane in dogs administered two morphine doses

2017 ◽  
Vol 47 (11) ◽  
Author(s):  
Karina Coelho ◽  
Eduardo Raposo Monteiro ◽  
Thais Feres Bressan ◽  
Betânia Souza Monteiro ◽  
Daniela Campagnol ◽  
...  
Keyword(s):  
Minimum Alveolar Concentration ◽  
Subcutaneous Tissue ◽  
Skin Incision ◽  
Noxious Stimulus ◽  
Tissue Dissection

ABSTRACT: This study aimed to evaluate the effects of intramuscular 0.5mg kg-1 (MOR0.5) and 1.0mg kg-1 (MOR1.0) morphine premedication on the minimum alveolar concentration of isoflurane (ISOMAC) in dogs. Eighteen client-owned female dogs were scheduled for elective ovariohysterectomy. Dogs received intramuscular MOR0.5 or MOR1.0 as premedication and propofol IV for induction of anesthesia. Isoflurane was delivered for maintenance of anesthesia and dogs were maintained under normocapnia and normothermia. Determinations of the ISOMAC were conducted by use of the “up-and-down” method. Noxious stimulus (placement of Backhaus towel clamps, a midline skin incision and subcutaneous tissue dissection) was delivered approximately 50 minutes after premedication with MOR0.5 or MOR1.0. The calculated ISOMAC was 0.98±0.15% in MOR0.5 and 0.80±0.08% in MOR1.0. The ISOMAC was significantly lower in MOR1.0 compared with MOR0.5 (P=0.010). Results of this study suggested that intramuscular premedication with morphine 0.5 and 1.0mg kg-1 decreases the ISOMAC in a dose-related manner in dogs.

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals Tingkat Pengetahuan Ibu Tentang Perawatan Luka Dan Kejadian Infeksi Daerah Operasi Di RSUD Banyumas

2021 ◽  
Vol 6 (2) ◽  
pp. 75
Author(s):  
Utami Purwaningsih ◽  
Kris Linggardini
Keyword(s):  
Surgical Site Infection ◽  
Wound Care ◽  
Good Health ◽  
P Value ◽  
Wound Infections ◽  
Knowledge Level ◽  
Site Infection ◽  
Chi Square ◽  
Cross Sectional ◽  
The Relationship

Surgical Site Infection is infections that occur after surgery. Control of the incidence of nosocomial infection is part of the parameters of good health services at the hospital. One in 10 mothers who give birth by cesarean has an infection. The level of patient knowledge about how to care for wounds is an important factor in decreasing the incidence of wound infection in the surgical area in SC patients. Objective: knowing the relationship between levels of knowledge of post-operative SC patients about wound care and the incidence of surgical site wound infections. Method: The design used descriptive correlative and cross sectional approach. The sample were 76 respondents. The data were collected in December 2019 by using a knowledge level questionnaire and a form of signs of infection from Morison 2004. Data analysis using chi square).  The results showed that there was a relationship between knowledge and the incidence of infection in the area of ​​operation (p value 0.001).  Keywords: nosocomial, surgical site infection (SSI), section caesarea (SC) 

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