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Electrocautery for cutaneous flap creation during thyroidectomy: a randomised, controlled study

Published online by Cambridge University Press:  03 March 2008

U Barbaros
Affiliation:
Department of General Surgery, Istanbul University, Turkey
Y Erbil*
Affiliation:
Department of General Surgery, Istanbul University, Turkey
N Aksakal
Affiliation:
Department of General Surgery, Istanbul University, Turkey
G Çıtlak
Affiliation:
Department of General Surgery, Istanbul University, Turkey
H İşsever
Affiliation:
Department of Public Health, Medical Faculty, Istanbul University, Turkey
A Bozbora
Affiliation:
Department of General Surgery, Istanbul University, Turkey
S Özarmağan
Affiliation:
Department of General Surgery, Istanbul University, Turkey
*
Address for correspondence: Dr Yesim Erbil, Department of General Surgery, Istanbul Medical Faculty, Istanbul University, 34340 Capa, Istanbul, Turkey. Fax: +90 212 6319771 E-mail: yerbil2003@yahoo.com

Abstract

Background:

Although electrocautery has been used widely in surgery, the fear of delayed wound healing and infection persists. We aimed to evaluate the risk factors for wound complications and the rate of wound complications, comparing the use of electrocautery or scissors in cutaneous flap creation during thyroidectomy.

Design:

The study group comprised 239 consecutive patients scheduled for thyroidectomy.

Subjects:

Patients were randomly assigned to cutaneous flap dissection by either electrocautery (group one, n = 126) or scissors (group two, n = 113). Age, gender, body mass index, American Society of Anesthesiology score, tissue weight, operating time, incision length, cutaneous tissue depth, thyroid function and surgeon experience were recorded and compared with the rate of post-operative wound complications in both groups.

Results:

There were no significant differences between the overall rate of post-operative wound complications, comparing groups one and two (7.9 vs 10.6 per cent, respectively; p = 0.74). Significant positive correlations were found between wound complication and age (Spearman's rank coefficient (rs) = 0.135, p = 0.036), body mass index (rs = 0.379, p = 0.0001), cutaneous tissue depth (rs = 0.677, p = 0.0001) and tissue weight (rs = 0.643, p = 0.0001). According to logistic regression analysis, a body mass index of more than 27.5 kg/m2 was associated with a 13.7-fold increased rate of post-operative wound complications.

Conclusion:

When creating cutaneous flaps during thyroidectomy, the use of electrocautery is as safe as the use of scissors. Such electrocautery does not increase the risk of wound complications in thyroid surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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