Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-19T23:26:33.668Z Has data issue: false hasContentIssue false

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wong, CK, Wheeler, MH. Thyroid nodules: rational management. World J Surg 2000;24:934–41Google Scholar
2Zarnegar, R, Brunaud, L, Clark, OH. Prevention, evaluation, and management of complications following thyroidectomy for thyroid carcinoma. Endocrinol Metab Clin North Am 2003;32:483502CrossRefGoogle ScholarPubMed
3Rosato, L, Avenia, N, Bernante, P, De Palma, M, Gulino, G, Nasi, PG et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg 2004;28:271–6CrossRefGoogle Scholar
4Fewins, J, Simpson, CB, Miller, FR. Complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am 2003;36:189206CrossRefGoogle ScholarPubMed
5Sheikh, B. Safety and efficacy of electrocautery scissors utilization for skin opening in neurosurgery. Br J Neurosurg 2004;18:268–72CrossRefGoogle Scholar
6Porter, KA, O'Connor, S, Rimm, E, Lopez, M. Electrocautery as a factor in seroma formation following mastectomy. Am J Surg 1998;176:811CrossRefGoogle ScholarPubMed
7Kearns, SR, Connolly, EM, McNally, S, McNamara, DA, Deasy, J. Randomized clinical trial of diathermy versus scissors incision in elective midline laparotomy. Br J Surg 2001;88:41–4CrossRefGoogle Scholar
8Franchi, M, Ghezzi, F, Benedetti-Panici, PL, Melpignano, M, Fallo, L, Tateo, S et al. A multicentre collaborative study on the use of cold scissors and electrocautery for midline abdominal incision. Am J Surg 2001;181:128–32CrossRefGoogle Scholar
9Soballe, PW, Nimbkar, NV, Hayward, I, Nielsen, TB, Drucker, WR. Electric cautery lowers the contamination threshold for infection of laparotomies. Am J Surg 1998;175:263–6CrossRefGoogle ScholarPubMed
10Cruse, PJE, Foord, R. A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973;107:206–10CrossRefGoogle Scholar
11Groot, G, Chappell, EW. Electrocautery used to create incisions does not increase wound infection rates. Am J Surg 1994;167:601–3CrossRefGoogle Scholar
12Johnson, CD, Serpell, JW. Wound infection after abdominal incision with scissors or diathermy. Br J Surg 1990;77:626–7CrossRefGoogle ScholarPubMed
13Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:250–78Google Scholar
14Aronson, WL, McAuliffe, MS, Miller, K. Variability in the American society of Anesthesiologists physical status classification scale. ABNA J 2003;71:265–74Google ScholarPubMed
15Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection. Am J Infect Control 1999;27:97132CrossRefGoogle ScholarPubMed
16Terzi, C. Antimicrobial prophylaxis in clean surgery with special focus on inguinal hernia repair with mesh. J Hosp Infect 2006;62:427–36CrossRefGoogle ScholarPubMed
17Kim, H, Brunner, E, Ritter, E, Thompson, D, Devereux, D. Relevance of methods of skin incision technique on development of wound infection. Am Surg 1990;56:129–30Google Scholar
18Rappaport, WD, Allen, R, Lick, S, Halldorsson, A, Chvapil, T, Holcomb, M et al. Effect of electrocautery on wound healing in midline laparotomy incisions. Am J Surg 1990;160:618–20Google Scholar
19Hussain, SA, Hussain, S. Incision with knife or diathermy and postoperative pain. Br J Surg 1988;75:1179–80CrossRefGoogle ScholarPubMed
20Madden, JE, Edlich, RF, Custer, JR, Panek, PH, Thul, J, Wangensteen, OH. Studies in management of contaminated wounds. Resistance to infection of surgical wounds made by knife, electrosurgery and laser. Am J Surg 1970;119:222–4CrossRefGoogle ScholarPubMed