Is it safe to incise skin by monopolar electrocautery? A comparative study

Nimesh B. Thakkar, Pranav Patel, Gautam Sonagra


Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.

Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.

Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.

Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.


Electrosurgery, Monopolar, Scalpel, Complications, Healing, Hospital stay, Wound infection

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John TB. The Oxford textbook of surgery. 2nd edition. Chapter 10.3. surgical Diathermy (Section of Anaesthesia and the Operating room). Moyle; 2000: 241-243.

Hurst RD, Fichera A, Michelassi F. Master of Surgery. Fourth edition. Baker R, Fischer J, editors. Volume 1. Chapter 14. Electrocautery, Argon beam coagulation, Cryotherapy, and other hemostatic and tissue ablative instruments. 2001: 238-250.

Kearn SR, Connolly EM, McNally S, McNamara DA, Deasy J. Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy. Br J Surg. 2001;88(1):41-4.

Dixon AR, Watkin DF. Electrosurgical skin incision vrsus conventional scalpel: a prospective trial. R.J Coll Surg Edinb. 1990;35(5):299-301.

Tipton WW, Garrick JG, Riggins RS. Healing of electrosurgical and scalpel wounds in rabbits. J Bone Joint Surg Am. 1975;57(3):377-9.

Mann W, Klippel CH. Electrosurgical skin incision. J Pediaty Surg. 1977;12(5):725-6.

Pearlman NW, Stiegmann GV, Vance V, Norton LW, Bell RC, Staerkel R, et al. A Prospective study of incision time, blood loss, pain and healing with carbon dioxide laser, scalpel, and electrosurgery. Arch Surg. 1991;126(8):1018-20.

Stolz AJ, Schutzner J, Lischke R, Simonek J, Pafko P. Is a scalpel required to perform a thoracotomy? Rozhl Chir. 2004;83(4):185-8.

Dixon AR, Watkin DF. Electrosurgical skin incision vrsus conventional scalpel: a prospective trial. R.J Coll Surg Edinb. 1990;35(5):299-301.

Ji G, Wu Y, Wang X, Pan H, Li P, Du W, et al. Influence of high-frequency electric surgical knife on healing of abdominal incision, experimental and clinical studies. Zhonghua Yi Xue Za Zhi. 2002;82(17):1199-202.

Arashiro DS, Rapley JW, Cobb CM, Killoy WJ. Histologic evaluation of porcine skin incisions produced by co2 laser, electrosurgery and scalpel. Int J Periodontics Restorative Dent. 1996;16(5):479-91.