This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Randomized double‐blind trial comparing the cosmetic outcome of cutting diathermy versus scalpel for skin incisions. BJS 2015; 102: 489-494.

Published: 18th February 2015

Authors: L. N. F. Aird, S. G. Bristol, P. T. Phang, M. J. Raval, C. J. Brown

Background

Controversy exists about whether cutting diathermy for skin incisions leads to a cosmetically inferior scar. Cosmetic outcomes were compared between skin incisions created with cutting diathermy versus scalpel. Wound infection rates and postoperative incisional pain were also compared.

Method

This was a randomized double‐blind trial comparing cutting diathermy and scalpel in patients undergoing bowel resection. Scar cosmesis was assessed at 6 months after surgery by a plastic surgeon and a research associate using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Patients also used POSAS to self‐evaluate their scars. Wound infections within 30 days were recorded, and incision pain scores were measured on the first 5 days after operation.

Results

A total of 66 patients were randomized to cutting diathermy (31) or scalpel (35). At 6 months, there was no significant difference between the diathermy and scalpel groups in mean(s.d.) VSS scores (4·9(2·6) versus 5·0(1·9); P = 0·837), mean POSAS total scores (19·2(8·0) versus 20·0(7·4); P = 0·684) or subjective POSAS total scores (20·2(12·1) versus 21·3(10·4); P = 0·725). Neither were there significant differences in wound infection rates between the groups (5 of 30 versus 5 of 32; P = 1·000). Pain scores on day 1 after operation were significantly lower in the diathermy group (mean 1·68 versus 3·13; P = 0·018), but were not significantly different on days 2–5.

Conclusion

Cutting diathermy is a cosmetically acceptable technique for abdominal skin incisions. There is no increased risk of wound infection, and diathermy may convey benefit in terms of early postoperative wound pain. Registration number: NCT01496404 (
http://www.clinicaltrials.gov).

Full text

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Randomized double‐blind trial comparing the cosmetic outcome of cutting diathermy versus scalpel for skin incisions. BJS 2015; 102: 489-494.

Background

Method

Results

Conclusion

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