I really don't understand why we're continuing to use scalpels for skin incision. Using the 'cut' option in cautery is faster, causes less blood loss and pain, and does not increase infections, in multiple studies.
Diathermy versus scalpel incisions in elective abdominal surgery: a comparative study.
"There was a significant increase in mean time taken for incision by scalpel when compared to cautery. Mean incision blood loss ...and postoperative pain was significantly higher in the scalpel group (p value <0.05) on postoperative day 1."
Advanced Cutting Effect System versus Cold Steel Scalpel: Comparative Wound Healing and Scar Formation in Targeted Surgical Applications.
"modern electrosurgical generators that produce pure sinusoidal "CUT" waveforms have shown reductions in thermal damage along incisions...Results showed noninferior wound healing/scar formation in skin incisions made with [cautery] compared with incisions made with a [scalpel].
Comparison of electrocautery incision with scalpel incision in midline abdominal surgery RCT. "...mean incision time per unit wound area in the electrocautery group and scalpel group was 9.40 ± 3.37 s/cm2 and 9.07 ± 3.40 s/cm2 (p = 0.87) respectively. The mean blood loss per unit wound area was significantly lower in the electrocautery group at 6.46 ± 3.94 ml when compared to that of 23.40 ± 15.28 ml in the scalpel group (p= < 0.0001, CI = 11.97–21.89). There was no significant difference in pain [or] wound infection rates…"
A comparative study to evaluate the outcome between electrocautery versus scalpel skin incision in tension-free inguinal hernioplasty: a tertiary care teaching centre experience. "...incision time was shorter in the electrocautery group (P <0.001). The blood loss was less with the electrocautery compared to the scalpel (6.53±3.84 ml vs. 18.16±7.36 ml, P<0.001). The cumulative numerical rating scale score for pain was 12.65 (standard deviation SD 8.06) and 17.12 (SD 9.49) in the diathermy and scalpel groups respectively (P<0.001). There was no statistically significant difference in wound infection and wound closure
(epithelialization time) (P=0.206)..."
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