November 2024
Compare the mean operative time, post-operative pain and blood loss with electrocautery verses scalpel in repeat caesarean sections for abdominal incisions
1Dr Shafaq Mehmood, 2Dr Sadia Aftab, 3Dr Naushin Farooq, 4Dr Tahreem Sehar, 5Dr Sannia Nasir:, 6Dr wajeeha Najeeb
1Medical officer, Gyne and Obs, WAH General Hospital)
2Assistant professor, MCH centre, PIMS)
3Consultant surgeon, gyne and obs, federal Government Polyclinic hospital)
4Medical officer, MCH Centre, PIMS)
5Post graduate resident MCH Centre, PIMS)
6House officer, gyne and obs, MCH Cente, PIMS)
Abstract
Introduction: There are many techniques of performing Caesarion section and each has its own advantages and disadvantages. The skin incision may be vertical, midline, Para median and the most common being Pfannenstiel incision. Electrocautery is an alternate method to open the skin by the use of an alternating current through tissue resistance to raise tissue temperature to achieve protein coagulation.
Objectives: To compare the mean operative time, post-operative pain and blood loss with electrocautery verses scalpel in repeat caesarean sections for abdominal incisions.
Study design: Randomized controlled trial.
Settings: Department of Obstetrics & Gynaecology, PIMS Hospital, Islamabad. Study duration: 30th June 2020 to 29th December 2020
Materials & Methods: Total 100 women with singleton pregnancy (assessed on USG) of gestational age 37-41 weeks (assessed by LMP) undergoing caesarean section of 18-45 years of age were selected. Women with GDM, Primigravida, hepatic or renal impairment were excluded. Group A included women who had incision with electrocautery. Group B included women who had incision with scalpel. All operations in both groups were done by myself pg4 resident and operative time, post-operative pain and blood loss was measured.
Results: In my study, the mean operative time in Group A (diathermy group) was 66.92 ± 7.39 minutes while in Group B (scalpel group) was 86.98 ± 5.84 minutes (p-value = 0.0001). Mean blood loss in Group A (diathermy group) was 194.32 ± 56.01 ml while in Group B (scalpel group) was 418.96 ± 26.18 ml (p-value = 0.0001). Mean post-operative pain in Group A (diathermy group) was 1.84 ± 1.13 while in Group B (scalpel group) was3.28 ± 1.37 (p-value = 0.0001).
Conclusion: This study concluded that the diathermy incision is better than scalpel skin incisions in terms of incision time, blood loss and post-operative pain.
Keywords: caesarean section, diathermy incision, blood loss.