Authors: Martin Caliendo, Leela Sharath Pillarisetty , Eneko Larumbe-Zabala
To evaluate if diathermy is superior to scalpel in making abdominal wall incision during repeat cesarean delivery in terms of incision time, blood loss and postoperative pain. A total of 96 pregnant women between 18-45 years, undergoing repeat cesarean delivery between 37-41 weeks gestation were randomized into two groups, one group underwent cesarean delivery with scalpel and the other with diathermy. The primary outcomes of the study is to compare the incision time, blood loss and the secondary outcome is to assess the pain scores between the two groups. A total of 96 women were evaluated and randomized into two groups, there were no differences in sample characteristics. We observed that the incision time using diathermy was significantly shorter, there was no statistical difference in pain assessment. For the blood loss the sample size was smaller and the difference was not statistically significant. Based on these results, we calculated that a sample of 146 subjects in each group would be necessary to show statistically significant differences in blood loss. Compared to scalpel, diathermy can be used to make abdominal wall incisions faster with no difference in blood loss or postoperative pain. We believe the results of this study can be used to support diathermy in making pfannenstiel incisions during some clinical scenarios when time is a critical factor, such as at emergency cesarean delivery the speed of diathermy makes it a superior alternative to scalpel. In situation when blood loss is a concern, such as in Jehovah’s Witness diathermy may offer advantages over scalpel.
Cesarean delivery, diathermy, scalpel, Incision time
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