Comparison of the appearance of postoperative scars following the use of electrocautery versus scalpel in elective mid line abdominal skin incisions a randomized controlled trial

This study targets patients scheduled for elective midline abdominal incisions ranging from 5 to 10 cm in length who meet the specified inclusion criteria and voluntarily provide informed consent For cases where the incision length exceeds 10 cm data will still be included in the intention to treat  analysis but such cases will be excluded from the per protocol analysis Prior to the procedure all patients will undergo thorough health assessments to evaluate their fitness for surgery They will also receive detailed information about the two incision methods including the associated benefits and risks  ensuring they can make an informed decision Once consent is obtained each patients demographic and clinical details will be recorded in a pre designed data collection form

To ensure randomization patients will be allocated to one of two groups using sealed envelopes opened only after the induction of anesthesia by a non-study staff member to maintain blinding Participants in Group A will have their skin incision performed using a 35 W electrocautery device in cut mode Erbe VIO 300 S 2018 while those in Group B will have their incision made with a scalpel For both groups the subcutaneous tissue and linea alba will be incised using electrocautery in cutting mode with coagulation mode employed as needed for haemostasis  All patients will receive standardized preoperative antibiotics to minimize infection risk  and skin closure will be carried out uniformly using 3 0 nylon sutures

Blinding measures are integral to the study design Both the patients and the follow up surgeon will remain unaware of the incision method used The follow up surgeon who is independent of the surgical team will be responsible for assessing outcomes to eliminate bias The study will evaluate several key parameters including intra operative metrics like incision time and blood loss per unit wound area Postoperative outcomes will focus on pain levels measured daily using the Visual Analogue Scale  from day 1 to day 5 and surgical site infection rates assessed on the 30th postoperative day in accordance with CDC guidelines If required wound cultures will be performed to identify any infectious agents At four months scar quality will be examined using two standardized tools the Vancouver Scar Scale  for physical appearance and the Patient and Observer Scar Assessment Scale  for comprehensive quality assessment

Follow up visits are scheduled for day 30 and four months post-surgery For patients discharged earlier remote evaluations will be conducted via photographs or teleconsultations with in person visits arranged for cases requiring closer examination At the four month follow up scars will be thoroughly assessed during an outpatient appointment by the blinded follow up surgeon