Scalpel Versus Electrocautery Dissections: The Effect on Wound Complications and Pro-Inflammatory Cytokine Levels in Wound Fluid

Aim: Electrocautery has been postulated as a risk factor for wound complications. This study was conducted to evaluate the effects of electrocautery and scalpel dissections on wound complications and local cytokine levels.Materials and Methods: Patients undergoing modified radical mastectomy were assigned to flap dissection with either electrocautery (n = 18) or scalpel (n = 20). Blood loss, drain volume and duration, seroma formation and wound complications were recorded. Tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 levels were measured in drain fluids at postoperative 24 hours.Results: The electrocautery group had significantly reduced blood loss and total drain volume, but increased seroma formation rate. Significantly elevated levels of TNF-alpha were measured in drain fluids of patients with electrocautery dissection.Conclusions: The use of electrocautery causes less bleeding and total drain output with an increased rate of seroma formation. Electrocautery dissection increases pro-inflammatory cytokine response in wound fluid,which may reflect an aggravated inflammation and increased potential for tissue damage.