{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T11:56:20Z","timestamp":1771674980237,"version":"3.50.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T00:00:00Z","timestamp":1424217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,3,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Controversy exists about whether cutting diathermy for skin incisions leads to a cosmetically inferior scar. Cosmetic outcomes were compared between skin incisions created with cutting diathermy versus scalpel. Wound infection rates and postoperative incisional pain were also compared.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a randomized double-blind trial comparing cutting diathermy and scalpel in patients undergoing bowel resection. Scar cosmesis was assessed at 6 months after surgery by a plastic surgeon and a research associate using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). Patients also used POSAS to self-evaluate their scars. Wound infections within 30 days were recorded, and incision pain scores were measured on the first 5 days after operation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 66 patients were randomized to cutting diathermy (31) or scalpel (35). At 6 months, there was no significant difference between the diathermy and scalpel groups in mean(s.d.) VSS scores (4\u00b79(2\u00b76) versus 5\u00b70(1\u00b79); P = 0\u00b7837), mean POSAS total scores (19\u00b72(8\u00b70) versus 20\u00b70(7\u00b74); P = 0\u00b7684) or subjective POSAS total scores (20\u00b72(12\u00b71) versus 21\u00b73(10\u00b74); P = 0\u00b7725). Neither were there significant differences in wound infection rates between the groups (5 of 30 versus 5 of 32; P = 1\u00b7000). Pain scores on day 1 after operation were significantly lower in the diathermy group (mean 1\u00b768 versus 3\u00b713; P = 0\u00b7018), but were not significantly different on days 2\u20135.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Cutting diathermy is a cosmetically acceptable technique for abdominal skin incisions. There is no increased risk of wound infection, and diathermy may convey benefit in terms of early postoperative wound pain. Registration number: NCT01496404 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.9751","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T15:13:01Z","timestamp":1424272381000},"page":"489-494","source":"Crossref","is-referenced-by-count":20,"title":["Randomized double-blind trial comparing the cosmetic outcome of cutting diathermy <i>versus<\/i> scalpel for skin incisions"],"prefix":"10.1093","volume":"102","author":[{"given":"L N F","family":"Aird","sequence":"first","affiliation":[{"name":"Divisions of General Surgery, University of British Columbia, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S G","family":"Bristol","sequence":"additional","affiliation":[{"name":"Divisions of Plastic Surgery, University of British Columbia, British Columbia, Canada"},{"name":"Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P T","family":"Phang","sequence":"additional","affiliation":[{"name":"Divisions of General Surgery, University of British Columbia, British Columbia, Canada"},{"name":"Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J","family":"Raval","sequence":"additional","affiliation":[{"name":"Divisions of General Surgery, University of British Columbia, British Columbia, Canada"},{"name":"Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C J","family":"Brown","sequence":"additional","affiliation":[{"name":"Divisions of General Surgery, University of British Columbia, British Columbia, Canada"},{"name":"Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,2,18]]},"reference":[{"key":"2021022218210249800_bjs9751-bib-0001","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/S0039-6060(96)80137-1","article-title":"Bovie and electrosurgery","volume":"119","author":"O'Connor","year":"1996","journal-title":"Surgery"},{"key":"2021022218210249800_bjs9751-bib-0002","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/0002-9610(94)90106-6","article-title":"Electrocautery used to create incisions does not increase wound infection rates","volume":"167","author":"Groot","year":"1994","journal-title":"Am J Surg"},{"key":"2021022218210249800_bjs9751-bib-0003","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S0002-9610(00)00561-4","article-title":"A multicentre collaborative study on the use of cold scalpel and electrocautery for midline abdominal incisions","volume":"181","author":"Franchi","year":"2001","journal-title":"Am J Surg"},{"key":"2021022218210249800_bjs9751-bib-0004","first-page":"299","article-title":"Electrosurgical skin incision versus conventional scalpel: a prospective trial","volume":"35","author":"Dixon","year":"1990","journal-title":"J R Coll Surg Edinb"},{"key":"2021022218210249800_bjs9751-bib-0005","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1002\/bjs.1800770610","article-title":"Wound infection after abdominal incision with scalpel or diathermy","volume":"77","author":"Johnson","year":"1990","journal-title":"Br J Surg"},{"key":"2021022218210249800_bjs9751-bib-0006","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1001\/archsurg.1991.01410320108015","article-title":"Prospective study of incisional time, blood loss, pain, and healing with carbon dioxide laser, scalpel, and electrosurgery","volume":"126","author":"Pearlman","year":"1991","journal-title":"Arch Surg"},{"key":"2021022218210249800_bjs9751-bib-0007","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.surg.2009.08.001","article-title":"Scalpel safety in the operative setting: a systematic review","volume":"147","author":"Watt","year":"2010","journal-title":"Surgery"},{"key":"2021022218210249800_bjs9751-bib-0008","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.amjsurg.2011.09.032","article-title":"Systematic review and meta-analysis of electrocautery versus scalpel for skin incisions","volume":"204","author":"Aird","year":"2012","journal-title":"Am J Surg"},{"key":"2021022218210249800_bjs9751-bib-0009","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/bjs.8708","article-title":"Systematic review and meta-analysis of cutting diathermy versus scalpel for skin incision","volume":"99","author":"Ly","year":"2012","journal-title":"Br J Surg"},{"key":"2021022218210249800_bjs9751-bib-0010","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/SLA.0b013e3181ff461f","article-title":"Meta-analysis of the effectiveness of surgical scalpel or diathermy in making abdominal skin incisions","volume":"253","author":"Ahmad","year":"2011","journal-title":"Ann Surg"},{"key":"2021022218210249800_bjs9751-bib-0011","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1086\/501620","article-title":"Guideline for prevention of surgical site infection","volume":"20","author":"Mangram","year":"1999","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2021022218210249800_bjs9751-bib-0012","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/00004630-199005000-00014","article-title":"Rating the burn scar","volume":"11","author":"Sullivan","year":"1990","journal-title":"J Burn Care Rehabil"},{"key":"2021022218210249800_bjs9751-bib-0013","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/01.prs.0000172982.43599.d6","article-title":"Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale","volume":"116","author":"van de Kar","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"2021022218210249800_bjs9751-bib-0014","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.3109\/09638280902874196a","article-title":"Franchignoni. How to assess postsurgical scars: a review of outcome measures","volume":"31","author":"Vercelli","year":"2009","journal-title":"Disabil Rehabil"},{"key":"2021022218210249800_bjs9751-bib-0015","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1097\/01.prs.0000181520.87883.94","article-title":"Standardized assessement of breast cancer surgical scars integrating the Vancouver Scar Scale, Short-Form McGill Pain Questionnaire and patients' perspectives","volume":"116","author":"Truong","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"2021022218210249800_bjs9751-bib-0016","doi-asserted-by":"crossref","first-page":"36.e1","DOI":"10.1016\/j.ajog.2010.02.001","article-title":"Cosmetic outcomes of various skin closures following cesarean delivery: a randomized trial","volume":"203","author":"Cromi","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"2021022218210249800_bjs9751-bib-0017","first-page":"e43","article-title":"A review of scar scales and scar measuring devices","volume":"10","author":"Fearmonti","year":"2010","journal-title":"Eplasty"},{"key":"2021022218210249800_bjs9751-bib-0018","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.jamcollsurg.2007.05.015","article-title":"Prospective evaluation for vacuum-assisted closure in abdominal compartment syndrome and severe abdominal sepsis","volume":"205","author":"Perez","year":"2007","journal-title":"J Am Coll Surg"},{"key":"2021022218210249800_bjs9751-bib-0019","volume-title":"Statistical Considerations for Clinical Trials and Scientific Experiments","author":"Schoenfeld"},{"key":"2021022218210249800_bjs9751-bib-0020","first-page":"427","article-title":"Steel scalpel versus electrocautery blade: comparison of cosmetic and patient satisfaction outcomes of different incision methods","volume":"38","author":"Chau","year":"2009","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2021022218210249800_bjs9751-bib-0021","article-title":"Cautery versus scalpel for abdominal skin incisions: a double blind, randomized crossover trial of scar cosmesis","author":"Stupart","year":"2013","journal-title":"ANZ J Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.9751","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/102\/5\/489\/36336646\/bjs9751.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/102\/5\/489\/36336646\/bjs9751.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T14:12:50Z","timestamp":1621519970000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/102\/5\/489-494\/6136563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,18]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,2,18]]},"published-print":{"date-parts":[[2015,3,12]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.9751","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2015,4]]},"published":{"date-parts":[[2015,2,18]]}}}