Diathermy versus Conventional scalpel skin incision in modified radical mastectomy; A comparison of outcome

  • Saad ullah sarfraz janjua postgraduate resident surgeon
Keywords: Adult, Female, Mastectomy, Tissue damage, Electrocautery, Seroma, Tissue damage, Axillary lymph node dissection



Modified radical mastectomy is a procedure with increasing incidence in parallel with the advancing diagnostics. The postoperative pain following modified radical mastectomy is troublesome and newer strategies and modalities are being introduced to combat this issue.



A quasi experimental study was conducted on total of 100 patients at surgical department of Benazir Bhutto Hospital, Rawalpindi undergoing MRM for CA breast. The patients were divided into two equal groups via lottery method. The diathermy skin incision patients were given group A while the surgical scalpel incision were given group B. Postoperative pain was assessed at 6 hours in the postoperative period by VAS. Effect modifiers like age, duration of surgery and side of surgery were controlled by stratification. Poststratification independent sample t test was applied. A p value ≤ 0.05 was considered as significant.



There was no significant difference between groups in terms of distribution of age, duration of surgery and side involved. The scalpel group had higher mean pain scores at 6 hours in postoperative period i.e. 4.22 ± 1.250 versus 5.10 ± 1.389 for group A and B respectively (p value 0.001).



The electrocautery skin incision is better than steel scalpel incision in term of postoperative pain reduction in patients undergoing MRM for breast cancer.



Adult, Female, Mastectomy, Tissue damage, Electrocautery, Seroma, Tissue damage, Axillary lymph node dissection


1. Ayandipo OO, Afuwape OO, Irabor D, Oluwatosin OM, Odigie V.
Diathermy versus Scalpel Incision in a Heterogeneous Cohort of General Surgery Patients in a Nigerian Teaching Hospital. Nigerian journal of surgery : official publication of the Nigerian Surgical Research Society. 2015;21(1):43-7.
2. Saeed S, Ali A, Zainab S, Junaid Khan MT. Scalpel versus diathermy of midline skin incisions: comparison of mean pain scores on second post-operative day. JPMA The Journal of the Pakistan Medical Association. 2017;67(10):1502-5. 3. Ayandipo OO, Adigun TA, Afuwape OO, Idowu OK. Comparison of
postoperative pain in diathermy and conventional scalpel Skin incision after mastectomy in Ibadan, Nigeria. Afr J Med Med Sci. 2015;44(1):27-31.
4. Nalavenkata S, Winter M, Kour R, Kour NW, Ruljancich P. Adult bipolar diathermy circumcision and related procedures in adults - a safe and efficient technique. Research and reports in urology. 2014;6:59-62.
5. Aird LN, Bristol SG, Phang PT, Raval MJ, Brown CJ. Randomized doubleblind trial comparing the cosmetic outcome of cutting diathermy versus scalpel for skin incisions. The British journal of surgery. 2015;102(5):489-94.
6. Talpur AA, Khaskheli AB, Kella N, Jamal A. Randomized, clinical trial on diathermy and scalpel incisions in elective general surgery. Iranian Red Crescent medical journal. 2015;17(2):e14078.
7. Stupart DA, Sim FW, Chan ZH, Guest GD, Watters DA. Cautery versus
scalpel for abdominal skin incisions: a double blind, randomized crossover trial of scar cosmesis. ANZ journal of surgery. 2016;86(4):303-6.
8. Elbohoty AE, Gomaa MF, Abdelaleim M, Abd-El-Gawad M, Elmarakby M. Diathermy versus scalpel in transverse abdominal incision in women undergoing repeated cesarean section: A randomized controlled trial. J Obstet Gynaecol Res.
9. Caffo O, Amichetti M, Ferro A, Lucenti A, Valduga F, Galligioni E. Pain and quality of life after surgery for breast cancer. Breast Cancer Res Treat. 2003;80(1):39-48.
10. Gul A, Ustundag H, Andsoy, II, Kalkanli S. Anxiety and pain in surgically treated breast cancer patients. Asian Pac J Cancer Prev. 2015;16(10):4261-4.
11. Wang JP, Lu SF, Guo LN, Ren CG, Zhang ZW. Poor preoperative sleep
quality is a risk factor for severe postoperative pain after breast cancer surgery: A prospective cohort study. Medicine (Baltimore). 2019;98(44):e17708.
12. Beyaz SG, Ergonenc JS, Ergonenc T, Sonmez OU, Erkorkmaz U,
Altintoprak F. Postmastectomy Pain: A Cross-sectional Study of Prevalence, Pain
Characteristics, and Effects on Quality of Life. Chinese medical journal. 2016;129(1):66-71.
13. Ferreira Laso L, Lopez-Picado A, Lamata L, Ceballos Garcia M, Ibanez Lopez C, Pipaon Ruilope L, et al. Postoperative analgesia by infusion of local anesthetic into the surgical wound after modified radical mastectomy: a randomized clinical trial. Plast Reconstr Surg. 2014;134(6):862e-70e.
14. Yao Y, Li H, He Q, Chen T, Wang Y, Zheng X. Efficacy of ultrasoundguided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial. Reg Anesth Pain Med. 2019.
15. Shrestha D. Evaluation of Pain Following the Use of Scalpel versus Diathermy for Skin Incision in Ear, Nose, Throat and Head and Neck Surgeries.
Journal of Nepal Health Research Council. 2018;16(1):58-60.

16. Okereke CE, Katung AI, Adesunkanmi AK, Alatise OI. Surgical outcome of cutting diathermy versus scalpel skin incisions in uncomplicated appendectomy: A comparative study. Niger Postgrad Med J. 2019;26(2):100-5.
17. Hajibandeh S, Hajibandeh S, Maw A. Diathermy versus scalpel for skin incision in patients undergoing open inguinal hernia repair: A systematic review and meta-analysis. International journal of surgery. 2020;75:35-43
How to Cite
S. ullah janjua, “Diathermy versus Conventional scalpel skin incision in modified radical mastectomy; A comparison of outcome”, JSS, vol. 8, no. 1, May 2021.