***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Pilonidal disease is a common debilitating condition . This prospect i ve r and omised study compared excision of pilonidal disease with a scalpel or diathermy with respect to operation time , postoperative pain , functional recovery and wound healing . PATIENTS AND METHODS Patients undergoing surgery for pilonidal disease were r and omised to excision by scalpel ( group 1 ) or diathermy ( group 2 ) . Patients received regular peri-operative oral analgesia and a st and ardised general anaesthetic technique . Duration of operation was recorded . Following surgery , pain , analgesic requirements , sedation , nausea and vomiting scores and time to mobilise and time to complete healing were compared . RESULTS Statistical significance between groups was obtained for five outcomes after 32 patients had been recruited ; of these , 81 % were admitted as emergencies with an abscess . The duration of surgery in group 2 was significantly less , postoperative pain scores and morphine requirements were lower and mobility was regained sooner . CONCLUSIONS We advocate the use of diathermy needle rather than scalpel blade when undertaking excision of pilonidal disease in both acute and chronic patients Forty nine consecutive mastectomy patients were r and omized to one of two groups . Twenty four patients had skin flaps created with the cold scalpel and twenty five with the electrocautery . The two groups were similar with respect to age , stage of disease , size of tumor , and weight . Cautery patients had significantly less operative blood loss when compared with scalpel patients , 352 versus 507 milliliters , respectively , P less than 0.05 . No cautery patient required transfusion compared with three transfused scalpel patients , P less than .005 . Total postoperative hemovac drainage and hospital stay were not significantly different between the two groups . Although the number of fever days and wound complications were slightly higher in the cautery group , the difference was not statistically significant . The electrocautery may be superior to the scalpel for mastectomy AIM The aim of this study was to evaluate the volume of blood loss , wound incision time and wound complication according to use of scalpel or electrosurgery during the creation of transverse abdominal incisions during repeated cesarean section ( CS ) . MATERIAL AND METHODS A r and omized controlled trial was carried out at Ain Shams University Maternity Hospital . We recruited 130 women with a history of one previous CS at the time of their planned lower-segment CS . Participants were r and omized to anterior abdominal wall opening from subcutaneous tissue till the peritoneum by either the use of scalpel with disposable blade ( No. 22 ) or diathermy using the st and ard diathermy pen electrode . The main outcome measures were the volume of blood loss from skin incision to the end of the peritoneal incision , the operative time and wound complication . RESULTS We observed a highly significant difference between the two groups in blood loss ( median [ interquartile range ] , 11 [ 8 - 15.25 ] g for the diathermy group vs 20 [ 18 - 23 ] g for the scalpel group , P < 0.001 ) and skin-to-peritoneum incision time ( median [ interquartile range ] , 7 [ 5 - 7.25 ] min for the diathermy group vs 10 [ 7 - 11 ] min for the scalpel group , P < 0.001 ) . The postoperative pain was less in the diathermy group but wound complications showed no statistical difference . CONCLUSION The use of diathermy in the opening of anterior abdominal wall during CS decreases blood loss and operative time but has no impact on postoperative pain or wound complications AIM To evaluate the incidence of surgical site infection ( SSI ) based on the type of scalpel used for incisions in the skin and in subcutaneous tissues . METHODS Observer-blind , r and omized equivalence clinical trial with two arms ( electrocautery versus conventional scalpel ) which evaluated 133 women undergoing elective abdominal gynecologic oncology surgery . A simple r and omization stratified by body mass index ( BMI : 30 kg/m(2 ) ) was carried out . Women were evaluated at 14 and 30 days following the operation . A multivariate analysis was performed in order to check whether the type of scalpel would be a risk factor for SSI . RESULTS Group arms were balanced for all variables , excepted for surgical time , which was significantly higher in the electrocautery group ( mean : 161.1 versus 203.5 min , P = 0.029 ) . The rates of SSI were 7.4 % and 9.7 % , respectively , for the conventional scalpel and electrocautery groups ( P = 0.756 ) . The exploratory multivariate model identified body mass index ≥30 kg/m(2 ) ( OR = 24.2 , 95 % CI : 2.8 - 212.1 ) and transverse surgical incision ( OR = 8.1 , 95 % CI : 1.5 - 42.6 ) as independent risk factors for SSI . The type of scalpel used in surgery , when adjusted for these variables and the surgery time , was not a risk factor for SSI . CONCLUSION This study showed that the SSI rates  for conventional scalpel and electrocautery were not significantly different . These results were consistent with others reported in the literature and would not allow a surgeon to justify scalpel choice based on SSI . TRIAL NUMBER NCT01410175 ( Clinical Trials - NIH ) BACKGROUND Electrocautery has been postulated as a factor in the risk of seroma formation after mastectomy . METHODS Eighty consecutive mastectomies in 74 patients were r and omly assigned to dissection of the mastectomy flaps with either scalpel ( n = 38 ) or electrocautery ( n = 42 ) . Total volume of fluid output through drains and aspirated from seromas was recorded . Other factors investigated included the type of drain utilized , estimated blood loss , and complications . RESULTS Seromas developed in 16 wounds in the electrocautery group compared with 5 in the scalpel group ( 38 % and 13 % , respectively ; P = 0.01 ) . Other factors with an independent risk for seroma included use of Jackson-Pratt drains compared with Blake drains ( P = 0.006 ) , and lower estimated blood loss ( P = 0.006 ) . No differences in characteristics of patients or in other complications were noted . CONCLUSIONS Use of electrocautery to create skin flaps in mastectomy reduced blood loss but increased the rate of seroma formation BACKGROUND Seroma formation remains a significant problem in abdominoplasty procedures --the cause of which remains to be eluci date d. It has been suggested that one of the causative factors for seroma formation is the use of h and held electrocautery as opposed to scalpel for abdominal flap dissection . METHODS Prospect i ve trial in 102 consecutive abdominoplasty patients r and omised to have abdominal flap dissection with either h and held electrocautery device on ' coagulation setting ' or sharp dissection with scalpel and monopolar electrocautery forceps  for  haemostasis  . In all other aspects the surgical technique was identical between the two groups . All drains were removed at 48 h , irrespective of drain volume . Primary outcome measure is postoperative seroma formation on clinical examination , secondary outcome measures are drain volume , weight of tissue removed , effect of liposuction and patient BMI . RESULTS Both study groups were similar in demographics with no significant difference in weight of tissue excised , BMI , drain output or post operative complictions . There was no significant difference in seroma formation rates between the h and held electrocautery group ( 17.2 % ) and the sharp dissection group ( 20.1 % ) . Overall , the seroma rate was 18.6 % . Liposuction to the flanks at the time of abdominoplasty was found to significantly increase the incidence of seroma , compared to patients having abdominoplasty alone . CONCLUSIONS Use of h and held electrocautery rather than scalpel for tissue dissection does not lead to increased seroma formation in abdominoplasty patients . Concomitant liposuction at the time of abdominoplasty increases the risk of seroma formation compared to patients having abdominoplasty alone Objective This prospect i ve , double-blind , r and omized , controlled trial was design ed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery . Methods A total of 369 patients who underwent diathermy incision ( group A : 185 patients ) or scalpel incision ( group B : 184 patients ) were analyzed . Variables analyzed were : surgical wound classification , length and depth of incision , incision time , duration of operation , incisional blood loss , postoperative pain , duration of hospital stay , duration of healing , and postoperative complications .  The inclusion criteria were all patients who underwent elective or emergency general surgery . The exclusion criteria were only cases with incomplete patients ’ data and patients who were lost to follow-up . This study was conducted at Fatima Hospital-Baqai Medical University and Shamsi Hospital ( Karachi ) , from January 2006 to December 2007 . Results Incision time was significantly longer for patients in group B ( p = 0.001 ) . Incisional blood loss also was more for patients in group B ( p = 0.000 ) . Pain perception was found to be markedly reduced during the first 48 h in group A ( p = 0.000 ) . Total period of hospital stay ( p = 0.129 ) and time for complete wound healing ( p = 0.683 ) were almost the same for both groups . Postoperative complication rate by wound classification did not differ markedly between the two groups ( p = 0.002 vs. p = 0.000 ) . Conclusions Diathermy incision has significant advantages compared with the scalpel because of reduced incision time , less blood loss , & reduced early postoperative pain Carbon dioxide laser incisions are reported to be less painful , less bloody , and less prone to seroma formation and to heal better than scalpel or electrosurgical incisions . We compared all three modalities in a prospect i ve r and omized study of cholecystectomy incisions .  Time required for the incision and incisional blood loss was less with electrosurgery than with the carbon dioxide laser or scalpel .  Postoperative pain and wound healing , however , were the same for all three techniques . The carbon dioxide laser appears to offer no advantage over conventional means of making a st and ard incision Abstract Background : Despite the studies of animals that demonstrate better wound healing after abdominal incisions with the use of a scalpel rather than electocautery , clinical experience does not confirm these findings . The purpose of this study was to compare the early postoperative and late-term wound complication rates between the scalpel and electrocautery in patients with gastrointestinal malignancies undergoing midline abdominal incisions . Methods : Patients undergoing midline abdominal incisions for gastrointestinal malignancies were r and omly divided into two groups according to the method used to perform the incisions : scalpel or electrocautery . Complications were investigated , diagnosed and compared in the early postoperative and late-term follow-up periods . The independent sample s , chi-square , and Student ’s t tests were used for statistical analysis . Results : Two hundred and eighteen patients were included to this study , of whom 97 ( 44.5 % ) were in the scalpel group and 121 ( 55.5 % ) in the electrocautery group . Both groups were similar with respect to their demographic , operative and postoperative characteristics . The analysis revealed no significant statistical differences in consideration of the incidences of either wound infection in the early postoperative period or incisional hernia in the late-term follow-up period between these two study groups ( p > 0.05 ) . Conclusions : Scalpel and electrocautery are similar in terms of early postoperative and late-term wound complications when used to perform midline abdominal incisions . Therefore , the choice of method remains a matter of the surgeon ’s preference Electrocautery is used increasingly for tissue dissection , although fears of excessive scarring and poor wound healing have curtailed its widespread use for skin incision . This study compared electrosurgical incision with traditional scalpel incision . AIM & OBJECTIVES To compare the electrocautery incision with scalpel incision in patients undergoing abdominal surgery using a midline incision with respect to incision time , blood loss during incision , postoperative incision site pain and wound infection . METHODS Patients undergoing midline abdominal surgery were r and omized into electrocautery and scalpel groups . The incision dimensions , incision time and blood loss during incision were noted intraoperatively . Postoperative pain and wound infection were recorded on every postoperative day for one week . RESULTS 41 patients in each of the two groups were analyzed . Gender and age distribution was similar in both the groups . The mean incision time per unit wound area in the electrocautery group and scalpel group was 9.40 ± 3.37 s/cm(2 ) and 9.07 ± 3.40 s/cm(2 ) ( p = 0.87 ) respectively . The mean blood loss per unit wound area was significantly lower in the electrocautery group at 6.46 ± 3.94 ml when compared to that of 23.40 ± 15.28 ml in the scalpel group ( p= < 0.0001 , CI = 11.97 - 21.89 ) . There was no significant difference in pain on any of the postoperative days between the two groups and there was no significant difference in the wound infection rates between the electro 
    Output:
    
Low-certainty evidence shows no clear difference in wound infection between the scalpel and electrosurgery .