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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1812304
Original Article

Outcomes of Craniotomy Scalp Incision Using Cutting Micro-Needle Diathermy versus Traditional Stainless-Steel Scalpel

Authors

  • Olakunle Michael Adegboye

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Olugbenga Timothy Odebode

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Salamat Ahuoiza Aliu-Ibrahim 

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Nurudeen Abiola Adeleke

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Oghenevwoke Enaworu

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Olukorede Olabanji Adekunle

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Hakeem Ayinde Yeqeen

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria

  • Akingbade Adebayo Akin-Dosumu

    1   Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
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Abstract

Background

Scalp incision bleeds profusely due to its high vascularity. In other regions of the body, studies have debunked the initial concern of poor wound outcomes thought to be associated with thermal skin injury if diathermy is used to make skin incision and found that skin incision with diathermy led to reduced incisional blood loss. Studies on cranial operations involving scalp incisions in which incisional blood loss is more likely are scarce.

Objective

The objective of this study was to compare the outcomes of scalp incisions using either cutting micro-needle diathermy (MND) or the traditional stainless-steel scalpel (TSSS) during craniotomy.

Materials and Methods

The study was a hospital-based, prospective, randomized comparative study. Consented adult patients who had craniotomy were randomized into either cutting MND or TSSS group. Outcome measures were volume of blood loss per wound length and incision duration per wound length during scalp incision, 30-day surgical site infection (SSI), and scar appearance at 3 months postoperatively.

Statistical Analysis

The data were analyzed using SPSS version 23, and statistical significance was set at p-value <0.05.

Results

A total of 56 patients were recruited for the study, with 28 patients in each group. The mean age of the patients was 36.21 ± 13.90 years. The mean volume of incisional blood loss per wound length was 3.21 ± 2.06 and 4.65 ± 3.25 mL/cm in MND and TSSS groups, respectively (p = 0.053). In the MND group, the mean incision duration per wound length was 0.39 ± 0.18 minutes/cm, while it was 0.35 ± 0.10 minutes/cm in the TSSS group (p = 0.364). Five patients (22.7%) and four patients (16.7%) developed SSI in the MND and TSSS groups, respectively (p = 0.885). At 3 months postoperatively, the mean scar score was 9.06 ± 0.94 in the MND group and 8.63 ± 1.26 in the TSSS group (p = 0.255).

Conclusion

The study revealed no significant difference in the outcomes of craniotomy scalp incision between the two methods of making scalp incision. The study concludes that the use of diathermy in making scalp incision is not inferior to the use of the traditional scalpel, and the method of scalp incision may be left to the discretion of the surgeon.

Keywords

blood loss - micro-needle diathermy - scalp incision - stainless-steel scalpel - surgical site infection

Ethical Approval

Approval for this study was obtained from the Human Research Ethical Committee of the hospital.


Authors' Contribution

O.M.A. was responsible for the conceptualization, methodology, study protocol, data collation, and drafting of the original manuscript. O.T.O., S.A.A.-I., and N.A.A. contributed to the methodology, reviewed and edited the manuscript, and provided supervision for the study. O.E., O.O.A., and H.A.Y. contributed to the study protocol, data collation, and manuscript review and editing. A.-D.A.A. also contributed to the study protocol and data collation.




Publication History

Article published online:
14 October 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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