Advanced Cutting Effect System versus Cold Steel Scalpel: Comparative Wound Healing and Scar Formation in Targeted Surgical Applications

BACKGROUND: Use of electrosurgery for skin incisions has been controversial due to concerns of delayed healing, excessive scarring, and increased infection. Recent studies using modern electrosurgical generators that produce pure sinusoidal “CUT” waveforms have shown reductions in thermal damage along incisions made with these devices compared with their predecessors. This study compares scar formation in incisions made using a cold steel scalpel (CSS) or the ACE Blade and Mega Power Generator (ACE system, Megadyne Medical Products, Draper, Utah) from patient and blinded observer perspectives. METHODS: Subjects seeking plastic surgery were enrolled in the study. Incisions on one side of each subject’s body were made with a CSS while equivalent incisions on the contralateral side were made with the ACE system. Differences between incision methods were evaluated by assessment of scar formation by observers and assessment of patient satisfaction relating to scar formation at 120 days postsurgery. RESULTS: Observers rated incision vascularization, pigmentation, thickness, and relief. The mean observer score (± SD) of incisions made with the ACE system was 11.1 ± 4.4 while that of incisions made with the CSS was 10.8 ± 3.7 (P < 0.0001). Patients rated incision pain, itching, discoloration, stiffness, thickness, and irregularity. The mean patient score of incisions made with the ACE system was 9.4 ± 9.2 while that of incisions made with the CSS was 9.3 ± 8.5 (P < 0.0001). CONCLUSIONS: Results showed noninferior wound healing/scar formation in skin incisions made with the ACE system compared with incisions made with a CSS.