Introduction: Scalpels have been used to make abdominal surgical incisions by manually cutting through tissue using a sharp blade. Electrosurgery becomes an integral and evolves part of surgical practice but less popular among surgeons. Fear of deep burns with electrosurgery and resultant scarring continues compared with the scalpel, which produces a clean, incised wound with minimal tissue destruction.

Aim of The Study: The aim of this study was to evaluate early and late postoperative wound complications using the cold knife.

Patients and Methods: This study was a Randomized Controlled Trial (RCT) that evaluated early and late postoperative wound complications using the cold knife, monopolar electrosurgery and combined both methods in patients with gynecological conditions undergoing abdominal incisions in a 6-month period in the Outpatient and Inpatient Clinics at Obstetrics and Gynecology Department of El Sayed Galal Hospital, Al-Azhar University.

Results: There are statistically significant differences between the studied groups regarding incision time, blood loss, VAS score over time in the first 24 hours and numder of doses of morphine and paracetamol. It has been concluded that electrosurgery can be considered safe and effective in making skin incision in abdominal incision compared to cold knife incision and does not increased wound sepsis.
Conclusion: Wound infection rate and significantly lower blood loss, postoperative pain and analgesia requirements, electrosurgery can be considered safe and effective in making skin incision in abdominal incision compared to cold knife incision.