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Disc battery ingestion and esophageal injury is well-known in children. Insertion of a disc/lithium battery into body’s natural orifices is rarely reported. We present a case of self-insertion of a lithium battery into the vagina by a 2 ½ year old female. Vaginoscopy was performed and the battery was retrieved which had corroded and caused vaginal ulceration. Post-operative outcome was favorable. Treating physicians must be aware of the hazardous effects of insertion of lithium batteries as it may cause significant damage in a short period.

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Background: Laparoscopic approach for management of adhesive bowel obstruction has become an established technique both in adults and children. There is an increased need of reporting of the outcome using this method of treatment in pediatric practice. Aim: To compare the outcome of laparoscopic vs open surgery in children with adhesive bowel obstruction. Materials and methods: Data were collected on children with adhesive bowel obstruction who were managed at a tertiary care level center for pediatric surgery from January 2007 to September 2017. Patients who were successfully managed by conservative management were excluded. Also the cases in which laparoscopic procedure was converted into an open surgery were excluded. Factors such as operative time, need for total parenteral nutrition, time to resume oral feeds, postoperative length of hospital stay, and complications during or after surgery were studied in laparoscopic and open group. Results: Eighty children with adhesive intestinal obstruction were admitted. Eight were managed conservatively hence excluded. Forty-two were managed by open surgery and laparoscopic management was performed for 30. Four (10.3%) out of these were converted into open laparotomy. These were also excluded. Operative time was not significantly different between open (122 minutes) vs laparoscopic group (138 minutes). During dissection, complications like serosal tear were higher (20 vs 0) in the open group. Resection anastomosis (15 cases) and wound infections (6 cases) rate was also higher with open laparotomy. Mean time in days to start oral feeds (2.5 vs 5.9) and length of hospital stay (5.5 vs 11.3) was significantly shorter in laparoscopic group. Conclusion: Laparoscopic management of adhesive bowel obstruction in children is safe and is associated with early postoperative recovery, shorter hospital stay and lower complication rate in comparison with open surgical management of these cases.

Introduction Topical agents are sometimes applied to surgical wounds after closure; these may include antiseptics or antibiotics. Minimal research has been undertaken to investigate the effect of topical regimens on the tensile strength of suture materials. Aim To investigate the effect of four commonly used wound care regimens on the tensile strength of suture materials. Methods The failure load of 9 different suture materials was tested using the Instron Electroplus E3000 tensile testing machine (Instron Corporation, Norwood, Massachusetts). Tensile strength was represented as the failure load, measured in Newtons (N), and defined as the maximal load that could be applied across the suture prior to failure. Each suture was tested dry and after immersion in one of 4 products for 7 days and tested on day 7. The immersion agents tested were: sodium chloride 0.9%, MicroSafe® (Sonoma Pharmaceuticals, Petaluma, CA), Aqueous Povidone‐iodine 10% solution (Betadine—Mundipharma), and Fucidin ointment. Results Sodium chloride 0.9%, MicroSafe®, Aqueous Povidone‐iodine 10%, and Fucidin seem to increase the failure load of most absorbable and non‐absorbable sutures. However, the failure load of Polyglactin 910 suture (Surgilactin, coated, violet‐Ethicon) is reduced by long‐term exposure to either sodium chloride 0.9% or MicroSafe®, while the failure load of the Polydioxanone suture (PDS Plus‐Ethicon) is reduced by long‐term exposure to MicroSafe® only. Conclusion In our experiment, the commonly used wound care products have been shown to alter the tensile strength of suture materials. Further human studies are required to ascertain the clinical validity and applicability of our findings.

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