Background: Inguinal hernia is the commonest type of external hernias. Lichtenstein tension free mesh repair is the most favoured technique of inguinal hernia repair nowadays for weakened inguinal wall using polypropylene mesh. The objective of this study is to determine the effectiveness of single versus triple dose antibiotic in reduction of postoperative wound infection in hernioplasty. Method: This is a prospective study done on patients in General Surgery Department, Sree Mookambika Institute of Medical Science, Kulaseharam, Kaniyakumari Dist., India., from 1 st june 2018 to 30 th November 2020. Total 120 patients were divided into 2 groups of 60 patients each in which Group-A received single dose antibiotic prophylaxis (Inj. Cefotaxim 1gm iv 30mins before surgery) and Group-B received 3 doses of antibiotic therapy (Inj. Cefotaxim 1gm iv 30 mins before surgery, post operatively 2 doses in 12hrs interval). Results: A total of 120 patients were included. Age of the patients ranged from 18 to 65 (Mean 46.21) years. In Group-A SSI was observed in 5 patients (8.33%) while 55 patients (91.66%) had a healthy scar. In Group-B SSI was seen in 4 patients (6.66%) and 56 patients (93.33%) had healthy scars. The difference between the two groups was not statistically significant (p=0.72).
Conclusion:Single dose antibiotic among patients undergoing open mesh repair for inguinal hernia is preferred option to prevent postoperative infection and it is cost effective too.
Aim and objectives: Lower Limb Amputation Is the Most Dreadful Complication of Various Factors for the patient as well as his families. This Study is to find the Prevalence of Lower Limb Amputations and factors contributing to amputation in our population. Method: The Retrospective quantitative study was conducted in Sree Mookambika Institute of Medical Sciences and hospital in the period of June 2018 to November 2019. Each patients are assessed periodically and evaluated. Following parameters are used to evaluate the contributing factors like age, sex, diabetes mellitus, systemic hypertension, chronic kidney disease, coronary heart disease, smoking, level of amputation and its post-operative complications. These parameters help to find the prevalence of lower limb amputations and study about the contributing factors which lead to amputation. Complications we encountered here are infections following the procedure, progression of gangrene due to inadequate blood supply or infective aetiology, uncontrolled diabetes mellitus. Infective cases are treated with appropriate antibiotics according to the culture and sensitivity report. In some cases where below knee amputations are converted to above knee amputations due to inadequate blood supply or progression of infection. Results: Over the period of 18 months, 124 lower limb amputation are performed (which includes ray amputation, below knee amputation and above knee amputation). Majority of patients in my study group belong to 41-50 years of age with 50% in total population. Male is more predominant with 64% comparing female gender with 34%. Among the total group diabetes were found in 75% of study population. Among those diabetic patients 58% were found to have HBA1C more than 10. Smoking is the only of the modifiable risk factors among the other risk factors which account for 54.8%. Chronic kidney disease with stage 4&5 were noted in 31 patients, majority of the patients were presented with non-healing chronic ulcer with 63%, where remaining presented with gangrene formations. Depending up on the mode of presentation and level of involvement, patients underwent amputation most common amputation we done are ray amputation for 67 patients followed by below knee amputation for 35 and above knee amputation for 14 patients, 8 patients who initially underwent below knee amputation due to inadequate blood supply and ascend of infections which was converted in to above knee amputation.
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