Background: The objective of present study is find out various patient factor including demographic data as well as operative data on occurrence of surgical site infection in patients of cholecyctectomy.Methods: A Prospective observational study of 273 patients of cholecystitis undergoing cholecystectomies for Surveillance of surgical site infections was conducted in the Department of General Surgery at the SSG hospital and Medical College Baroda during a period from 1st December 2013 to 30th November 2015. All patients operated for cholecystectomy are included irrespective of technique. Data collected from each patient were: Case start date and time, case end date and time, discharge date & time, case length, postoperative length of stay in hospital, patients characteristics (age, sex, ASA score), operative characteristics like, pathological diagnosis report of specimen, microorganism isolated based on culture report and antibiotic resistance pattern from infected wounds, antibiotic prophylaxis given perioperatively and antibiotics administered to treat SSI`s, intra operative spillage and bleeding, date of infection, urgent/elective procedure.Results: During the period of 24 months total 273 patient were undergone cholecystectomy out of which 12 (4.3%) patients were developed SSI. SSI rate is affected by various factors which are statistically significant are sex of patients, age, type of procedure, ASA score >3.Conclusions: The overall incidence of SSIs in the present study was 4.3%. The rates of SSI were more in patient with higher age, with male sex, emergency procedure and higher ASA score.
Pilonidal sinus is a blind-end tract lined with granulation tissue, which leads to a cystic cavity lined with epithelial tissue. This case report aims to present a case of pilonidal sinus presenting in an unusual location-the intermammary region, in a 16-year-old female patient who presented with complaints of serous discharge mixed with pus intermittently from the intermammary region for 5 months. Although a pilonidal sinus is most commonly seen at the sacrococcygeal region, the presence of one such entity in the intermammary region of a female represents a rare occurrence with very few cases reported worldwide-more so in young females with large, heavy, and pendulous breasts. A proper surgical repair in terms of its excision and closure remains the mainstay in management.
Background: The objective of the study was to evaluate the superiority of preemptive analgesia with instillation of 0.5% bupivacaine before rather than after surgery for laparoscopic cholecystectomy.Methods: A prospective, randomized study of 264 patients in whom laparoscopic Cholecystectomy (LC) was conducted in the department of General Surgery at the SSG and Medical College Baroda during a period of 25 months from October 2010 to October 2012. Randomization was done with prepared close enveloped which randomly allocate the patient in either group A or B. Data collected from each patient were: age, sex, ASA score, hospital stay, duration of surgery, no of trocar used, first request for analgesics, vomiting, duration of surgery, intraperitoneal drain was kept or not , length of hospital stay, any other postoperative complication.Results: During the period of 24 months total 264 patients were undergone cholecystectomy. On comparison between Group A and B, data shows that the mean VAS is less at all assessment (4, 8 & 24 hrs) for Group A as compared to Group B. Mean parietal pain score VAS is less for Group B as compared to Group A at all assessments.Conclusions: Use of bupivacaine in optimal dose in GB bed reduced the visceral pain and use in skin, SC tissue, muscular tissue reduced the parietal pain. Use of bupivacaine before GB removal is much more cost effective than after removal of GB.
Background:To evaluate the incidence of early recurrence and chronic groin pain in the two groups of patients (group A=ligation and excision, group B=invagination) with indirect inguinal hernia and to observe different intraoperative and post-operative parameters in both groups. Methods: This prospective randomized study was done in SSG Hospital and Government Medical College, Vadodara from 1 st December 2016 to 30 th November 2017. All the cases of indirect inguinal hernia attending the surgical OPD in SSG hospital were enrolled in this study. All the patients underwent Lichtenstein tension free repair. A total of 50 patients were enrolled in this study. MedCalc Software Version 12.5.0 was used for the analysis of the data and Microsoft word and Excel was used to generate graphs and tables. Results: 50 patients of indirect inguinal hernia with more than 18 years of age were enrolled and divided into two groups. Intra operative complications, post-operative pain by VAS and post-operative complication observed, which was found insignificant. There was no seroma and induration on both the study group at 3 months and 6 months interval. No local swelling (recurrence) in inguinal region was seen in patients (both group A and group B) during the 6 months follow up period. Conclusions: This study shows no difference in outcome of results in Lichtenstein tension free hernia repair for indirect inguinal hernia with two different technique in dealing with sac except less postoperative pain in invagination of sac as compare to ligation and excision.
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