Background: The objectives of the study were to study the operative time, the effect on wound healing, cosmetic results, patients acceptance and total cost with the use of sutures and staples.Methods: The study was conducted on 100 patients who were undergoing elective surgery from January 2016 to July 2017 in our institute. The patients were randomly selected to receive either suture or staple.Results: The study group included 50 patients who underwent wound closure by staplers and 50 patients underwent suturing. The commonest region of the surgical wounds was Mc Burneys site. The time taken for wound closure using staplers showed statistically significance difference over closure with suture, it took the stapler 4 times less duration to perform wound closure. The average cost of using stapler was higher than suturing. The appearance of the scar among the staple group was good in 90% of those who returned for follow-up at 1 month, 10% had average scar. The patients acceptance was better in staple group with less pain during removal as compared to suture group. P-value calculated using students unpaired T-test. P<0.0001 which was highly significant.Conclusions: Staples did not cause excess wound pain and allows saving in time with better cosmetic results.
To evaluate the outcome of sclerotherapy and closed haemorrhoidectomy. Materials & Methods: 24 patients of anorectal disease were included and were operated in this period, 7 patients underwent closed haemorrhoidectomy, 9 patients were given sclerotherapy. Patients of anorectal abscess were excluded and correction of anemia done followed by posted to surgery. Grade I and II Haemorrhoids were treated with sclerosant and Grade III and IV are treated with closed haemorrhoidectomy. Both procedures were done under spinal anesthesia. Results: 7 patients underwent closed haemorrhoidectomy and 9 patients underwent sclerotherapy. Postoperative complications in both groups were studied like pain, bleeding per rectum, mucosal discharge, urinary discharge and wound dehiscence are treated and follow up done. No case arrived with any symptoms of recurrence in the follow up of next 6 months. Conclusion: Sclerotherapy is the preferred technique for hemorrhoids (especially Grade I & II) with minimal duration of stay, early return to the work and less post operative pain and it can be done as a daycare procedure. For Grade III& IV haemorrhoids, closed hemorrhoidectomy is ideal and beneficial.
The aim of the study is to compare open appendicectomy and laparoscopic appendicectomy with respect to Duration of the operative procedure, Analgesic requirement, Post-operative Complications, Duration of hospital stay, Cost factor involved. Materials and Methods:The study subject consists of the patients admitted in the surgical wards of all units of our institute, involved 50 cases that were consecutively selected, where the investigator was a part of the surgical team managing the patients, by using random sampling technique. Results: The mean age of the patients in two groups was 27.2 and 25.5 years respectively. Duration of surgery was 54 min in the open group and 71 min in the laparoscopy group. This difference was statistically significant (P<0.01). Average pain score was 2.72 in open group as compared to 1.21 in laparoscopic group with P< 0.001 which was significant. The duration of analgesics used parenteral and oral in days were on an average 6.44 and 2.2 for open and laparoscopic group respectively. Conclusion: Overall laparoscopic appendicectomy is better than appendicectomy in selected patients with acute or recurrent appendicitis.
Background: Circumcision is the most common surgical procedure in children worldwide. The aim of this study was to study the safety and complication of Plastibell circumcision in neonates and infants.Methods: This prospective study of 420 male children less than 1 years who underwent Plastibell circumcision for religious or cultural indication in the Department of Surgery at KBN Institute of Medical Sciences, Kalaburagi, during February 2016 to January 2018. Children were divided into two groups; neonates (0 to 4 weeks) and infants (5 weeks to1 year). Parents were given specific instructions on care of the device on discharge and followed up on day 3 and on day of separation of the Plastibell.Results: During the study period, 420 cases of Plastibell circumcision fulfilling the inclusion criteria were included and analyzed. Out of the total cases, 120 (28.57%) were neonates, whereas the remaining 300 (71.42%) were infants. Mean surgical time was 4±2 minutes. The mean number of days for Plastibell to separate was 6.2 days, Plastibell ring separation in neonates earlier (3 days to 7 days) as compared to infants (5 days to 12 days). Out of the total 420 cases 65 (15.47%) cases developed minor complications. In neonates, out of 120 cases only 05 (4.16%) developed complications. In infants, out of 300 cases, 60 (20%) developed complications.Conclusions: Neonates had shorter time for the Plastibell to separate and with fewer complications than infants. Though complications were present, they were few and could be managed easily. Plastibell circumcision is safe in neonates and infants.
Aim: To compare the outcomes in children who underwent emergency surgery and those who underwent percutaneous drainage for appendicular abscess. Materials and Methods: In this prospective study, 45 children of appendicular abscess detected on ultrasonogram (USG) were included in the study. The following characteristics were registered: age, gender, the time from onset of symptoms to seeking care, pain, vomiting, fever and general peritonitis; white blood cell count. The size, location of the abscess was noted on USG. After the diagnosis, we divided the patients into two groups based on the type of management. Patients who underwent emergency surgery and appendectomy (Group 1) which composed of twenty patients (14 males and six females) with their ages ranged from 3 to 18 years, and patients treated with ultrasound-guided percutaneous drainage and interval appendectomy (Group 2) which composed of 25 patients, (15 males and ten females) with their ages ranged from 2 to 18 years. Results: Group 1 included twenty patients and Group 2 included 25 patients. In Group 1, on USG the average size of the abscess was 7.2 ± 2.5 cm. After the surgery regained their functional recovery during a mean period of 3.2 ± 1 days. In Group 2, on USG average abscess size was 6.8 ± 2.4 cm. After the procedure regained their functional recovery on the second day. No major complications were noted in Group 2. On the contrary, 12 patients (60%) of Group 1 show complications in the form of wound infection in eight children and wound dehiscence in four children. Conclusions: USG-guided percutaneous drainage was safe and effective way of management of appendicular abscess.
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