The prevalence of diabetic foot ulcers (DFUs) in India is 11.6%. DFU accounts for major cost expenditure, morbidity, and mortality.1 Ozone gas has antimicrobial and antioxidant properties. We studied efficacy of topical ozone gas therapy in promoting healing of DFU. This is an observational comparative cohort study, n = 160, There were two groups of patients namely: those who received Conventional wound management alone C and those who received topical ozone therapy in addition to conventional wound management O + C therapy groups (81 each). Study group, i.e., O + C received five alternate day sessions of ozone therapy by bagging method for 30 minutes each session. Both groups were observed for 30 days for wound healing parameters like reduction of wound surface area, wound diameter, presence and character of discharge, granulation tissue, healing wound edges, microbial negativity, and requirement of revision (re-debridement and/or amputation) surgery. Mean baseline ulcer surface area is 17.43 ± 8.6 cm2 for C and 17.87 ± 9.2 cm2 (range 1–50 cm2) in O + C group. Percentage change in ulcer surface after 21 days in O + C group is 32.37% compared with 17.15% in C group, which is statistically significant (p = 0.01). Rates of microbial negativity and ulcer healing were significantly faster in ozone group. There was a statistically significant decrease in hospital stay, number of revision surgeries required, and mortality in ozone group. Topical ozone gas was well tolerated. Our study supports the efficacy of ozone therapy in DFU healing and reduction in the chances of infection and revision (re-debridement and/or amputation) surgery. More research is needed for dose, duration, and exposure time standardization.
Background: Enterostomy is one of the commonest surgeries performed in general surgical practise. It leads to considerable alteration in life style of patients after surgery in the form of physical, mental, social, spiritual, economic, educational, vocational, marital, sexual problems. We designed study to assess the extent of these affections on quality of life (QOL) and suggest measure to improve it.Methods: We conducted a cross sectional survey using validated City of Hope-quality of life-Ostomy questionnaire questionnaire which was administered to patients following up for routine stoma care in stoma clinic of our hospital. We included patients who have undergone stoma creation between 2 months to 1 year prior to taking the QOL questionnaire. Demographic data and data collected about four main domains of QOL namely, physical, psychological, social and spiritual was statistically analysed for significance, dependence and correlation.Results: Commonest stoma type in our study was temporary ileostomy done for perforative peritonitis. Presence of ostomy makes significant impact on patients clothing style, occupation and sexual activity and suffered depression. Majority of patients (82.5%) fell in fair to average when their scores of QOL were compared. All four domains of life correlated positively to each other.Conclusions: As all domains of life are related to each other intervention to improve any one of them will cause resultant improvement of all domains of QOL. We suggest holistic approach by pre and postoperative counselling, training by trained enterostomal therapists, psychiatrist, treating surgeons and economic and sexual rehabilitation.
Background: Conventional double layered technique of intestinal anastomosis are widely in practise. Some surgeons also practice single layer technique either continuous or interrupted. This was a prospective observational study to compare safety, efiicacy and feasibility of single versus double layered continuous techniques.Methods: Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like length of suture material used, time taken for anastomosis, and that for entire surgery, postoperative complications, return of bowel activity etc. Data such obtained was analysed for statistical significance by applying chi-square test and unpaired ‘t’ test.Results: Length of suture used for single layer (mean of 15.06 cm) was statistically significantly lesser than that for double layer (mean 19.90 cm) (p.0.001). Time taken for anastomosis and overall surgical time too was significantly less for single layer group (p.0.001 and 0.022 respectively). Complications including anastomotic dehiscence were not significantly different between two groups. Postoperative recovery of bowel function was earlier in single layer group with marginal statistical significance (p=0.048).Conclusions: Thus in our study, single layer continuous method of intestinal anastomosis resulted in significant reduction in time, suture material length and cost; without any difference in complications and it marginally hastens the postoperative recovery of bowel function. So single layer continuous method can be recommended for intestinal anastomosis.
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