Introduction: Hernia is defined as the protrusion of all or part of a viscus through the wall that contains it. Laparoscopic and tension-free open repairs are the two procedures that are being performed globally in inguinal hernia surgery. Aim: To compare the benefits of fibrin glue versus absorbable tackers in laparoscopic Transabdominal Preperitoneal (TAPP) inguinal hernia repair and to appraise their outcomes. Materials and Methods: A randomised clinical trial was conducted at a tertiary hospital of SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India for 18 months, from March 2021 to August 2022. Total of 54 patients who had laparoscopic TAAP hernia repairs were divided into two groups each with 27 participants, group A mesh fixed using fibrin glue and group B mesh fixed using absorbable tackers. All the patients were followed-up for atleast three months postsurgery. Operating time, postoperative pain and complications data were collected. The Chi-square and Unpaired t-test determined the statistical significance of the data. Results: Total of 54 patients aged 18 to 60 years were included in the study with no significant differences (p-value=0.696). The same was true for gender (11 males and 43 females), with no significant differences (p-value=0.735) in group A and group B between male and female patients. In current study, there was a statistically significant difference in pain levels between groups after 24 hours, hours (group B: 5.33±1.30 and group A: 6.56±0.51) however, after 48 hours (group B: 4.07±0.87 and group A: 4.63±0.49) and 72 hours (group B: 2.74±0.76 and group A: 2.63±0.49), there was no significant difference in the severity of the pain between the groups. At one week follow-up the level of pain score was significantly different. There was also a significant difference in haematoma between groups (p-value=0.038). In addition, there was a significant difference in return to normal activities in one week (p-value=0.033), two weeks (p-value=0.022), and four weeks between groups (p-value=0.019). Conclusion: The use of fibrin sealant for mesh fixation in TAPP surgery has superior short-term outcomes when compared to tackers in terms of postoperative pain, return to normal activities and reduced incidence of haematomas.
Introduction: According to research by the World Health Organisation (WHO), there are 347 million diabetics worldwide, and by 2030, it will overtake smoking as the seventh leading cause of death and diabetic people have a lifetime risk of up to 25% for developing a foot ulcer. Many novel techniques are emerging to fasten wound healing, including cellular therapies using PlateletRich Plasma (PRP) and collagen-based dressings. Aim: To compare the efficacy between instillation of autologous PRP and conventional dressing using normal saline/povidone iodine in Diabetic Foot Ulcers (DFU). Materials and Methods: This randomised control clinical study was conducted in the Department of General Surgery at SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India. The duration of the study was 18 months, from April 2021- September 2022. A total of 174 DFU patients were included in the study, meeting inclusion and exclusion criteria’s. Patients were divided into case (n=87) and control group (n=87). For six weeks, the case group got autologous PRP, while the control groups regularly had standard dressings. Wound areas were measured using ruler scale weekly and percentage of healing was monitored for 12 weeks. The data were analysed with International Business Machines (IBM)- Statistical Package for Social Sciences (SPSS) version 21.0. Results: In a group of 87 each, 174 patients with chronic non healing DFUs were randomly assigned to the study group (PRP) or the control group (conventional dressing method) throughout the 9 months study. Age ranged from less than 40 years to more than 61 years in the present study of 174 patients, with the age group between 51 and 60 years having the highest percentage of patients (50.6%), followed by the age group over 61 years (23.6%). About 12 weeks after the treatment, it was discovered that, the case group had a 86% reduction in wound area of 86.51±15.71 mm, whereas, the control group had a 61% reduction in wound area of 65.47±30.18 mm and 65.1% of patients from the case group showed wound healing, while 42.7% of patients from the control group showed wound healing. These findings were found to be statistically significant (p-value <0.001). Conclusion: The use of PRP led to a higher rate of wound healing in less time when compared to traditional wound care in the therapy of chronic DFUs, as shown in the present study. For chronic DFUs, PRP was able to speed up healing, making it a potentially viable and promising treatment
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