Background: Lower limb ulcer is a common disease among the Indian population with a prevalence of approximately 1% to 2% which is slightly higher in the older population. There are various modalities of treatment with the main aim being early wound healing. This study is done to compare the results of negative pressure dressing and conventional dressing in lower limb ulcers.Methods: This study, done at the Department of Surgery, G. K. General Hospital and Gujarat Adani Institute of Medical Sciences, Bhuj, from October 2017 to September 2018 is a prospective study. A total of 120 patients were randomly divided in two group comprising of 60 patients each. The patients in Group A were treated with negative pressure dressing while those in Group B were treated with conventional dressing. The patients were assessed, in both test and control groups, with parameters like appearance of granulation tissue, bacterial clearance and wound healing.Results: 80% of the patients belonged to the age group of 41-60 years while others were less than 40 years. We observed that in Group A majority of the patients had wound healing in 11-40 days while in Group B majority patients took 31-60 days for their wounds to be healed.Conclusions: We conclude that negative pressure dressing is more efficient as compared to conventional dressing for healing of lower limb ulcers, enabling a shorter hospital stay and early resumption of daily activities to the patient.
Introduction
Appendicectomy is commonly a safe and low bleeding risk procedure. However, some hospital guidelines stipulate a requirement for routine pre-operative blood group and save (G&S).We aim to determine if pre-operative G&S is required for appendicectomies by looking at the number of tests vs transfusion conducted.The cost of G&S is £4.14 per sample in our trust.
Method
A retrospective review was conducted over a 3-month period. Patient data and demographics were identified using the hospital coding, theatre records and transfusion departments.
Results
118 consecutive appendicectomies were identified. Of which, 99 laparoscopic vs 19 open (13 started open vs 6 converted to open) operations were performed. No patients required a blood transfusion during their admission. There was a total of 219 G&S conducted. Cross matching tests for these procedures cost a total of £906. We estimate a cost projection of £3624 for G&S tests over a year and £18120 over 3 years.
Conclusions
Bleeding complications requiring transfusion following appendicectomies are very uncommon. In our unit, 0% of patients identified required a transfusion during their admission. We suggest stopping routine pre-operative G&S for these patients would be clinically safe and would lead to financial savings and reduce pre-operative waiting time.
Aberrant biliary anatomy is not uncommon. Isolated aberrant segment V duct is extremely rare. We report a case of isolated segment V duct injury during laparoscopic cholecystectomy.
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