scholarly journals P050 INTRODUCTION OF MINIMAL INVASIVE PROCEDURES WITH EXTRAPERITONEAL MESH PLACEMENT MAY REDUCE MORBIDITY AND LENGTH OF HOSPITAL STAY IN PATIENTS WITH INCISIONAL HERNIA - A SINGLE CENTER'S EXPERIENCE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Lena Kundel ◽  
Christian Gröger ◽  
Ulrich Adam ◽  
Hartwig Riediger
Keyword(s):  
Incisional Hernia ◽  
Hospital Stay ◽  
Open Surgery ◽  
Length Of Hospital Stay ◽  
Minimal Invasive ◽  
Wound Complications ◽  
Invasive Procedures ◽  
Hernia Surgery ◽  
Mesh Placement ◽  
Duration Of Surgery

Abstract Aim “Sublay mesh placement is the gold standard in the treatment of incisional hernias. In open surgery, high rates of wound complications are reported. Various minimal invasive procedures with extraperitoneal mesh placement (MIPEX) are currently under evaluation in order to improve the clinical results. We report our experience with an increased use of MIPEX techniques” Material and Methods “The perioperative results of all consecutive patients from 1/2018 to 4/2021with incisional hernia surgery were reviewed. For the purpose of this study, the results of patients with MIPEX were compared to STANDARD treatment (open surgery and/or intraperitoneal mesh). All patient data were registered prospectively in the Herniamed database. ” Results “103 out of 170 patients were treated with MIPEX and 67 with STANDARD. MIPEX were MILOS/E-MILOS (n = 48), TAPP (n = 15), laparoscopic sublay (n = 5), ETEP (n = 17) and other (n = 18) with additional TAR in (n = 16). Five procedures were performed robotically. Mean duration of surgery (DOS) was 150 minutes in MIPEX and 116 minutes in STANDARD (n.s.). Morbidity was 7% in MIPEX and 19% in Standard (p < 0.5). Mean length of hospital stay (LHS) was 4 days in MIPEX and 8 days in STANDARD (p < 0.5). In subgroup analysis of patients with large hernias (EHS-3, n = 31), DOS was 320 minutes (MIPEX) vs. 159 minutes (STANDARD); p < 0.01 and LHS was 8 days (MIPEX) vs. 12 days (STANDARD), p < 0.01.” Conclusions “MIPEX included a broad spectrum of procedures. With the implementation of MIPEX, DOS increased significantly in large hernias. Morbidity and LHS were significantly reduced in all patients.”

scholarly journals COMPARATIVE STUDY OF INGUINAL HERNIA REPAIR WITH PLACEMENT OF MESH ANTERIOR AND POSTERIOR TO FASCIA TRANSVERSALIS IN CASES OF UNILATERAL INGUINAL HERNIA

2020 ◽  
pp. 39-41
Author(s):  
Angshuman Mukherjee ◽  
Dhrubajyoti Maulik
Keyword(s):  
Inguinal Hernia ◽  
Wound Complications ◽  
Hernia Surgery ◽  
Mesh Placement ◽  
Unilateral Inguinal Hernia ◽  
Fascia Transversalis ◽  
Inguinal Pain ◽  
Duration Of Surgery ◽  
Pain Duration ◽  
Superiority Trial

Background: Since inception hernia surgery evolved a lot and achieved the gold standard of Lichtenstein hernioplasty. Chronic post-surgical inguinal pain and mesh related wound complications are still issues of concern for surgeons. To minimize these problems different modifications are being evaluated worldwide. OBJECTIVE: To compare the incidence of post-surgical chronic inguinal pain duration of surgery between two different techniques of mesh placement, one is placing the mesh anterior to Fascia Transversalis and other is placing the mesh posterior to Fascia Transversalis. STUDY DESIGN: Randomized superiority trial done among patients selected from opd and divided in two groups undergone hernioplasty by two different techniques of mesh placement. MATERIALS AND METHODS: Each group of patients contained fifty patients of 18 to 65 years of age with unilateral inguinal hernia. Duration of surgery recorded and post-surgical chronic inguinal pain evaluated at 2 weeks 2 months 4 months and 6 months after surgery. CONCLUSION: The study showed that placement of mesh posterior to fascia tranversalis gave better result than placing it anterior to FT in respect of post operative chronic pain but with a longer operative duration.

Clinical evaluation of two adult oxygenator systems in terms of mortality and major adverse events

Perfusion ◽  
2021 ◽  
pp. 026765912110638
Author(s):  
Hüsnü Kamil Limandal ◽  
Mehmet Ali Kayğın ◽  
Servet Ergün ◽  
Taha Özkara ◽  
Mevriye Serpil Diler ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Artery Bypass ◽  
Length Of Hospital Stay ◽  
Fresh Frozen Plasma ◽  
Wound Complications ◽  
Significant Difference ◽  
Delayed Sternal Closure ◽  
Fresh Frozen ◽  
Major Adverse Events

Purpose The primary aim of this study was to examine the effects of two oxygenator systems on major adverse events and mortality. Methods A total of 181 consecutive patients undergoing coronary artery bypass grafting in our clinic were retrospectively analyzed. The patients were divided into two groups according to the oxygenator used: Group M, in which a Medtronic Affinity (Medtronic Operational Headquarters, Minneapolis, MN, USA) oxygenator was used, and Group S, in which a Sorin Inspire (Sorin Group Italia, Mirandola, Italy) oxygenator was used. Results Group S consisted of 89 patients, whereas Group M included 92 patients. No statistically significant differences were found between the two groups in terms of age ( p = .112), weight ( p = .465), body surface area ( p = .956), or gender ( p = .484). There was no statistically significant difference in hemorrhage on the first or second postoperative day ( p = .318 and p = .455, respectively). No statistically significant differences were observed in terms of red blood cell ( p = .468), fresh frozen plasma ( p = .116), or platelet concentrate transfusion ( p = .212). Infections, wound complications, and delayed sternal closure were significantly more common in Group M ( p = .006, p = .023, and p = .019, respectively). Extracorporeal membrane oxygenators and intra-aortic balloon pumps were required significantly more frequently in Group S ( p = .025 and p = .013, respectively). Major adverse events occurred in 16 (18%) patients in Group S and 14 (15.2%) patients in Group M ( p = .382). Mortality was observed in six (6.7%) patients in Group S and three (3.3%) patients in Group M ( p = .232). No statistically significant difference was found between the two groups in terms of length of hospital stay ( p = .451). Conclusion The clinical outcomes of the two oxygenator systems, including mortality, major adverse events, hemorrhage, erythrocyte and platelet transfusions, and length of hospital stay, were similar.

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals Is Endoscopic Discectomy the Next Gold Standard in the Management of Lumbar Disc Disease? Systematic Review and Superiority Analysis

2020 ◽  
pp. 219256822094881
Author(s):  
Sathish Muthu ◽  
Eswar Ramakrishnan ◽  
Girinivasan Chellamuthu
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Gold Standard ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Disc Disease ◽  
Lumbar Disc Disease ◽  
Endoscopic Discectomy ◽  
Duration Of Surgery

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether endoscopic discectomy (ED) shows superiority compared with the current gold standard of microdiscectomy (MD) in management of lumbar disc disease. Materials and Methods: We conducted independent and duplicate electronic database search including PubMed, Embase, and Cochrane Library from 1990 till April 2020 for studies comparing ED and MD in the management of lumbar disc disease. Analysis was performed in R platform using OpenMeta[Analyst] software. Results: We included 27 studies, including 11 randomized controlled trials (RCTs), 7 nonrandomized prospective, and 9 retrospective studies involving 4018 patients in the meta-analysis. We stratified the results based on the study design. Considering the heterogeneity in some results between study designs, we weighed our conclusion essentially based on results of RCTs. On analyzing the RCTs, superiority was established at 95% confidence interval for ED compared with MD in terms of functional outcomes like Oswestry Disability Index (ODI) score ( P = .008), duration of surgery ( P = .023), and length of hospital stay ( P < .001) although significant heterogeneity was noted. Similarly, noninferiority to MD was established by ED in other outcomes like visual analogue scale score for back pain ( P = .860) and leg pain ( P = .495), MacNab classification ( P = .097), recurrences ( P = .993), reoperations ( P = .740), and return-to-work period ( P = .748). Conclusion: Our meta-analysis established the superiority of endoscopic discectomy in outcome measures like ODI score, duration of surgery, overall complications, length of hospital stay and noninferiority in other measures analyzed. With recent advances in the field of ED, the procedure has the potential to take over the place of MD as the gold standard of care in management of lumbar disc disease.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Laparoscopic Urological Surgery: Our Initial Experiences

2020 ◽  
Vol 23 (1) ◽  
pp. 17-23
Author(s):  
Shiba Prasad Nandy ◽  
AKM Akramul Bari ◽  
Anirban Ghose ◽  
Hasmot Ali Mia ◽  
Md Alamgir ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Radical Nephrectomy ◽  
Open Surgery ◽  
Renal Cyst ◽  
Conversion To Open Surgery ◽  
Cyst Excision ◽  
Excellent Outcome ◽  
Duration Of Surgery ◽  
The Mean

Introduction and Objective: Laparoscopic surgery is increasingly exercised in urology due to improvements in technical capabilities and experience. It comes with many advantages compared to open surgery such as lesser degree of pain and haemorrhage, shorter hospital stay and better cosmetic results. This study is carried out to evaluate the outcomes and complications of urological laparoscopic surgery cases performed Chittagong Medical College Hospital, Chattogram, Bangladesh. Methods: This was a hospital based prospective observational study of total 29 patients, who received laparoscopic surgery of different kinds between January 2017 and September 2019 for urological causes with a minimum one month follow-up. Included patients were assessed in terms of demographic characteristics, preoperative diagnosis, type of laparoscopic approach, duration of surgery and hospitalization, complications after surgery and need for conversion to open surgery. Results: The mean age was 45.03 years where 12 patients were women and 17 were male. All patients underwent trans-peritoneal procedures where2 patients received renal cyst excision, 4 simple nephrectomy, 5 ureterolithotomy, 9 radical nephrectomy, 1 radical cystectomy, 2 adrenalectomy, 3 pyelolithotomy and 3 pyeloplasty. Three of the 29 patients required conversion to open surgery. Except these patients, no major complication or mortality was encountered. The mean duration of surgery for the most commonly applied procedures were as follows: renal cyst excision 87.5 (70-105) min, simple nephrectomy 141.25 (120-170) min, ureterolithotomy 120 (100-140) min, radical nephrectomy 215.56 (180-260) min, pyelolithotomy 120 (100-140) min, and pyeloplasty 156.67 (130-190) min. The mean hospital stay was 4.59±1.7 (2-8) days. Conclusions: The success and complications rate of the laparoscopic urological surgeries performed in our hospital were consistent with those reported in the literature. In the light of technological advances and increasing experience, we believe that laparoscopic surgery is an effective technique with excellent outcome along with a safe and feasible alternative to open surgery in the field of urology. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.17-23

scholarly journals A new minimally invasive surgical technique for the treatment of ovarian cysts in children

2021 ◽  
Vol 23 (5) ◽  
pp. 677-682
Author(s):  
O. V. Spakhi ◽  
A. H. Zaporozhchenko ◽  
V. V. Morhun ◽  
O. P. Pakholchuk
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Ovarian Neoplasms ◽  
Abdominal Cavity ◽  
Length Of Hospital Stay ◽  
Ovarian Cysts ◽  
Group Iii ◽  
Group I ◽  
Duration Of Surgery

The topical issue of pediatric surgery is the treatment of ovarian cysts based on the development of new technologies for surgical correction of the disease. Aim. To analyze the effectiveness of using a new minimally invasive method for removal of cystic ovarian neoplasms in children. Material and methods. A retrospective analysis of 77 female patients with ovarian cysts, aged from 3 months to 17 years, was carried out. The patients were divided into 3 groups depending on the various surgical techniques used for their treatment. Group I consisted of 32 (41 %) girls who underwent cystectomy according to the new transabdominal technique for removing ovarian cysts in children. Group II included 19 (25 %) children who underwent a laparoscopic surgery. Group III comprised 26 (34 %) children who underwent a hybrid laparoscopy-assisted cystectomy. The following indicators were analyzed: the age of patients, the nature and number of complications of the disease course, the size of cystic neoplasms, the duration of surgical interventions, the number of cases accompanied by cyst contents leaking into the abdominal cavity during surgical manipulations, and the length of hospital stay. Results. The mean age of all patients was 11.23 ± 0.57 years. Planned hospitalizations amounted to 46 (59.7 %) cases. The duration of surgery in group I was almost 1.5 times lower (P < 0.05) than that in patients of group II and 2 times shorter than in children of group III (P < 0.05). Free cyst contents leaking into the abdominal cavity was observed in 35 (91.4 %) patients of Group III, which required additional measures aimed at the abdominal cavity sanation. The proposed minimally invasive transabdominal surgical technique prevented this complication in all 32 patients of Group I. The length of hospital stay did not differ significantly (P > 0.05) between children groups I and II and did not exceed 7.50 ± 0.35 (M ± SEM) days. This indicator was almost 1.5 times higher in Group III patients. Conclusions. The new minimally invasive transabdominal method for removing cystic ovarian neoplasms in children provided minimal trauma with maximum ablasticity and cosmetic effect of the operation. The proposed technique made it possible to prevent the development of intraoperative and postoperative complications, significantly reduce the duration of surgery and the recovery time of patients.

scholarly journals Surgical Site Infection In Laparotomy

2018 ◽  
Vol 4 (1) ◽  
pp. 22-25
Author(s):  
Pashupati N. Bhatta ◽  
Umesh Kumar Yadav ◽  
Gorakh Nath Mishra ◽  
Randhir Jha ◽  
Kumar Shrestha
Keyword(s):  
Risk Factor ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Median Length ◽  
National Medical College ◽  
Medical College ◽  
National Medical ◽  
Duration Of Surgery

INTRODUCTION: Surgical site infection (ssi) is one of the most common surgical complications which increases the rate of morbidity and mortality and increases the health care cost by prolonging the hospital stay.  AIMS AND OBJECTIVES: The main objective of the study was to find out the incidence of ssi in emergency laparotomy in general surgery and to find out the associated risk factor for ssi.MATERIAL & METHODS: Study was carried out in national medical college, Birgunj from January 2011 to June 2012 after getting ethical clearance from Institutional Review Committee National Medical College. Total 200 cases were included in study and follow up done up to 30 days postoperatively. RESULTS: Out of 200 patients, 76 patients developed ssi. The total incidence of ssi was 38%.The rate ssi in clean-contaminated, contaminated and dirty wound were 18.2%, 33.3% & 45.5% respectively. Age, type of surgical operation and prolonged duration of surgery were the significant risk factor for ssi while sex, BMI were not statistically significant. The median length of hospital stay with ssi was 16 days while the median length of hospital stay without ssi was 10 days.CONCLUSION: The rate of ssi was found to be higher in our study in comparison to western study but neariy same when comparing to study of Asian countries. so, we emphasize for the need of  evidence based infection control and recommend for better surveillance program me for control of ssi in each hospital.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 22-25

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