scholarly journals Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Ahmed Siddique Ammar ◽  
Syed Asghar Naqi ◽  
Shehrbano Khattak ◽  
Ahmed Raza Noumani
Keyword(s):  
Sampling Technique ◽  
Wound Dehiscence ◽  
P Value ◽  
Emergency Laparotomy ◽  
Abdominal Wound ◽  
Creative Commons ◽  
Surgical Ward ◽  
Group A ◽  
Abdominal Wound Dehiscence ◽  
Group B

Objective: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure. Methods: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared. Results: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063). Conclusion: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn’t help in healing of wound and reclosure of the dehisced abdominal wound is needed. doi: https://doi.org/10.12669/pjms.37.4.3671 How to cite this:Ammar AS, Naqi SA, Khattak S, Noumani AR. Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure. Pak J Med Sci. 2021;37(4):1118-1121.  doi: https://doi.org/10.12669/pjms.37.4.3671 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparative study of abdominal wound dehiscence in continuous versus interrupted fascial closure after emergency midline laparotomy

2019 ◽  
Vol 6 (3) ◽  
pp. 886
Author(s):  
Rajesh Kumar Bansiwal ◽  
Tarun Mittal ◽  
Rajeev Sharma ◽  
Sanjay Gupta ◽  
Simrandeep Singh ◽  
...  
Keyword(s):  
Rectus Sheath ◽  
Wound Dehiscence ◽  
Fascial Closure ◽  
Emergency Laparotomy ◽  
Abdominal Wound ◽  
Midline Laparotomy ◽  
Medical College ◽  
Group A ◽  
Abdominal Wound Dehiscence ◽  
Group B

Background: Laparotomy wound dehiscence is still a puzzle for most of the surgeons. Mortality associated with dehiscence has been estimated at 10-30%. Patients undergoing emergency laparotomy suffer from one of these comorbid conditions which are detrimental to healing. In this scenario interrupted suturing has been found to give good strength and have less incidence of wound dehiscence. The objective of the study was to compare the incidence of abdominal wound dehiscence in emergency midline laparotomy.Methods: This study was conducted on 300 consecutive patients undergoing emergency midline laparotomy in the Department of Surgery, Government Medical College and Hospital. Methods group-A: closed by suturing the rectus sheath using polydioxanone suture 1-0 (PDS) in continuous layer suturing method. group-B: closed by suturing the rectus sheath using polydioxanone suture 1-0 in interrupted layer suturing method.Results: The mean age in group A was 40.47 years and 37.47 in group B. In Group A 20.1% patients had burst abdomen and 5.4% in group B.Conclusions: Interrupted closure of abdominal wall fascia is better in emergency laparotomy as compared to continuous closure.

scholarly journals Role of subcutaneous vacuum suction drain in prevention of abdominal wound complication in emergency laparotomy

2020 ◽  
Vol 7 (6) ◽  
pp. 1873
Author(s):  
Vinod Kumar Pandey ◽  
Dhruv Chandra ◽  
Raj Kumar ◽  
Anil Singh ◽  
Tej Pratap ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dehiscence ◽  
Wound Complication ◽  
P Value ◽  
Emergency Laparotomy ◽  
Burst Abdomen ◽  
Vacuum Suction ◽  
Suction Drain ◽  
Group A ◽  
Group B

Background: Some of the most common wound complications following laparotomy include hematoma formation, seroma formation, wound infection, burst abdomen and wound dehiscence. Closed-suction drains (CSDs) help to drain any wound collection and also reduce any dead space in the wound thereby promoting healing and preventing complication.Methods: We conducted a prospective study and included patients presenting with acute abdomen in emergency department. Patients were selected as per inclusion and exclusion criteria. Two groups (group A and B) with equal number of patients were created based on closed envelope technique. CSD was placed in the wound of patients in group A. Wound healing and complications were compared between the two groups.Results: 50 patients were included in the study with 25 in each group. Hematoma formation was found to be significantly more among group B (24.0%) compared to group A (4.0%). Seroma formation (p value =0.03917), SSI rate (p value =0.039) and wound dehiscence/burst abdomen (p value =0.0415) was more in group B than group A. The mean wound healing time (days) and mean hospital stay (days) was significantly more in group B.Conclusions: Placing a subcutaneous vacuum suction drain at the time of abdominal wall closure during emergency laparotomy results in better wound healing and reduces postoperative wound complication, hospital stay time, morbidity and also decreases overall healthcare cost.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

scholarly journals COMPARISON OF TRIGGER POINT PRESSURE RELEASE WITH ULTRASOUND THERAPY TO DECREASE RHOMBOIDS TRIGGER POINTS PAIN

2016 ◽  
Vol 5 (2) ◽  
pp. 32-36
Author(s):  
Azam Mahmood ◽  
Saad Saleem ◽  
Muhammad Usman Khan
Keyword(s):  
Pain Score ◽  
Outcome Measures ◽  
Trigger Point ◽  
Sampling Technique ◽  
P Value ◽  
Ultrasound Therapy ◽  
Pressure Release ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVE To compare the effects of trigger point (TrP) pressure release with ultrasound therapy to reduce rhomboid pain due to TrP. STUDY DESIGN Experimental study STUDY SETTINGS Outpatient department of Ziauddin Hospital, Clifton campus, Karachi, Pakistan. SAMPLE SIZE 50 patients SAMPLING TECHNIQUE Simple random sampling. The patients were divided into two groups of 25. Group A were given TrP pressure release treatment with exercise and group B were given ultrasound (u/s) treatment with exercise. OUTCOME MEASURES The outcome measures were visual analog scale (VAS) for pain and functional rating index (FRI) for functional performance RESULTS In group A, mean pain score on VAS before the treatment were 5.88±1.130 and after treatment were 1.80±1.041 with a p-value of <0.006. Group B, mean pain score on VAS before treatment were 6.56±1.446, after treatment were 2.72±1.208, with a p-value of <0.006. The mean FRI in group A before treatment was 39.92 ± 2.691 and after treatment was 29.60 ± 5.454, with a p-value of 0.002. The mean FRI in Group B before treatment was 41.12 ± 2.505 and after treatment was 35.92 ± 4.183, with a p-value of 0.002.

Comparison of the Outcomes of Laparoscopic Approach with Open Method for Primary Ventral Hernia Repair

2021 ◽  
Vol 15 (6) ◽  
pp. 1626-1628
Author(s):  
Rahmat Ullah Shah ◽  
Sadia Shah ◽  
Gul Sharif ◽  
Adnan Badar ◽  
Sheikh Muhammad Ibqar Azeem ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Approach ◽  
Wound Dehiscence ◽  
P Value ◽  
Open Method ◽  
Group A ◽  
Group B ◽  
Primary Ventral Hernia

Aim: To compare the outcomes of laparoscopic approach with open method in patients undergoing primary ventral hernia repair. Study Design: Randomized control trial Place and Duration: This study was conducted at Kuwait Teaching Hospital and Lady Reading Hospital Peshawar during the period of January 2017 to December 2019. Methods: One hundred and ninety patients of both genders with ages ≥18 years were included. All the patients were divided in to two groups, i.e’ Group A consists of 95 patients received open procedure and Group B with 95 patients received laparoscopic approach for primary ventral hernia repair. Outcomes in term of complications, hospital stay and recurrence rate were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. Results: There were 65 (68.4%) females and 30 (31.6%) males in Group A and in Group B 35 (36.8%) males and 60 (63.2%) females. Mean age of patients in Group A was 40.14±3.31 years and in Group B it was 42.94±8.55 years. In Group B hospital stay was shorter than Group A (3.11±1.20 days Vs 5.9±3.9 days). According to the wound infection we found significant difference between Group A and Group B (12.6% and 4.2%);[p-value <0.05]. In Group A 5.3% patients had developed wound dehiscence while in Group B none of patient found to have wound dehiscence (p-value <0.05). Recurrence rate was also high in Group A 7.4% vs 2.1% in Group B (p=<0.05). Conclusion: It is concluded that laparoscopic repair of primary ventral hernia is safe and effective with lesser complications as compared to open method. Keywords: Ventral Hernia, Laparoscopic, Open Procedure, Wound Infection, Wound Dehiscence, Recurrence

scholarly journals Effectiveness between Salam Leaf Booking Water and Red Ginger Towards Reducing Acid Levels in Patients of Gout Arthritis

2021 ◽  
Vol 2 (1) ◽  
pp. 6-11
Author(s):  
Hartono ◽  
Chicilia Puspita Darmaningrum
Keyword(s):  
Uric Acid ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Test Analysis ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Red Ginger ◽  
Boiled Water

Background. The prevalence of Gout Arthritis in the world is 34.2%. Gout Arthritis is characterized by an increase in uric acid levels >7.2 mg/dl in men and >6 mg/dl in women. This disease can be treated pharmacologically and non-pharmacologically, one of which is bay leaf and red ginger. Research purposes. The purpose of this study was to determine the effectiveness of boiled water of bay leaves and red ginger on reducing uric acid levels in patients with gout arthritis. Methods. This research method is a pre-experimental static-group comparison design. The sampling technique used purposive sampling. A sample of 60 respondents was divided into two groups of 30 respondents each, group A intervention boiled bay leaf water for 7 days, group B intervention boiled red ginger water for 7 days. Both groups were observed uric acid levels before and after the procedure using the GCU tool. Result: The results of the paired t-test analysis of group A p = 0.000 and group B p = 0.005 p value <0.05 which means there is a difference between before and after intervention A and intervention B were given. The results of the Independent t-test analysis showed that there was a difference in uric acid levels. after intervention A and intervention B with p = 0.004. The results showed that boiled water of bay leaves was more effective than boiled water of red ginger in reducing uric acid levels. Conclusion. Boiled water of bay leaves is more effective than boiled water of red ginger in reducing uric acid levels in gout arthritis patients

scholarly journals KIMS 14: a new scoring system to predict abdominal wound dehiscence following emergency laparotomy

2017 ◽  
Vol 4 (4) ◽  
pp. 1230
Author(s):  
Akshay V. Gokak ◽  
Ramesh H. ◽  
Abhijit D. H. ◽  
Vasant T.
Keyword(s):  
High Risk ◽  
Scoring System ◽  
Significant Risk ◽  
Wound Dehiscence ◽  
Emergency Laparotomy ◽  
Abdominal Wound ◽  
Duration Of Symptoms ◽  
Midline Laparotomy ◽  
Duration Of Surgery ◽  
Abdominal Wound Dehiscence

Background: Abdominal wound dehiscence is a common complication of emergency laparotomy in Indian setup. Wound dehiscence carries with it a substantial morbidity and mortality. Hence, we have developed a scoring system which can predict wound dehiscence following emergency laparotomy and prophylytic measures can be taken preoperatively to prevent this. Objectives were to identify independent risk factors for abdominal wound dehiscence and to develop a scoring system to recognize high risk patients.Methods: An observational, longitudinal, analytical and retrospective study was done from July 2014 to January 2017 in KIMS Hubli, Karnataka, India, where the sample studied were patients who underwent midline laparotomy during the study period. 30 cases of abdominal wound dehiscence were taken and 60 controls.Results: 30 cases of abdominal wound dehiscence following emergency laparotomy were reported and compared with 60 selected controls. Age, gender duration of symptoms hypotension, anemia hyperbilirubinemia, hypoproteinemia, uremia, duration of surgery, contaminated wounds, COPD/chest infections were statistically significant. Multivariate binary logistic regression showed Hypoproteinemia, uremia duration of surgery contaminated wounds and chest infection/COPD as independent significant risk factor and a scoring system was developed using these variables.Conclusions: The scoring system developed can identify the high-risk patients and necessary measures can be taken to prevent this complication.

scholarly journals Comparison of outcome of interrupted versus continuous closure technique of rectus sheath in emergency laparotomies patients in terms of wound dehiscence.

2021 ◽  
Vol 28 (04) ◽  
pp. 455-458
Author(s):  
Kaleem Ullah ◽  
Shams Uddin ◽  
Azam Shoib ◽  
Muhmmad Danish Yaseen
Keyword(s):  
Total Duration ◽  
Rectus Sheath ◽  
Wound Dehiscence ◽  
Emergency Laparotomy ◽  
Medical Sciences ◽  
Female Ratio ◽  
Group A ◽  
Randomized Controlled Trail ◽  
Group B ◽  
Continuous Closure

Objective: To compare outcome of interrupted versus continuous closure of rectus sheath in emergency laparotomy patients, in terms of wound dehiscence. Study Design: Randomized Controlled Trail. Setting: Department of Casualty Surgical Pir Abdul Qadir Shah Institute of Medical Sciences, Gambat. Period: 1st January to 30th June 2020. Material & Methods: Total duration of study was 6 months. Total of 150 patients (75 in each group) were studied. Interrupted closure of rectus sheath was done in group “A” patients while continuous closure was done in group “B” patients, and efficacy in terms of wound dehiscence was compared in both groups. Results: Overall male to female ratio was1.29:1. The average age of the patients was 39.41 years +13.02SD.   Wound dehiscence in Group “A” was found in 2.6% cases while 6.6% in Group “B” patients. Conclusion: Interrupted closure of Rectus sheath in emergency laparotomy is more effective than continuous closure in preventing wound dehiscence.

scholarly journals Comparison of efficacy of large tissue bites versus small tissue bites for midline abdominal wound closure

2020 ◽  
Vol 7 (2) ◽  
pp. 455
Author(s):  
Tappa Mahammad Mustaqrasool ◽  
Bharat Dikshit ◽  
Deepak Phalgune
Keyword(s):  
Incisional Hernia ◽  
Surgical Site Infections ◽  
Wound Dehiscence ◽  
Suture Technique ◽  
Fascial Closure ◽  
Abdominal Wound ◽  
Closure Time ◽  
Small Tissue ◽  
Group A ◽  
Group B

Background: Incisional hernia is common complication after median laparotomy, with reported incidence varying between 2% and 20%. For prevention of incisional hernia, many clinical trials and meta-analyses have demonstrated that mass closure technique with simple running suture is good option to close midline incision. An attempt was made in this study to compare efficacy of large tissue bites vs small tissue bites for midline abdominal wound closure.Methods: Three hundred thirty patients admitted for midline laparotomy were randomized into Group A, and Group B. Group A, and Group B patients underwent abdominal closure by small bites technique, and large bites technique respectively. Patients were followed at 7th postoperative day, 1 month, 6 months, and 12 months. Primary outcome measures were incidence of incisional hernia, incidence of postoperative complications like post-operative pain, surgical site infections, wound dehiscence whereas, secondary outcome measure was fascial closure time. Inter-group comparison of categorical, and continuous variables was done using Chi-square test/Fisher’s exact test and unpaired ‘t’ test respectively.Results: Incidence of incisional hernia was significantly higher in large bites suture technique compared to small bites suture technique at 12 months follow up. Mean time required for fascial closure time was significantly higher in small bite group compared to large bite group. There was no statistically significant difference in postoperative pain, surgical site infections, and wound dehiscence among the two groups.Conclusions: The rate of incisional hernia was lower in small bites technique compared with large bites technique in midline abdominal incisions.

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