scholarly journals Open versus Closed Hemorrhoidectomy - An Experience at Mayo Hospital

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Muhammad Shoaib ◽  
Abrar Ashraf Ali ◽  
Nabeel Naqvi ◽  
Khalid Masood Gondal ◽  
Abdul Majeed Chaudhry
Keyword(s):  
Wound Healing ◽  
Wound Dehiscence ◽  
Postoperative Hospital Stay ◽  
Analgesic Requirement ◽  
Closed Technique ◽  
Complete Wound Healing ◽  
Closed Hemorrhoidectomy ◽  
One Year ◽  
Open Versus ◽  
Surgical Unit

Hemorrhoids are a common problem that affects a larger group of population. It affects both sexes and is more common in the more prosperous societies, perhaps related to exercise, diet and bowel habits. The objective of the study was to compare the outcome of the two conventional methods of haemorrhoidectomy, open and closed techniques for 3rd degree prolapsing and complicated haemorrhoids. This would be a non-interventional type of study comparing the two methods conducted at surgical unit-1 Mayo Hospital, Lahore comprising of fifty patients selected randomly and equally divided in two groups. No statistically significant differences were found between the two methods regarding complications and postoperative hospital stay (P>0.05). Pain and the analgesic requirement on the day of surgery and the first postoperative day was significantly lower (P<0.05) in open haemorrhoidectomy group. Complete wound healing took longer in open haemorrhoidectomy as compared to closed technique, 3 patients suffered wound dehiscence after closed haemorrhoidectomy. Only 4% in each group develop recurrence after one year. Open haemorrhoidectomy leads to more reliable wound healing with lesser complications, though heeling time is more as compared to the closed technique. Both techniques are fairly efficient for treating third degree haemorrhoids.

scholarly journals Early versus late dressing removal in clean and contaminated midline laparotomy wounds: a non-randomized pilot study

2018 ◽  
Vol 5 (9) ◽  
pp. 3051
Author(s):  
Vijayakumar C. ◽  
Prabhu R. ◽  
Muthukrishnan V. ◽  
Kalaiarasi R. ◽  
Swetha T.
Keyword(s):  
Wound Healing ◽  
Wound Dehiscence ◽  
Final Analysis ◽  
Early Discharge ◽  
Midline Laparotomy ◽  
Early Removal ◽  
Deep Surgical Site Infection ◽  
Laparotomy Wound ◽  
Complete Wound Healing ◽  
Removal Group

Background: This study was carried out to evaluate the efficacy of early versus late dressing removal in clean and contaminated midline laparotomy wounds.Methods: Fifty patients aged ≥18 years who were admitted and operated for surgical procedures (both emergency and elective) were included in the study. All laparotomy wounds had fulfilled the CDC criteria.  Twenty-five patients each were included in early dressing removal group and the late removal group. In early removal group, the laparotomy wound dressing was removed within 48 hours and in late removal group, was removed after 48 hours of surgery. The incidences of superficial and deep surgical site infection (SSI) in both groups were analysed. Other secondary parameters like incidence of wound dehiscence and secondary suturing were also analysed.Results: Twenty-five patients each, in early removal group and in late removal group were included for final analysis. The incidence of superficial SSI (%) was significantly less in early removal group (65.50 versus 89.50; p= <0.001). The duration (days) required for complete wound healing (8.52 versus 10.65; p=0.734) was significantly less in the early removal group. The length of postoperative hospital stay (days) was significantly less in early removal group (10.30 versus 14.90; p= <0.001).Conclusions: Early removal of dressing significantly reduces the incidence of superficial SSI in midline clean and contaminated laparotomy wounds. It also significantly reduces the duration required for complete wound healing and facilitates early discharge of the patient compared to late dressing removal.

OPEN VERSUS CLOSED HEMORRHOIDECTOMY – A COMPARATIVE STUDY

2021 ◽  
pp. 46-47
Author(s):  
Sujeet Kumar Bharti ◽  
Kirti Priya
Keyword(s):  
Wound Healing ◽  
Bleeding Complications ◽  
P Value ◽  
Operative Outcomes ◽  
Open Hemorrhoidectomy ◽  
Post Operative Pain ◽  
Routine Work ◽  
Closed Hemorrhoidectomy ◽  
Group B ◽  
Open Versus

Background and Objectives: - Hemorrhoids are specialized, highly vascularized cushions within the normal anal canal. Hemorrhoidectomy is considered as an effective treatment for III degree and IV degree hemorrhoids. The conventional Milligan-Morgan open hemorrhoidectomy remains the more commonly performed operation. Ferguson's closed hemorrhoidectomy has gained considerable attention because of the less pain, faster wound healing and better patient compliance. Nonetheless, randomized controlled trials have reported conicting results regarding post-operative outcomes between two methods. Methods: - 60 patients were included in this study, who underwent hemorrhoidectomy, by split them into two equal groups. Group A underwent open hemorrhoidectomy and group B underwent closed hemorrhoidectomy. Patient in each group were studied in terms of post-operative pain, wound healing, bleeding, length of hospital stays and the results were analysed and tested with statistical methods. Results: - In study of 60 cases, peak incidence was found at 46 years of age and more common in males (5.67:1). Difference in pain between the 2 groups was found statistically signicant (P value <0.05). 29 (96/67%) patients had completely healed wound from group B (closed) at 3rd week compared to 5 (16.67%) from group B. 7 (23.3%) patients in closed group had complications, in contrast to 25 (83.3%) in open group. Conclusion: - We got in this study that patients who underwent Ferguson's closed hemorrhoidectomy had less post-operative pain, bleeding, complications, early healing of wound and early back to routine work compared to Milligan-Morgan's open hemorrhoidectomy group

scholarly journals Comparison of insulin soaked dressing with the conventional dressing in diabetic ulcers.

2021 ◽  
Vol 28 (7) ◽  
pp. 951-956
Author(s):  
Hafiz Bilal Ahmed ◽  
◽  
Ramlah Ghazanfor ◽  
Usman Qureshi ◽  
Usman Akram ◽  
...  
Keyword(s):  
Wound Healing ◽  
Controlled Trial ◽  
Healing Process ◽  
P Value ◽  
Random Allocation ◽  
Diabetic Ulcers ◽  
Group A ◽  
Complete Wound Healing ◽  
Group B ◽  
Surgical Unit

Objective: This study aims at demonstrating the benefits of insulin soaked dressing for the treatment and accelerating the healing process of diabetic ulcers thus helping the faster wound healing, reducing morbidity and also decrease the cost of management in patients with diabetic ulcers. Study Design: Randomized Controlled Trial. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi. Period: November 2016 to May 2017. Material & Methods: The study was initiated after approval from the institutional research forum of Rawalpindi medical college. Patients fulfilling the selection criteria reporting at surgical unit – I, Holy Family Hospital, Rawalpindi were included in the study. Written informed consent was taken. Random allocation of the study participants to either study group was done by using lottery method, 60 patients were randomly allocated to either group A(insulin soaked dressing) or Group B (conventional dressing), each with 30 patients. Results: In Group A, insulin soaked dressing was applied whereas patients in Group B were applied with conventional dressing. Mean age (years) of patients was 48.04+13.45 whereas there were 32 (53.3) male and 28 (46.7) female patients. In the study, mean duration (day) of complete wound healing in patients with diabetic ulcers receiving insulin soaked dressing and conventional dressing was 39.80 + 8.04 and 47.60+6.52 respectively which was statistically significant (p-value 0.000). Conclusion: The study concluded that in patients with diabetic foot ulcer, average duration of complete wound healing was significantly less in patients with insulin soaked dressing as compared to conventional dressing.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

scholarly journals COMPARISON OF WOUND HEALING RATE AND TIME TO COMPLETE WOUND HEALING ACCORDING TO WOUND LOCATION IN CRITICAL LIMB ISCHEMIA

2013 ◽  
Vol 61 (10) ◽  
pp. E2105
Author(s):  
Norihiro Kobayashi ◽  
Muramatsu Toshiya ◽  
Tsukahara Reiko ◽  
Ito Yoshiaki ◽  
Hirano Keisuke
Keyword(s):  
Wound Healing ◽  
Critical Limb Ischemia ◽  
Healing Rate ◽  
Limb Ischemia ◽  
Complete Wound Healing ◽  
Wound Healing Rate

Hyperbaric oxygen treatment for University of Texas grade 3 diabetic foot ulcers: a retrospective cohort study

2021 ◽  
Vol 30 (9) ◽  
pp. 722-728
Author(s):  
Rutger C Lalieu ◽  
Willem Mulder ◽  
René D Bol Raap ◽  
Saskia Stolk ◽  
Casper Smit ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Wound Care ◽  
Complete Healing ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
University Of Texas ◽  
Complete Wound Healing ◽  
Grade 3

Aim: Hard-to-heal diabetic foot ulcers (DFUs) may increase the risk of amputation. This study reports the positive influence of hyperbaric oxygen therapy (HBOT) on hard-to-heal DFUs involving underlying bone. Method: A single-centre, retrospective cohort study reporting the results of HBOT and wound care on hard-to-heal University of Texas grade 3 DFUs (i.e., involving underlying bone) between 2013 and 2019. Outcome measures were primarily (near-) complete wound healing (i.e., ≥80% ulcer surface area reduction) and amputation rate (minor or major), and secondarily the number of hyperbaric sessions and improvement in quality of life (QoL) and pain score. Results: The study included 206 patients, of whom 74 (36%) achieved complete wound healing, and 75 (36%) near-complete healing. Amputations were performed in 27 patients (13%): 12 (6%) minor and 15 (7%) major. The median number of HBOT sessions was 42. Participants who achieved complete healing received a median of 43 sessions, compared with 10 for those who required major amputation. Patients with at least 30 sessions were less likely to undergo amputation (odds ratio: 0.08; 95% confidence interval (CI): 0.03–0.21). Mean QoL increased by 7.6 points (95%CI: 3.9–11.3; p<0.01) and median pain score fell from 3 to 1 (0–3) (p<0.01). Conclusions: The addition of HBOT to standard wound care may lead to a decreased amputation risk, improved wound healing and increased QoL for people with a University of Texas grade 3 DFU. An adequate number of HBOT sessions is required to achieve optimal clinical results. Objective selection criteria and shared decision-making are suggested to improve dropout rates.

Updates in Diabetic Wound Healing, Inflammation, and Scarring

2021 ◽  
Author(s):  
Nina Dasari ◽  
Austin Jiang ◽  
Anna Skochdopole ◽  
Jayer Chung ◽  
Edward Reece ◽  
...  
Keyword(s):  
Wound Healing ◽  
Disease Process ◽  
Wound Dehiscence ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Diabetic Wound ◽  
Complex Process ◽  
Diabetic Wound Healing ◽  
Almost All ◽  
Diabetic Wounds

AbstractDiabetic patients can sustain wounds either as a sequelae of their disease process or postoperatively. Wound healing is a complex process that proceeds through phases of inflammation, proliferation, and remodeling. Diabetes results in several pathological changes that impair almost all of these healing processes. Diabetic wounds are often characterized by excessive inflammation and reduced angiogenesis. Due to these changes, diabetic patients are at a higher risk for postoperative wound healing complications. There is significant evidence in the literature that diabetic patients are at a higher risk for increased wound infections, wound dehiscence, and pathological scarring. Factors such as nutritional status and glycemic control also significantly influence diabetic wound outcomes. There are a variety of treatments available for addressing diabetic wounds.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

2003 ◽  
Vol 10 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Nomdo S. Renken ◽  
Cees H.A. Wittens ◽  
Peter M.T. Pattynama ◽  
Nico A.J.J. Du Bois ◽  
Lukas C. van Dijk
Keyword(s):  
Minimally Invasive ◽  
Limb Salvage ◽  
Long Term Results ◽  
Open Technique ◽  
Treatment Groups ◽  
Closed Technique ◽  
Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

scholarly journals ACUTE CHOLECYSTITIS

2010 ◽  
Vol 17 (02) ◽  
pp. 185-192
Author(s):  
TARIQ HASSAN CH ◽  
ASGHAR ALI ◽  
MUNAWAR JAMIL
Keyword(s):  
Hospital Stay ◽  
Wound Dehiscence ◽  
Biliary Tree ◽  
Postoperative Hospital Stay ◽  
Total Hospital ◽  
Acute Calculous Cholecystitis ◽  
Total Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: Gallstones are common biliary pathology. The Vast majority of subjects are asymptomatic. About 0.2% of the population suffering from gallstones develop acute cholecystitis every year. In case of acute calculous cholecystitis, cholecystectomy can be performed early i.e during the same admission or interval i.e after 6 weeks of conservative management. Objective: To compare the early and interval cholecystectomy in acute calculous cholecystitis for morbidity, postoperative hospital stay, total hospital stay and complications. Study Design: Quasi-experimental study. Setting: Department of Surgery Bahawal Victoria Hospital Bahawalpur. Duration of Study: Two year study from December 2007 to December 2009. Subject and Methods: Sixty patients fulfilling the inclusion criteria were selected for this study. The patients were divided into two groups. Group A patients were managed by early cholecystectomy and group B patients by intervalcholecystectomy. Postoperatively patients were evaluated for postoperative hospital stay, total hospital stay and postoperative complications. Results: The mean age of the patients in group A was 42.2 + 10.7 years and in group B was 42.2+ 10.7 years. The Male to female ratio was 1:4 in both groups. The mean postoperative hospital stay in group A was 4.0+ 1.8days and in group B was 3.8+ 1.4 days. The mean total hospital stayin group A was 6.5 + 1.7 days and in group B was 10.2 + 1.3 days. The P value was less than 0.001, which was significant. In distribution of postoperative complications, in group A there were 1(3.3%) injury to biliary tree, 4(13.3%) wound infection,1(3.3%) wound haematoma, 3 (10%) seroma and 1(3.3%) wound dehiscence. While in group B there were 1(3.3%) injury to biliary tree, 3(10%) wound infection,2 (6.7%) wound haematoma, 2(6.7%) & no patient of wound dehiscence. Conclusion: Our study suggests that early cholecystectomy is a better treatment option than interval cholecystectomy because it has less total hospital stay, needs single hospital visit and has no risk of developing complications during wait for surgery.

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