scholarly journals TO COMPARE THE DURATION OF SURGERY IN SINGLE DOSE INTRAVENOUS ANTIBIOTIC PROPHYLAXIS OVER NO ANTIBIOTIC PROPHYLAXIS IN THE PREVENTION OF WOUND INFECTION FOLLOWING LICHTENSTEIN TENSION FREE INGUINAL HERNIOPLASTY

Author(s):  
Prteet Negi ◽  
Priyanka Thakur ◽  
Ramesh Bharti ◽  
Amar Verma ◽  
Rajesh Sharma ◽  
...  

Background: We conducted a study to compare the duration of surgery in single dose intravenous antibiotic prophylaxis over no antibiotic prophylaxis in the prevention of wound infection following Lichtenstein tension free inguinal hernioplasty Methods: This prospective study was conducted in the Department of Surgery, Dr. Rajendra Prasad Government Medical College Kangra at Tanda from May 2018 to December 2019after being approved by institutional protocol review committe and ethics committee.50 patients were included in the study.These patients were randomised into two groups i.e. Group A (Antibiotic Group) and Group B (Non-antibiotic Group). Results: The mean duration of surgery in Antibiotic group (Group-A) was 56.6±15.66 minutes whereas it was 50.2±9.62 minutes in Non-antibiotic group (Group-B). The mean duration of surgery was more in Antibiotic group (Group-A) as compared to Non-antibiotic group (Group-B), however the difference was not statistically significant (p= 0.088).    Conclusion: In our study, we concluded that statistically insignificant difference was found in the duration of surgery in Antibiotic and Non-antibiotic Group Keywords: Duration of surgery, Antibiotic, Pre-operative

2019 ◽  
Vol 6 (4) ◽  
pp. 1264
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Preetham Anguraj ◽  
Jeyakumar Sundaraj ◽  
Manimaran Pethuraj

Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.


Author(s):  
Suneet Katoch ◽  
Mukesh Kumar Jamwal ◽  
Sanjay Kumar

Background: In this study we compare the duration of surgery   after single dose antibiotic prophylaxis at different time interval in patients undergoing elective laparoscopic cholecystectomy Methods: The present study was conducted at Department of Surgery, Dr RPGMC Kangra at Tanda. The 50 patients admitted for elective laparoscopic cholecystectomy, aging less than 75  years of both the genders were included Results: In the present study, mean duration of surgery of the patients in group A and group B was 59.80±15.91 minutes and 63.12±12.50 minutes Conclusion: Our study we concluded that mean duration of surgery difference was not statistically significant between group A and group B. Keywords:  Duration of surgery, Cholelithiasis,  Cholecystectomy.


2021 ◽  
pp. 65-69
Author(s):  
S. Yashwanth ◽  
S. Dayakar

INTRODUCTION: Over the years, surgeons tried the placement of mesh at different locations like On-lay, Under-lay, Sub-lay and pre-peritoneal, retroperitoneal intraperitoneal, Inter-muscular, etc. with each procedure having its advantages and disadvantages. Commonly Onlay and sub lay mesh repairs are done. Though the literature says, sub lay procedures have fewer complications and a high success rate. However, in a few studies, the ideal position for mesh repair appears to be retro muscular, where the force of abdominal pressure holds the mesh against deep surfaces of muscles. In this study, a comparison of both Onlay and retro rectus procedures with regards to the duration of surgery, postoperative complications like seroma, wound infection, wound dehiscence, and also the period of postoperative stay in the hospital. The aim of the study is To compare 'Onlay' versus 'retro rectus' mesh repair in inuencing the outcome in incisional hernia with regards to Duration of surgery, Postoperative complications like seroma formation, wound infection, Postoperative stay, Recurrences. PATIENTS AND METHODOLOGY: Type of Study: A Prospective comparative study Study Setting: Department of general surgery, Narayana Medical College & Hospital, Nellore.Study Period: November 2018 to September 2020 Study Sample: 50 cases, divided into two groups by random allocation technique. Groups A and B with 25 patients in each group. RESULTS: The mean age of cases in Group A is 40.48 years. The mean age of patients in Group B is 44.08 years. Youngest was 31 years and 36 years in group A and group B, respectively, and the eldest was 51 years and 53 years in group A and group B, respectively. In Group A, 11 were male, and 14 were female, and in Group B, 11 were male, and 14 were female. The male to female ratio in the study was 1:1.27. The mean Operative Time in Group A was 1.93 Hrs, and that in Group B was 2.98Hrs. Nine patients (36%) in group A and one patient (4%) in group B had seroma formation. Eight patients (32%) in group A and one patient (4%) in group B had a wound infection. The mean Hospital Stay in Group A was 5.44 Days, and Group B was 4.88 days. No short-term recurrences were noted in either of the two groups when followed for six months. CONCLUSION : Retrorectus mesh repair is an excellent alternative to Onlay mesh repair that may apply to incisional hernia. The mesh-related overall complication rate like seroma wound infections and hospital stay is less than Onlay mesh repair.


2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E F Ebied ◽  
A A Khalil ◽  
A I I Soliman

Abstract Background Hernia is a common problem of the modern world with an incidence ranging from 5%-7%. Of all groin hernias, around 75% are inguinal hernias. Recently with advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the Work To compare between self fixating mesh and non self fixating mesh in laproscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence. Patients and Methods This study was conducted on 30 adult patients presenting with inguinal hernias. They were divided into 2 equal groups of 15 patients each. The first group (A): includes fifteen patients and was operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique using self -gripping (SGM group) (Parietex ProGrip] Laparoscopic (PPL) meshes), while the second group (B): includes fifteen patients and were operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique with non-self fixating mesh. Results The postoperative pain assessment at 24 hours and 4 weeks shows that the mean VAS score for GROUP A was (3.70 ± 1.72) and for GROUP B (3.90 ± 1.25) while after 1 month duration follow up, the mean VAS score was (1.25 ± 0.79) for Group A and (1.20 ± 0.77) for Group B with no difference between the two groups confirming the atraumatic nature of the self gripping mesh. Conclusion After this comparative study, both mesh fixation with absorpable tacks and fixation using SGM approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.


Author(s):  
Shivpal Moond ◽  
K.P. Banerjee ◽  
Rakhi Arya

Objective: To compare efficacy, safety and tolerance of combination of Mifepristone and Misoprostol versus Misoprostol alone in induction of labour in late intrauterine fetal death (>24 weeks). Methods: This prospectively study included 160 women with late intrauterine fetal death (IUFD) after 24 weeks of gestation and divided the women randomly into two groups each containing 80 women. In Group-A : Mifepristone 200 mg single dose was given and after 24 hrs Tab Misoprostol (intravaginally) administered and repeated 4 hourly upto a maximum of 5 doses, while in Group-B : Only Tab Misoprostol administered intravaginally 4 hourly upto maximum 5 doses. Induction-delivery interval and number of doses of Misoprostol was calculated.    Results: The mean induction-delivery interval in Group-A was 13.02 ± 3.74 hours and in Group-B was 16.09 ± 2.99 hours (p-value <0.0001). Mean doses of Misoprostol required in Group-A was 3.36 ± 1.08 hours and in Group-B was 4.32 ± 0.65 hours (p-value <0.0001). Conclusion: Combination of Mifepristone and Misoprostol is more effective as comparison to Misoprostol in terms of induction-delivery interval and number of doses of misoprostol required.    Keywords: IUFD, mifepristone, misoprostol, induction of labour, induction-delivery interval.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Kevin Emeka Chukwubuike

Abstract Background The purpose of this study was to assess the effect of a single dose of testosterone on the diameter of the glans penis. Methods This was a prospective evaluation of the effect of a single dose of testosterone on the diameter of the glans penis of children with hypospadias. The diameter of the glans penis was measured transversely at the level of the coronal sulcus using Vernier calipers. The patients were categorized into two groups: Group A and Group B. Group A received intramuscular testosterone at the dose of 2 mg per kilogram body weight. Group B did not receive any testosterone and served as control. The diameter of the glans penis was evaluated at the beginning of the study and at 4 weeks after the testosterone injection. Results Overall, 64 patients were evaluated. There were 32 patients in group A (50%) and 32 patients in group B (50%). The mean diameter in group A before and after testosterone injection was 17.6 mm ± 2.5 SD and 17.8 ± 2.3 SD, respectively. The mean diameter in group B at onset and after 4 weeks was 17.6 mm ± 2.4 SD and 17.7 ± 2.4 SD, respectively. p = 0.12 which is statistically insignificant. Conclusion Single dose of testosterone in children with hypospadias does not produce significant increase in the diameter of the glans penis.


Author(s):  
Ramya Sreevarshni Shunmugha Sundharam ◽  
Hiremath P. B. ◽  
Sankareswari R.

Background: Surgical site infections better prevented by parenteral antibiotic in sufficient doses generally should be given before the operation which helps to achieve the therapeutic drug level both in the blood and related tissue during the operation. Ceftriaxone, when administered together as a prophylaxis can fulfil the above criteria of a good antibiotic. Thus, this study was planned to assess the efficacy of prophylactic antibiotic usage to that of regular antibiotics usage in patients undergoing elective surgeries.Methods: This randomized controlled study was conducted in a tertiary care teaching hospital during the study period of June 2017 to April 2018 with 140 cases. Group A received a single dose of Injection Ceftriaxone 1g. Group B, received Injection Ceftriaxone 1 gm and Injection Metronidazole 500 mg for five days. The data was entered in excel sheet and analyzed using SPSS (Version 16).Results: The mean age group in Group A and Group B was found to be 34.24±10.5 and 35.97±11.89, respectively. There was no statistical significance between group A and B for incidence of infection in the post-operative period and duration of hospital stay. The mean value in group A for duration of surgery was found to be 67.5±13.5 and in group B mean value was 72.1±14.9. (p value <0.05).Conclusions: This study demonstrated that administration of prophylactic antibiotic rather than conventional antibiotic at caesarean and gynecological surgeries are not associated with significant difference in post-operative morbidities.


2021 ◽  
Author(s):  
Heidar Safarpour ◽  
Mohammad Hadi Imanieh ◽  
naser honar ◽  
sajad hekmati ◽  
Naeimehossadat Asmarian

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.


2012 ◽  
Vol 7 (1) ◽  
pp. 12-18
Author(s):  
S Kumar ◽  
PJ Lakhey ◽  
P Vaidya ◽  
BN Patowary ◽  
CR Praveen ◽  
...  

Laparoscopic cholecystectomy is the 'gold standard' for benign diseases of gallbladder. It has rapidly gained popularity and it is one of the commonly performed operations in Nepal. The need for antibiotic prophylaxis when performing an elective laparoscopic cholecystectomy may not be as important as it is thought in low risk group. Despite, low postoperative infection rate in laparoscopic cholecystectomy in low risk group, the same criteria of antibiotic prophylaxis previously applied to conventional surgery are routinely used for laparoscopic surgery, even though its actual need has not been ascertained. Aim of this study was to assess the efficacy of antibiotic prophylaxis in elective laparoscopic cholecystectomy with respect to postoperative Surgical Site Infection (SSI) in low risk group. Study was carried out in The Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from May 2005 to June 2006 (14 months).This was a prospective randomized study done on 104 consecutive patients undergoing laparoscopic cholecystectomy. Patients were randomized into case group (group A) and control group (group B) with 52 patients in each group. Two and four patients from Group A and Group B respectively were excluded. In Group A, 50 patients received one gram ceftriaxone intravenously 30 minutes prior to induction of anesthesia and in Group B, all 48 patients received 10 milliliters (ml) of isotonic sodium chloride solution intravenously 30 minutes before induction. In both groups, age, sex, ultrasonogram findings, duration of surgery, American society of anesthesiologists patient classification score, antibiotic administration, bile spillage during surgery, length of postoperative hospital stay and postoperative SSI were recorded. Patients were advised to follow up in Surgical Out-patient Clinic if there was any evidence of SSI within 30 days. SSI was reported and classified as, superficial incisional, deep incisional or space / organ SSI. There were a total of 98 patients included in the study; 50 in Group A and 48 in Group B. In group A, three (6%) patients and in Group B, also three (6.3%) patients had superficial incisional SSI. None of them had deep or organ / space SSI. Comparison of data showed no statistically significant difference between two groups (P- 1.00). DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5962 JCMSN 2011; 7(1): 12-18


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