A Comparative Analysis of Wound Closure Techniques in Uncomplicated Open Inguinal Hernia Surgery: Sutures vs. Skin Staplers

  Objective: This study compared the results of wound closure with skin staplers and traditional sutures in uncomplicated open inguinal hernia surgery. Methods: An 18-month prospective cohort study was carried out in a tertiary care facility. Patients (n = 100) who met the eligibility requirements were randomly assigned to one of two groups: suture (n = 50) or skin stapler (n = 50). We evaluated wound infection rates, wound healing times, postoperative pain levels, and aesthetic results. Chi-squared tests, t-tests, and Mann-Whitney U tests were used in the statistical analysis. Results: Skin staplers demonstrated lower wound infection rates (2% vs. 10%) and faster wound healing (10.5 ± 1.8 days vs. 14.2 ± 2.1 days) compared to sutures. Postoperative pain scores were consistently lower in the skin stapler group at 24 hours (2.4 ± 0.8 vs. 3.7 ± 1.2), 1 week (1.4 ± 0.6 vs. 2.1 ± 0.9), and 4 weeks (0.6 ± 0.3 vs. 0.9 ± 0.4) post-surgery. Skin staplers with a higher percentage of "excellent" results (54% vs. 14%) had better cosmetic results. Conclusion: In uncomplicated open inguinal hernia surgery, skin staplers are superior to conventional sutures in terms of lower wound infection rates, quicker wound healing, decreased postoperative pain, and enhanced cosmetic results. Surgeons’ ought to think about how skin staplers could improve patient satisfaction and outcomes. Inguinal hernia surgery wound closure techniques may be improved with further study and practical practice

Role of Selective Node Dissection in the Treatment of Node-Negative Neck in Oral Carcinoma

  Background: Oral carcinoma is a severe oncological problem that calls for all-encompassing therapeutic strategies. In these circumstances, substantial neck dissection has historically been used to treat node-negative neck, which carries a risk of morbidity. The usefulness of selective node dissection, a possibly less invasive approach, is still being studied. Methods: From November 2020 to July 2022, 50 patients with oral cancer and node-negative neck involvement participated in this observational prospective study. Population statistics, tumor features, surgery specifics, and postoperative results were gathered and examined. Selective node dissection was carried out in accordance with predetermined standards. Results: A demographic study showed that patients were predominantly male (70%), with an average age of 57.4 years. The floor of the mouth (20%), buccal mucosa (30%), and the tongue (40%) were the three most frequent sites for tumors, with squamous cell carcinoma accounting for 90% of all histological subtypes. An average of 27 lymph nodes were removed during the surgical surgery, and other procedures, like neck dissection (90%), were also carried out. Infection (10%), problems with the healing of the wound (6%), and nerve injury (4%), were all postoperative consequences. The results of the survival are still being analyzed. Conclusion: This observational prospective analysis offers important new understandings of the function of selective node dissection in the management of oral cancer with node-negative neck. Future research will ascertain its impact on survival outcomes and improve its therapeutic application, ultimately boosting patient care in the therapy of oral cancer. The findings suggest its potential advantages in minimizing surgical morbidity

Comparative Study on the Efficacy of Single-Layer vs. Double-Layer Small Gut Anastomosis in Patients Admitted to a Tertiary Care Center

Background: For a number of gastrointestinal diseases, small bowel resection with anastomosis is a common surgical treatment. The choice of anastomotic technique, specifically between single-layer and double-layer approaches, is still up for debate. Methods: Between December 2020 and June 2022, 50 patients who had small intestinal resections participated in this prospective observational study. Single-layer anastomosis (n = 28) and double-layer anastomosis (n = 22) groups of patients were created. Anastomotic leaks, postoperative complications, hospital stay, bowel function recovery, and patient satisfaction were all included in the outcome measures. Chi-squared and t-tests were utilized in the statistical analysis. Results: There was no statistically significant difference between the anastomotic leak rates of 7.1% in the single-layer group and 4.5% in the double-layer group (p > 0.05). Similar postoperative problems, hospital stays (averaged 6 days), recovery times for bowel function (averaged 3 days), and patient satisfaction levels were seen in both groups. Conclusion: Current study shows that single-layer and double-layer techniques yield equivalent results in small bowel resection and anastomosis. The fact that these procedures have similar anastomotic leaks, postoperative complications, hospital stays, and bowel function restoration times suggests that the surgeon's preference and experience may influence the decision. Both groups have great patient satisfaction, suggesting that the anastomotic approach has little to no impact on patient treatment

Predictive Accuracy of PESAS Score in Emergency Abdominal Surgeries

Background: Because of their unpredictability and potential for negative outcomes, emergency abdominal procedures provide considerable clinical problems. For the purpose of optimising patient care and guiding surgical decisions, accurate preoperative assessment is crucial. In this situation, the “Physiological Emergency Surgery Acuity Score (PESAS)” has shown promise as a tool for risk categorization and prognostication. The purpose of this study was to assess how well the PESAS score predicted the outcomes of emergency abdominal surgery. Methods: 80 patients with clinical signs of an acute abdomen were enrolled in a tertiary care facility over the course of 18 months. Each patient was evaluated using the PESAS score, which is based on physiological factors such heart rate, blood pressure, breathing rate, and level of awareness. Low-risk (PESAS 8), intermediate-risk (PESAS 9–12), and high-risk (PESAS 13–15) patient categories were created. The results of the surgery, including both survival and non-survival, were documented Results: The survival rate for patients with PESAS scores of 8 or less was 100%, while the survival rate for patients with scores of 9 to 12 was 16.66%. 0% of patients whose scores were between 13 and 15 survived. These results show a significant relationship between PESAS scores and successful surgical outcomes. Conclusion: For predicting surgical outcomes in urgent abdominal procedures, the PESAS score is an invaluable preoperative tool. It facilitates decision-making, risk classification, and improved preoperative communication with patients and their families. To completely incorporate the PESAS score into clinical practise, which could result in better patient-centred treatment and resource allocation, more investigation and validation studies are required

Predictive Value of CRP and Lactate Levels for Bowel Gangrene/Strangulation in Patients with Bowel Obstruction

Background: Bowel blockage is a frequent and potentially fatal illness that requires quick identification of consequences like gangrene and strangling of the bowel. In order to diagnose intestinal gangrene/strangulation in patients with bowel obstruction, this study evaluated clinical symptoms and laboratory markers, specifically C-reactive protein (CRP) and lactate levels. Methods: One hundred patients who presented with intestinal obstruction participated in prospective observational research that we conducted. Clinical signs were evaluated, including guarding, vomiting, abdominal distension, irreducible edema, and pain in the abdomen. For the purposes of measuring lactate and CRP, blood samples were taken. Radiological findings, intraoperative assessment, and histological examination were required as part of the diagnostic criteria for intestinal gangrene/strangulation. Results: Common clinical symptoms were stomach discomfort (98%), vomiting (67%), and abdominal distension (58%). In 40% of individuals, irreversible edema was observed. In 54% of instances, a history of constipation was mentioned. Gangrenous bowel was substantially related with elevated lactate and CRP levels (p 0.001). In gangrenous bowel, mean lactate concentrations were 870.25 mmol/L compared to 536.62 mmol/L in viable bowel, and mean CRP concentrations were 141 mg/L compared to 68.23 mg/L in viable intestine. Conclusion: Bowel blockage is typically diagnosed based on clinical signs such abdominal pain and unremitting swelling. Furthermore, in these individuals, high CRP and lactate levels are useful indicators for detecting intestinal gangrene/strangulation. The incorporation of these markers into clinical practice may help patients with intestinal obstruction receive early management and experience better results. To determine precise cutoff values for these markers in everyday practice, more study is required

Clinical Profile and Surgical Management of Incisional Hernias: A Retrospective Study

Background: An iatrogenic hernia known as an incisional hernia develops at the site of prior surgical incisions and poses therapeutic difficulties. For prevention and therapy, it is essential to comprehend their clinical presentation and management. The clinical characteristics and treatment of incisional hernias at a tertiary care facility are reviewed in this study. Methods: At the Department of General Surgery, a retrospective study was done. Demographic information, clinical presentation, surgical history, hernia features, post-operative problems, and comorbidities were gathered from 60 patients who underwent incisional hernia surgery. Results: 60% of the patients were female, and the age ranges of 35 to 45 and 56 to 65 were the most common. 15% of patients reported pain prior to surgery. Lower segment cesarean sections (38.33%) and Pfannenstiel incisions (45%) were the most frequent prior surgeries. 83.33% of patients had infraumbilical hernias, and 11.67% had post-operative surgical site infections. A significant comorbidity was obesity. The chosen surgical technique was sublay (preperitoneal) meshplasty. Conclusion: Infraumbilical incisions, in particular, showed a female predominance in incisional hernias. Comorbidities, especially obesity, were associated with the development of hernias. Strenuous infection control procedures are required to prevent post-operative surgical site infections. Commonly employed is sublay meshplasty. The prevention and treatment of incisional hernias are influenced by these findings

Comparative Analysis of Tacker and Glue Fixation in Laparoscopic Mesh Repair of Ventral Hernias

Background: Ventral hernias require cautious correction to avoid complications. They are a common surgical problem. Tacker and glue fixation are two widely used methods for laparoscopic mesh repair. This study compared the results of laparoscopic ventral hernia repair using tacker and glue fixation. Methods: From December 2020 to June 2022, 52 patients who met the inclusion criteria were enrolled in a prospective trial. To the glue or tacker fixation group, the patients were ostensibly assigned at random. Hospital stay, hernia recurrence, complications, operating time, and postoperative discomfort were all evaluated. Results from the two groups were compared using statistical analysis. Results: Tacker fixation increased early postoperative pain scores (p = 0.029) and greatly decreased operating times (p< 0.001). However, there were no appreciable differences in the two groups' incidence of general complications (p = 0.437) or hernia recurrence (p = 0.624). The hospital stay was reduced for the glue fixation group (p = 0.001). Conclusion: Tacker fixation and glue fixation are both acceptable techniques for laparoscopic ventral hernia repair, each with specific benefits and drawbacks. The decision should be made with the needs of each patient in mind as well as the surgeon's preferences, taking into account things like operating time, postoperative discomfort, and hospital stay. To fully comprehend these fixation techniques, more research is necessary on long-term results including chronic discomfort and hernia recurrence

Comparative Study of Endovenous Laser Ablation and Sclerotherapy for the Treatment of Lower Limb Varicose Veins

Objective: The comparison of endovenous laser ablation (EVLA) with sclerotherapy for the treatment of varicose veins in the lower limbs will focus on their efficacy, safety, patient-reported results, and cost-effectiveness. Methods: 190 suitable patients with symptomatic lower limb varicose veins were divided into the EVLA and sclerotherapy groups at random. Age, gender, and patterns of venous insufficiency were noted as baseline parameters. Reduced severity of varicose veins (CEAP classification), patient-reported improvement (VCSS and AVVQ scores), and adverse events were the primary end measures. Cost-effectiveness analysis and quality of life (EQ-5D scores) were secondary goals. Results: Sclerotherapy and EVLA both reduced the severity of varicose veins and enhanced patient-reported results. The majority of adverse events were minor and comparable between groups. Both groups had a marked improvement in quality of life. According to a cost-effectiveness analysis, EVLA might have a marginally better long-term value than sclerotherapy. Conclusion: For lower limb varicose veins, EVLA and sclerotherapy are both safe and effective treatment options, with comparable results in terms of symptom reduction and quality of life enhancement. Individual patient features, preferences, and the availability of healthcare resources should all be taken into account when deciding between these treatment modalities, with cost-effectiveness somewhat favouring EVLA. To determine the therapy outcomes' long-term viability, more investigation is required