The Significance of the Southampton Wound Grading System in Surgical Site Infections

Objective: This study aimed to assess the significance of the Southampton wound grading system in predicting and managing surgical site infections (SSIs) among patients undergoing surgery. Methods: A retrospective cohort study was conducted at tertiary care center, involving 120 surgical patients, comprising 105 elective surgeries and 15 emergency surgeries. Patients were categorized based on the Southampton wound grading system, and data on age, gender, surgery type, and SSI occurrence were collected. Statistical analysis included chi-squared tests and Fisher's exact tests. Results: Higher-grade wounds, particularly Grade V, exhibited a significant association with SSIs, emphasizing the system's clinical relevance. Elective surgeries displayed a lower SSI rate (18.75%) compared to emergency surgeries (81.25%). Gender-wise distribution revealed a slightly higher SSI rate among females (18.75%) compared to males (81.25%). Conclusion: The Southampton wound grading system proves valuable in risk stratification, aiding clinicians in tailoring preventive measures. While higher-grade wounds are at greater risk, comprehensive patient assessment and adherence to infection control protocols remain pivotal in SSI prevention. Future research should explore patient-specific variables and surgical practices to refine preventive strategies. Overall, this study underscores the importance of proactive SSI management in diverse surgical setting

Urine Trypsinogen 2 as a Diagnostic Marker for Acute Pancreatitis: A Prospective Study

Background: Acute pancreatitis presents diagnostic challenges due to its diverse clinical presentation and limitations of traditional serum biomarkers. This study explores the diagnostic potential of urine trypsinogen 2 in acute pancreatitis, an area relatively unexplored in our institution. Methods: A prospective study involving 96 patients admitted between December 2020 and June 2022 with symptoms suggestive of pancreatitis was conducted. Urine trypsinogen 2 levels were quantitatively assessed alongside serum amylase and lipase. Radiological investigations were employed when necessary. The final diagnosis integrated clinical, biochemical, and radiological findings. Results: Urine trypsinogen 2 exhibited a sensitivity of 88.4% and a specificity of 91.7%, outperforming serum amylase and approaching serum lipase. Comparative analysis revealed significant advantages of urine trypsinogen 2 in sensitivity, specificity, and predictive values. Conclusion: Urine trypsinogen 2 emerges as a non-invasive, accurate, and early diagnostic marker for acute pancreatitis, with the potential to enhance diagnostic precision and improve patient outcomes. Further validation in diverse clinical settings is warrante

Evaluation of Lumbar Sympathectomy in Peripheral Arterial Disorder of Lower Limbs

Peripheral arterial disorders of the lower limbs, including chronic arterial ischemia, present significant clinical challenges. Lumbar sympathectomy has emerged as a potential therapeutic option to address these issues. Aim: This study aimed to evaluate the efficacy and safety of lumbar sympathectomy in patients with chronic arterial ischemia in the lower limbs. Methods: A prospective observational study was conducted on 60 patients admitted to a tertiary care center between December 2020 and June 2022. Demographic data, comorbidities, preoperative ankle-brachial index (ABI), and the location of arterial stenosis were documented. All patients underwent lumbar sympathectomy. Postoperative outcomes, including limb perfusion, pain relief, and ulcer healing, were assessed. Comparative analysis with existing literature from PubMed was conducted. Results: Lumbar sympathectomy significantly improved limb perfusion, as indicated by a substantial increase in ABI. Pain relief was reported by 86.7% of patients, and 60% experienced improved ulcer healing rates. No intraoperative complications were observed. Comparative analysis with previous studies supported current findings. Conclusion: Lumbar sympathectomy appears promising in enhancing limb perfusion, relieving pain, and promoting ulcer healing in patients with chronic arterial ischemia in the lower limbs. Long-term follow-up studies are warranted to confirm the durability of these benefits and assess potential complications. This procedure offers hope for improved outcomes in this challenging patient population

Evaluation of the Accuracy of the AIRS Scoring System in Managing Acute Appendicitis

Background: Appendix inflammation characterizes acute appendicitis, a common surgical emergency. In order to avoid complications, a precise and prompt diagnosis is essential. A potential diagnostic tool is the Appendicitis Inflammatory Response Score (AIRS) scoring system. The purpose of this study was to assess the reliability of the AIRS score in treating acute appendicitis in a particular patient population. Methods: At a Tertiary care facility in Karad, India, a prospective study was carried out between December 2020 and June 2022. Patients with right iliac fossa discomfort and a tentative diagnosis of acute appendicitis were admitted to the surgery department. Patients with immunity-compromising conditions are excluded from consideration. Based on clinical indicators, laboratory values, and radiological results, the AIRS score was generated. The AIRS score was taken into account when making surgical decisions. Results: 130 participants participated in the trial. The AIRS score showed strong specificity and sensitivity. Sensitivity was 94.4% and negative predictive value was 87.5% in the low-risk category (AIRS scores 1-2). The sensitivity was 85.6% and the positive predictive value was 84.0% in the moderate-risk group (AIRS scores 3-4). The high-risk group (AIRS score 5) demonstrated a sensitivity of 97.3% and a positive predictive value of 91.0%. Conclusion: To help in the diagnosis and treatment of acute appendicitis, the AIRS scoring system successfully divided patients into risk groups. Our results support the use of the AIRS score as an auxiliary tool to improve clinical decision-making in instances of acute appendicitis, while more research is necessary

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

The Role of Collagen Dressing in Enhancing Healing and Preventing Complications at Donor Sites following Split-Thickness Skin Graft Harvesting

Background: In reconstructive and plastic surgery, split-thickness skin graft (STSG) treatments are frequently used to treat a variety of skin abnormalities. However, managing donor sites is difficult because of issues including infection and delayed recovery. Although collagen-based dressings have showed potential in the field of wound healing, STSG donor sites have not been the subject of in-depth research. Methods: 100 patients getting STSG participated in this prospective randomized controlled trial, which was run between December 2020 and June 2022. The collagen dressing group (n = 50) and the standard saline dressing group (n = 50) were randomly assigned to the patients. Secondary outcomes were patient-reported outcomes and cosmetic evaluation, whereas primary results included healing rate and complication incidence. Results: Complete wound closure was achieved by 85% of patients in the collagen dressing group by postoperative day 30, compared to 62% in the regular saline dressing group. This represents a significant improvement in healing rates. When compared to the standard saline dressing group (18%), complications were lower in the collagen dressing group (6%). Patients who received collagen dressings reported less discomfort and greater satisfaction with their wound treatment. The collagen dressing group had better aesthetic results, according to cosmetic evaluation (80% rated "excellent"). Conclusion: At STSG donor sites, collagen dressings dramatically improve healing, lower complications, and enhance patient experiences. The use of collagen dressings in reconstructive and cosmetic surgery is supported by these data, which also point to prospective advantages. For these results to be validated and optimized, more study is required

Comparative Study of Laparoscopic Cholecystectomy Techniques: Traditional Clipping versus Harmonic Scalpel Closure

Background: Laparoscopic cholecystectomy (LC), a widely used surgical procedure to remove the gallbladder, can vary in how the cystic duct and artery are closed. This study compared the safety and effectiveness of LC performed using the standard method (TM) with LC performed with harmonic scalpel assistance (HLC). Methods: A prospective comparison research with 30 patients in each group (LC and HLC) of 60 patients scheduled for LC was conducted. The length of the hospital stays, the number of antibiotics used, the number of surgical problems, postoperative bile leakage, and the length of the operation were all recorded. Suitable tests were used in the statistical analysis. Results: When compared to LC, HLC showed considerably shorter operating times (35.1 4.079 vs. 47.933 8.026 minutes, p0.0001) and less frequent need for antibiotics (3.267 0.691 vs. 4.367 0.809 days, p0.0001). Surgery-related complications were comparable between groups (LC 10% vs. HLC 6.67%, p=0.549). Postoperative bile leakage in HLC (0%) were trending lower than LC (6.67%, p=0.157). A shorter hospital stay was the result of HLC (3.1 + 0.547 vs. 4.4 + 0.855 days, p0.0001). Conclusion: In comparison to LC, HLC offers benefits such as faster recovery times, less need for antibiotics, and shorter hospital stays. Although there were no appreciable differences in postoperative problems in HLC, there was a tendency towards less intraoperative complications. These results back up the use of HLC as a secure and effective cholecystectomy option. It is need to do additional study with larger cohorts and longer follow-up

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

Evaluation of Breast Disease Using Triple Assessment Test with Ultrasonography as the Fourth Component

Breast disease is a significant health concern, with varying clinical presentations and diagnostic challenges. This study aims to assess the accuracy and utility of ultrasonography (USG) as an adjunct component to the Modified Triple Assessment Test (MTT) in the screening and diagnosis of breast diseases. A total of 40 patients with breast complaints, including lumps, nipple discharge, or retraction, were included. The MTT, consisting of clinical examination, mammography, fine-needle aspiration cytology (FNAC), and histopathological examination (HPE), was performed on all patients under informed consent. USG was added as a fourth component. Data on age distribution, parity, menstrual status, side of breast lump, location of tumors, and histopathological findings were collected and analyzed. In the 30-39 age group, breast lumps were common, with nulliparous women showing more malignant cases. Pre-menopausal women had benign lumps, while peri-menopausal and post-menopausal women had more malignancies. Left-sided lumps prevailed, and the upper outer quadrant was the common location. Clinical examination had high accuracy, as did ultrasonography (USG). This study underscores the importance of personalized breast health approaches, considering age, parity, and menstrual status. The combination of clinical examination, mammography, FNAC, and USG (MTT) provides a reliable diagnostic tool for breast disease, with MTT serving as a valuable modality for breast carcinoma diagnosis and treatment planning

Diagnostic Efficacy of Abdominal Contrast-Enhanced Computed Tomography in Acute Abdominal Conditions: A Retrospective Study"

This study's objective was to evaluate the diagnostic value of abdominal contrast-enhanced computed tomography (CECT) in people who had sudden abdominal symptoms. Methods: From eligible patients between the ages of 18 and 75, clinical data including demographics, clinical history, and laboratory findings were gathered. Using a standardised imaging technique, abdominal CECT was performed on all patients. To find acute abdominal diseases and check for consequences, seasoned radiologists analysed the CECT pictures. To assess the effectiveness of CECT, sensitivity, specificity, and other diagnostic measures were calculated. Results: For a variety of acute abdominal diseases, including appendicitis, diverticulitis, bowel obstructions, ischemia, and traumatic injuries, abdominal CECT consistently showed sensitivity and specificity above 90%. Appendicitis was the most prevalent condition, followed by diverticulitis and intestinal obstructions, according to the distribution of diagnoses. In a small number of patients, complications such the development of abscesses, perforations, and thickening of the gut wall were noted. Conclusion: Abdominal contrast-enhanced computed tomography is an essential technique for identifying specific pathologies and potential complications early on, providing high diagnostic accuracy for the diagnosis of acute abdominal disorders. These results underline how crucial it is to incorporate CECT into the diagnosis process for patients presenting with acute abdominal symptoms, eventually improving patient treatment and outcome