THE INFLUENCE OF DREINAGE IN THE TREATMENT OF CHRONIC PILONIDAL SINUS DISEASE USING MIDLINE CLOSURE

Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate was 18/90 (20%). Infection occurred in 18 patients (20%), dehiscence occurred in 10 patients (11.1%). Mean recurrence rate during follow up period was 12/90 (13.3%); range, 24-84 months. There was no statistically significant difference among three groups in hospital stay length (p>0.05), in complication rate (χ2=1.66, p>0.05), nor in recurrence rate (χ2=1.91, p>0.05). Statistically significant difference was shown between complication rate among non drained and actively drained patients (χ2=1.11, p<0.05). Primary midline closure is not a satisfactory method in the treatment of chronic pilonidal sinus, especially without drainage, leading to numerous complications and high rate of recurrence

Level of physical activity and daily sitting time: factors of sedentary lifestyle in young adults

Tjelesna aktivnost ubraja jedna je od osnovnih ljudskih potreba za funkcioniranje i održavanje zdravlja. Najveći problem današnje djece, adolescenata i studenata je način provođenja slobodnog vremena, koje je pretežno ispunjen gledanjem televizije, korištenjem računala i mobitela. Sedentarni stil života, bilo da je shvaćen kao reducirano vrijeme provedeno u tjelesnoj aktivnosti odnosno vrijeme provedeno u sjedenju, smatra se neovisnim čimbenikom rizika za nastanak različitih kroničnih bolesti i direktno utječe na smrtnost. Ovim istraživanjem htjeli smo utvrditi i objasniti razlike u tjelesnoj aktivnosti i vremenu provedenom u sjedećem položaju između dvije grupe ispitanika, studenata kineziologije u Pekingu i u Zagrebu. U istraživanju je sudjelovalo 238 ispitanika, studenata kineziologije s Kineziološkog fakulteta u Zagebu (UNIZG) i Pekinškog fakulteta za sport (BSU). Sudionici su ispunili IPAQ upitnik u kratkom obliku (IPAQ SF), prisjećajući se svih aktivnosti koje su obavljali u proteklih sedam dana. Rezultati sugeriraju kako obje grupe ispitanika zadovoljavaju kriterije propisane od strane SZO vezane uz preporučenu razinu tjelesne aktivnosti, iako su uočene značajne razlike između dviju grupa (UNIZG 186,79 minuta dnevno ± SD ; BSU 109,93 minuta dnevno ± SD). Isto tako, obje grupe ispitanika provode manje vremena u sjedećem položaju u odnosu na opću populaciju. Međutim, smatramo da su rezultati provedenog vremena u sjedećoj poziciji za ovu populaciju previsoki (UNIZG 221,27 minuta ± SD ; BSU 380,30 minuta ± SD). U današnje vrijeme kada moderne tehnologije dodatno potiču sjedilački način života, izuzetno je bitno djecu i mlade ljude sustavno poticati na uključivanje u različite sportske programe kako bi razvili cjeloživotnu naviku bavljenja redovitim tjelesnim vježbanjem. U protivnom, velika je mogućnost razvoja dugoročnih zdravstvenih poremećaja nastalih pod utjecajem sedentarnog načina života.Physical activity is one of the basic human needs to maintain health and normal functioning. The biggest problem of today’s children, adolescents and students is the way they spend their leisure time, which is mostly occupied with watching television, using computers and mobile phones. A sedentary lifestyle, whether understood as a reduced time spent in physical activity or time spent sitting, is considered an independent risk factor for the development of various chronic diseases and directly affects mortality. With this research, we wanted to identify and explain the differences in physical activity and sitting time between two groups, kinesiology students in Beijing and Zagreb. The study involved 238 participants, kinesiology students from the Faculty of Kinesiology, University in Zagreb (UNIZG) and the Beijing Sport University (BSU). Participants completed the IPAQ questionnaire in short form (IPAQ SF), recalling all the activities they had performed in the past seven days. The results suggest that both groups are achieving recommended level of physical activity according to the WHO, although significant differences were found between the two groups (UNIZG 186.79 minutes per day ± SD; BSU 109.93 minutes per day ± SD). Likewise, both groups of participants spend less time in a sitting position compared to the general population. However, we believe that the results of time spent while sitting are too high for this population (UNIZG 221.27 minutes ± SD; BSU 380.30 minutes ± SD). Nowadays, when modern technologies additionally encourage a sedentary lifestyle, it is extremely important to systematically encourage children and young adults to get involved in various sports programs in order to develop a lifelong routine of regular physical exercise. Otherwise, there is a high possibility of developing longterm health disorders caused by a sedentary lifestyle

Wounds of extremities: experience with 480 wounded extremitie

Prikazani su rezultati liječenja 1186 stradalih u domovinskom ratu na području općine Vinkovci, i to od 01. srpnja 1991. do 30. lipnja 1992. god. Od svih ozlijeđenih muškarci su činili 85,49% (1014), žene 10,3 (122) i djeca 4,2% (50). Najveći je broj ozlijeđen krhotinama eksplozivnih naprava (granate, rakete) 85,48%, minama 8,48%, metkom 4,18%, a 1,92% je zadobilo opekotine, obično III stupnja. Učinjeno je 178 (28,52%) zahvata na gornjim i 302 (48,39%) kirurška zahvata na donjim udovima. Moderna oružja s projektilima velikih početnih brzina dovode do izuzetno ozbiljnih rana s masivnom destrukcijom tkiva. Krhotine bombi, granata ili mina postižu brzinu i od 1800 m/sec. Razarajući učinci prijenosa velike kinetičke energije na tkiva su dobro poznati i proučeni. Iako i nije izravno pogođena projektilom, kost će frakturirati ako se nađe unutar prostora zvanog "privremena šupljina", koja može biti i 30-40 puta veća od promjera projektila, a koštani ulomci postaju sekundarni projektili i dodatno proširuju područje tkivnog oštećenja. Najteže ozljede udova posljedica su eksplozivnog djelovanja mina ili granata. Načela primarnog zbrinjavanja otvorenih prijeloma u ratnih rana su jasno određena: • ekscizija kože • ekscizija svih devitaliziranih dijelova tkiva • odstranjenje stranih tijela • odstranjenje fragmenata kortikalisa koji su bez kontakta s tkivom • fragmenti spongioze se mogu očistiti i koristiti kao koštani graft • ispiranje rane • stabilizacija kosti (metoda izbora je vanjska fiksacija) • rekonstrukcija magistralnih krvnih žila • izbjegavati primarnu rekonstrukciju živaca ili tetivaThere are 1186 casualites, victims of the 1991-1992 war in Vinkovci, Eastern Slavonija, Croatia, represented in this text. Out of them, 480 were operated on for a war wound of an extremity. Types of wounds and their distribution, methods of surgical treatment and the results have been analyzed

THE INFLUENCE OF DREINAGE IN THE TREATMENT OF CHRONIC PILONIDAL SINUS DISEASE USING MIDLINE CLOSURE

Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate was 18/90 (20%). Infection occurred in 18 patients (20%), dehiscence occurred in 10 patients (11.1%). Mean recurrence rate during follow up period was 12/90 (13.3%); range, 24-84 months. There was no statistically significant difference among three groups in hospital stay length (p>0.05), in complication rate (χ2=1.66, p>0.05), nor in recurrence rate (χ2=1.91, p>0.05). Statistically significant difference was shown between complication rate among non drained and actively drained patients (χ2=1.11, p<0.05). Primary midline closure is not a satisfactory method in the treatment of chronic pilonidal sinus, especially without drainage, leading to numerous complications and high rate of recurrence