New Indian Journal of Surgery

Hydatid disease is a cyclo zoonotic parasitic infection caused by Echinococcus granulosus. This disease is commonly found in the liver and lungs but no organ of the body is immune. When found at unusual sites in the body they show atypical presentations and pose a diagnostic challenge. In such conditions, a high index of suspicion, radiological investigations as well as histopathological examination are necessary in establishing the diagnosis. We present a review of the occurrence of hydatid disease at common as well as unusual sites and our experience with clinical presentation and management of hydatid disease.

Background: Complicated inguinal hernia is one of the most common conditions encountered in a surgical emergency. Of various surgical procedures available we are comparing Desarda’s and Modified Bassini’s repair in our study. Aims & Objectives: To compare Desarda’s repair with Modified Bassini’s repair in complicated inguinal hernia concerning the duration of the procedure and various post-operative complications. Methods: We have included 52 patients with complicated inguinal hernias presenting to the emergency department after taking informed consent and ethical committee clearance. Patients were randomly divided into two groups using computer software Group A and Group B. Group A: Consists of 26 patients and underwent Modified Bassini’s repair. Group B: Consists of 26 patients and underwent Desarda’s repair. Various intraoperative and post-operative complications were studied. The patient was followed up for a 3 years period for recurrence of an inguinal hernia. Results: Desarda’s repair had less post-operative pain score. Complications such as seroma formation and recurrence in the follow-up period were less compared to Modified Bassini’s repair. Conclusion: Desarda’s repair was found to be a better alternative for a complicated inguinal hernia when compared to Modified Bassini’s repair.

Introduction: Reconstruction with a free flap is routinely done at site especially head and neck and oral because of better surgical and functional outcomes, improved esthetics results, and overall higher success rates. Aim & Objective: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions and study various demographic and pre-operative factors associated with it. Methods: This was a retrospective study of 45 patients undergoing reconstructions with free flaps from January 2020 to December 2022. Different types of free flap were performed like Anterolateral thigh, Free fibula osteocutaneous flap (FFOCF), free functioning muscle transfer (FFMT), Free radial artery forearm flap (FRAF), The medial sural artery perforator (MSAP), latissimus dorsi (LD), myocutaneous flap, superficial circumflex iliac artery perforator (SCIP). Results: The patients included total 45 participants, with 35 men and 10 women, with a mean age of 45.56 years. Oral malignancy was the most common cause. Squamous cell carcinoma represented the majority of the diagnosed tumors (31.1%) followed by ameloblastoma. The most common recipient vessels were the internal jugular vein (91.4%), the facial artery (77.4%) followed by superior thyroid artery. The overall flap success rate was 93.33%. Venous thrombosis was the most common cause for re-exploration. The majority of patients had satisfactory cosmetic and functional results of both donor site and recipient site on 1 month follow up. Conclusion: Microsurgical free flap seems to be a valuable and successful method in head and neck surgery. The reconstruction can be done by skilled surgeons with post-op monitoring.

Background: Necrotizing soft tissue infections are frequently associated with a fulminant presentation and fatal outcomes. A side from critical care and antibiotic therapy, aggressive surgical treatment is essential for the treatment of necrotizing fasciitis. The purpose of this study was to see if post-operative procalcitonin, lactate dehydrogenase, albumin, and culture sensitivity could be used to predict successful surgical intervention. Methods: The study group consisted of 92 patients treated with clinical signs of sepsis caused by a necrotizing soft tissue infection. All patients received radical surgical treatment, and S.PCT, S.LDH, Albumin and wound culture and sensitivity were sent on POD3. Results: Out of 92 patients’ mortality was seen in 11 patients and amputation was done in 6 patients. The biochemical markers which were included in the study showed significant results (p<0.01) * that is serum procalcitonin and serum LDH were elevated and s. albumin was low in all patients who are died and amputated except in one patient. There was no significant in the microbial flora and the outcome of the patient. Conclusions: The biochemical markers PCT, LDH, Albumin following major surgical procedures for necrotizing soft tissue infections represents a valuable clinical tool indicating successful surgical eradication of the infectious focus.

Aim of this case report is to assess the role of cyclical negative pressure wound therapy (CNPWT) in management of skin graft donor site healing. Clinical examination of the donor site before and after the use of cyclical negative pressure wound therapy (CNPWT) was done. Cyclical negative pressure wound therapy (CNPWT) is effective in healing of donor site wound. Cyclical negative pressure wound therapy (CNPWT) may be used in donor site healing.

Introduction: Diabetic foot ulcer is one of the most common conditions encountered in surgical OPD. The incidence of a diabetic foot ulcer is around 15% among the diabetic population. Around 80% of non-traumatic amputation is due to chronic diabetic foot ulcer. Recent advances are made in treating wounds in which platelet-rich plasma (PRP) and platelet rich fibrin matrix (PRFM) therapy have proven beneficial. Materials and Methods: A prospective study was conducted from February 2021 to February 2023, for a period of 2 years which included 42 patients. Group A received autologous platelet rich plasma therapy (PRP) and group B received autologous platelet rich fibrin matrix therapy (PRFM) each consisting of 21 patients. Results: PRFM Group showed better reduction in ulcer size compared to respective PRP Group, and demonstrated statistically significant p-values. Around 47% of the subjects had complete closure of the ulcer after 5 sessions of PRP dressing while it was 90% with PRFM dressing. Conclusion: PRFM is better modality to treat diabetic foot ulcer when compared to PRP therapy