New Indian Journal of Surgery

Burns are one of the most common injuries among the children, which are due to thermal, scald, electrical burn injuries. Scald injuries tend to be the most common type of burn injury under the age of five, accounting for over 65% of the cases.In current scenario, various scaffolds are used to improve the quality of healing process and reduce the scar formation. Collagen acts as a scaffold through which regeneration of tissues occurs and also helps in new vessel formation. Other scaffolds like amniotic membrane which has unique antiinflammatory, bacteriostatic property helps in proper epithelization and reduces scarring and silicone gel sheets has hydrophobic property, which reduces scarring and provides analgesia. In this study we attempted three layered scaffold dressing for an second degree scald burn pediatric patient.

Introduction: Benign prostatic hyperplasia, one of the most common diseases among ageing men. BPH prevalence increases from approximately 50% at 60 years to 90% in men older than 85 years. Lower urinary tract system significant impact on the overall quality of life.The treatment options include: 1. Watchful waiting: if the symptoms are mild and not causing any change. 2. Medical treatment - Alfa-receptor antagonists, 5 alfa-reductase antagonists, antimuscarinics, phosphodiesterase 5 inhibitors and their combinations. 3. Surgical management is preferred in patients with an IPSS score more than 19-traditional monopolar Transurethral resection of the prostate (TURP), Prostatic Urethral Lift. Aims and Objectives Aim of the study: To study the outcomes of medical management of BPH based on the IPSS. Objectives of the study: Primary Objective: To study the outcomes of medical management of BPH in terms of reduction of IPSS, change in prostate size, post-void residual volume as assessed by USG with medical management. Secondary Objectives: 1. To study the age distribution in BPH 2. To study the symptomatology of BPH. This prospective observational study was carried out. A total of 55 patients presenting with lower urinary tract symptoms secondary to BPH were enrolled for the study. International Prostate Symptom Score was assessed on presentation and patient was started on either monotherapy or combination therapy depending on the prostate volume and then reassessed at 3 and 6 months after starting drug therapy. Conclusion: Medical treatment for LUTS/BPH aims to produce rapid, sustained, and safety improvements in the lower urinary tract symptoms associated with benign prostatic hyperplasia that affect the quality of life in the majority of men over the age of 45. Combined therapy of an α1-adrenergic receptor antagonist (tamsulosin) plus a 5-alpha reductase inhibitor (dutasteride) is a good approach for meeting these objectives.

Normal wound healing is a complex process involving three phases namely inflammatory, proliferating, and remodeling. Studies have shown that sucralfate has a beneficial effect on ulcers, skin lesions, and burn wounds by promoting healthy granulation thereby preparing the wound bed. Whereas non cultured keratinocyte graft has proven to promote epithelialization of the wound. In this study, we used non cultured keratinocyte graft with sucralfate in a pediatric patient with burn wounds onthe face.

Aims & Objectives: To study the groin hernias in adult and its outcome in terms of clinical presentation, precipitating factors, intra-operative findings & complications. Materials and Methods: This prospective clinical observational study was carried out in 400 patients with complaints related to the groin region to the department of general surgery in a tertiary care center over a period of 2 years after ethical committee approval. Observation & Results: In this study inguinal swelling was the most common presentation in (77.25%), followed by localized pain in swelling (12%), localized pain in swelling with vomiting (2.25%) localized pain, vomiting And constipation in (5.75%) and distention in (1.25%) patients.The male-to-female ratio of groin hernia was 13.3, indicating a male preponderance. Unilateral groin hernias (83.5%) with right sided preponderance (49.75%) were more common than bilateral cases (16.5%) Uncomplicated groin hernias were seen in 86.75% patients while complications were seen in 12.25% patients as irreducible (6.75%), obstructed (4.25%) and strangulated (2.25%) In emergency operated case 1 patient had anastomostic leak in post-operative period and patient later succumbed. In 2.25% emergency and 1.5% elective patients had surgical site infection. Conclusion: In this study we found an association between groin hernias&various precipitating factors, comorbidities and occupation .Both complicated and uncomplicated groin hernias are most common in males. Uncomplicated groin hernias are more prevalent than complicated ones. Uncomplicated groin hernias are posted for elective hernia repair &are managed by Lichtenstein’s tension free mesh repair while incidence of complicated groin hernias is low and requires emergency surgical management &is associated with high morbidity and mortality.

In complicated wounds, healing is a challenge, particularly for the elderly with co-morbidities, which is a major concern. It can lead to prolonged treatment, pain, and morbidity and require major reconstructive procedures, which foist enormous financial and social burdens. Negative pressure wound therapy (NPWT) or vacuum-assisted closure (VAC) is a miracle and more acceptable method as an alternative in wound management that relies on sub atmospheric pressure and encourages the wound for spontaneous healing or by reducing the burden of reconstructive procedures. VAC application methods include thorough debridement, haemostasis, and the application of sterile sponge or foam dressing. A tube with fenestrations is submerged in the sponge, and the wound is wrapped to make it airtight or watertight with adhesive tape. The vacuum pump with fluid collection container is connected to the fenestrate tube. The pump delivers intermittent or continuous suction with pressure ranging from 50-55 to 120-125 mmHg. The NPW dressings are replaced on the third day. Negative pressure therapy reduces wound oedema and bacterial load, stabilizes the wound environment, improves perfusion, and stimulates angiogenesis and granulation tissue. All these mechanisms facilitate the possibility of primary wound closure and reduce the need for other reconstructive procedures. VAC therapy seems to be more effective and simpler than traditional dressings for wound care management in reduction in wound size and volume, depth, treatment duration, and cost.