To evaluate the outcome of sacrococcygeal pilonidal sinus excision using karydakis technique

Objective: To evaluate the outcome of sacrococcygeal pilonidal sinus excision using karydakis technique. Study Design: Prospective case series study. Place and Duration of Study: This study was carried out in the Department of General Surgery Unit 111, Ward 26, Jinnah Post graduate Medical Centre, Karachi form March 2005 to Feb 201 2. Materials and Methods: The study included 85 consecutive patients who underwent pilonidal sinus excision by karydakis technique fulfilling the inclusion criteria. We excluded the cases of pilonidal abscess and the cases which came with acute infections. Patients under 12 years were also excluded. A prospective method of data collection was utilizes by filling in the proforma designed for the study. A complete record of the procedure, follow up was done initially on weekly basis for one month and then fortnightly for 6 months and subsequently monthly for 30 months. Results: Total of 85 patents were included in our study in which 68 [80%] were male and 17 [20%] were female. The mean age of the group was 30.56 years. All patients were followed postoperatively for 30 months. Mean hospital stay was 2.5 days. Majority 63[74.1%] of the patients underwent smoothly without major complication. In all 85 patients wound closed with prolene 210 interrupted sutures. In 9[10.6%] patients developed minor wound infection while 4[4.7%] patients develop wound dehiscence and 3[3.52%] patients develop recurrence. In all 85 patients prophylactic antibiotics amoxicillin + clavulanic acid 1.2gm was used. In infected patients accounting to a total of 13[15.3%], both major and minor infections were included and appropriate antibiotic was used as indicated in the culture and sensitivity report. Conclusion: Karydakis technique is superior to midline excision surgery. It is associated with significantly shorter complication rate, shorter hospital length of duration, rapid healing, cost effective, good cosmetic satisfaction, a high patient satisfaction rate and low rate of recurrence

To compare the frequency of superficial surgical site infection after laparoscopic versus open appendectomy

To compare the frequency of Superficial Surgical Site infection after laparoscopic versus open appendectomy. Randomized clinical trial study. This study was conducted at Surgical Department Jinnah Post Graduate Medical Centre Karachi and Dow University Hospital from August 2013 to January 2014. The source of data was patients admitted in emergency. Patients were selected on the basis of clinical features. The data was collected with the help of Performa attached. It included demographic data of the patient, presenting complaints, operative findings, Surgical site infection. Random patients were placed in two groups. Surgical site infection by observation of pain, redness, tenderness and purulent discharge from the wound. Patients included were of both gender and age above 13 years presented to emergency department diagnosed as acute appendicitis on the basis of history and examination and exclusion of under 12 years of age, appendicular mass, CLD, I.H.D, DM and renal failure. Out of 270 patients, 153[56.7%] patients were males and 117[43.3%] patients were female. In Present study the different operative findings with their distribution among gender are shown in table. In other findings three patients with ruptured ovarian cyst and one with Mackel's Diverticulitis in which procedure was converted to open and resection and anastomosis of small intestine was done. SSSI is found to associated with operative finding with a significant P value 0.001. Superficial Surgical Site Infection were observed in both procedure laparoscopic appendectomy allotted in 134 cases but four cases are converted to open procedure so they are excluded from the results. The reason for conversion in three cases was difficulty in mobilizing the appendix because of adhesion and in one case Mackel's Diverticulitis found which need open procedure for formal small intestine resection and anastomosis. Superficial Surgical Site Infection was observed in three cases of Laparoscopic appendectomy and in 15 cases of Open Appendectomy group with the P value 0.005. Laparoscopic appendectomy is a better choice because of its reduced frequency of SSSI when compared with open procedure. SSSI is an important complication