ABSTRACT
Background: If properly used in appendicitis, antibiotics can reduce the rate of infection by 50%. The use of post-operative antibiotics for preventing infective complications in non-perforated cases is still controversial.Methods: A randomised prospective study was conducted in the Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi with patients who presented acute appendicitis. A minimum number of 30 patients each in group A (pre-operative and post-operative antibiotics) and group B (only pre-operative antibiotics) were evaluated for 18 months, from January 2018 to June 2019.Results: The mean age of group A is 29.9±15.16 years and in group B is 25.97±9.470 years (p value=0.122, insignificant). There was male preponderance. The seroma formation in both the groups was 10.00% and no patients developed intra-abdominal abscess. The incidence of local site oedema was 10% in both the groups A and B and their p value is insignificant. In both the groups A and B, 10% of the people developed pus discharge from the stitch line and the p value is insignificant. In group A, 6.67% of the patients and in group B 10.00% of the patients developed stitch line inflammatory changes and the p value insignificant. In group A, 13.3% and in group B, 10.00% of the patients developed fever and their p value is 1. The mean length of hospital in case 1.23±0.5 days (group A) and is 1.17±0.45 days (group B) (p value=0.508).Conclusions: Hence we can conclude that a well-chosen and adequately-timed pre-operative antibiotics are adequate in preventing post-operative complications and post-operative antibiotics do not affect the same.
ABSTRACT
Background: Inguinal hernia repair is one of the most commonly performed procedures by general surgeons. Cyanoacrylate is the generic name for a family of fast acting adhesives. The aim of the present study done in Department of General Surgery, Safdarjung Hospital, New Delhi was to compare the newer emerging technique of mesh fixation.Methods: A total of sixty patients were included in the present study and were allotted in case and control group randomly by sealed envelope technique. In case (study) group, all the patients underwent mesh fixation by cyanoacrylate glue and in control group, by prolene 3-0 sutures.Results: Most frequency in age group 31-40 yrs, males:females ratio >1 and right sided inguinal hernia was more common. Bi-lateral hernia was common in elderly. Indirect: direct ratio 4.5:1. Operating time period for the patients of the case (study) group is less than control group. P value of post-operative pain in immediate post-operative period (day 1 and 2) and POD 30, 60 and 90 was not of clinical significance whereas the p-value on 6,120,150 and 180 post op day was of clinical significance. In our study, there was a case of incidental observation: a) reaction due to use of cyanoacrylate glue, b) rejection of mesh for which mesh had to be removed.Conclusions: There is no statistically significant difference between mesh fixation with cyanoacrylate glue and mesh fixation by prolene suture techniques in immediate post-operative pain. Statistically significant difference favoring mesh fixation by cyanoacrylate glue technique was seen with respect to operating time and post-operative groin pain with increasing post-operative duration.