Skin closure after groin hernia repair in children : a comparative study of three suture materials and two suture techniques

Objective The surgical scar is of great importance both to the patient and surgeon. For the patient an ugly scar may not only present a cosmetic problem but in some cases it may also impair function; and the surgeon is always confronted with the problem of possible litigation. This study was undertaken to evaluate the effect of different suture materials and skin suture techniques on surgical scars. Patients and Methods Three suture materials (chromic catgut 3/0; silk 3/0 and nylon 3/0) and two skin closure techniques (transcutaneous interrupted mattress and subcuticular continuous running sutures) were compared in a randomized partially blinded fashion using a groin skin crease incision. The resulting scars were graded after two years using a conceived three-level scale. Results Subcuticular nylon sutures gave the best cosmetic results followed by subcuticular chromic catgut. Transcutaneous interrupted mattress silk sutures left the worst scars followed by subcuticular continuous running silk sutures. Conclusion The use of suture materials for skin closure is still the norm in developing countries. We therefore suggest that for any particular suture material; the subcuticular continuous running technique should be used and whenever possible the suture material of choice should be nylon

Paediatric urological trauma at Nwewi; South Eastern Nigeria : a two-year experience

Objectives: To evaluate the factors implicated in paediatric urologic trauma at Nnamdi Azikiwe University Teaching Hospital (NAUTH); Nnewi; and to determine how these factors could influence the management. Patients and Methods: All medical cases of paediatric urological trauma managed at NAUTH between January 1st; 2000 and December 31st; 2001 were analyzed retrospectively on the basis of the patient records. The patient group included neonates up to children aged 15 years. Apart from the biodata; the cause of the trauma; the organ(s) injured; the treatment given and its outcome were critically analyzed. Results: In the two years under review; 257 cases of paediatric trauma were managed. Out of these; urological trauma was found in 18 patients (7) with a male/female ratio of 5:1 (15 males and 3 females). The commonest causes of paediatric urological trauma in our environment were found to be circumcision mishaps followed by road traffic accidents (RTA) caused by commercial motorcyclists. Treatment was mainly surgical. There was no mortality but we recorded morbidity in four cases (22.2). Conclusion: Our study shows that most of our paediatric urological trauma is preventable. We conclude that paediatric urological trauma in our environment would be drastically reduced if there were laws stipulating that circumcisions should only be done by qualified personnel and if the existing traffic laws of the country were strictly enforced