ABSTRACT
Compression bandaging is a key aspect following stripping for varicose vein surgery. With adequate compression, formation of subcutaneous hematoma can be prevented and thereby prevent revascularisation of the hematoma leading to recurrence of varicose vein. Various techniques exist to provide compression. Our modification provides an easy alternative to achieve immediate compression following stripping and is especially useful in a setting where staff is very limited. Materials required include a 10 cm width gauze bandage, 1% lidocaine with epinephrine, and number 1 silk suture in addition to the conventional tools for open varicose vein surgery. The gauze bandage is introduced along with the stripper which is passed from groin to below knee. The bandage is kept in the subcutaneous tunnel till perforator ligation, groin wound closure and application of compression bandage. The gauze bandage is removed through a small window within the compression stocking below the knee and the wound closed in a single layer. From 2005 to 2020, 410 patients underwent varicose vein surgery with the modified technique. Of these, 1 patient developed complication secondary to hematoma formation which was managed conservatively. Our modification of the varicose vein stripping technique is shown to be a cost effective and simple technique which provides immediate compression and effortlessly facilitates haemostasis till wounds are closed and compression stockings applied. in various literatures.
ABSTRACT
Background: The study of brachial artery is an important arterial conduit from the clinical point of view toanatomists, general surgeons, radiologists, plastic surgeons, and even cardiovascular thoracic surgeons in theconduct of reparative surgery.Therefore, the present study was designed to study the course, branching patternand termination of Brachial Artery and its clinical significance of these variations.Materials and Methods: The present study was conducted on 30 upperlimbs of 15 cadavers embalmed & belongingto theDepartment of Anatomy, Govt. Medical College,Alappuzha over the period of 1 year. By conventionaldissectionmethod a longitudinalincision was given along the midline of arm through the deep fascia, inferiorupto cubital fossa. Brachial artery was identified, cleaned & dissected and assessed the length of brachial artery,level of termination of brachial artery, variation in the branching pattern and the course in relation to themedian nerve was noted.Results: The average length of the brachial artery was 25.23 cms. 73.3% of the brachial artery followed theclassical pattern as given in Gray’s Anatomy. Variation in the branching pattern, presence of accessory brachialartery, origin of profunda brachial artery was noted. 3.3% trifurcation of brachial artery into Radial, Ulnar &Common interosseous at the level of neck of radius.Brachial artery terminated at the level of neck of radius in76.67%, radial tuberosity13.33%, mid arm3.33%, proximal arm 6.67%.Discussion and Conclusion: Variationsof brachial artery in its relationship with the median nerve, pattern andlevel of termination are common. These may complicate arm surgical exposure, flap and vascular surgery.Hence, Knowledge of possible variations in the branching pattern of various arteries is important during vascularand reconstructive surgery.
ABSTRACT
Antegrade transmalleolar drilling method is one of the options for the treatment of osteochondral lesion of talus (OLT). We present five patients who underwent tibial drilling for treatment of OLT and later developed distal tibial cystic formation induced by cartilage opening or heat necrosis during drilling. Antegrade transmalleolar drilling can be a possible option for the treatment of OLT if the lesion is not easily reachable; however, other viable treatment should be considered due to its possibility of distal tibial pathologic change.