Comparison between two methods of excision and primary closure of pilonidal sinus

Controversy still exists about the best surgical method for the treatment of pilonidal sinus. The aim of this study was to compare two methods of excision and primary closure. One hundred and seventy-three patients with pilonidal sinus, 119 [69%] men and 54 [31%] women, and a mean age of 23.3 +/- 7.5 yrs and divided into two Groups of A [electrocautery] and B [excision] for the removal of pilonidal sinus. Wound complications, hospital stay, times to heal, return to work, patient's comfort and recurrence rate were recorded for the two groups. The postoperative follow-up was 6 months. All patients were able to resume their normal lives and activities 7-9 days after the operation. Wound infection and recurrence rate were significantly [P<0.05] less prevalent in Group A [5% and 3.8%] than in Group B [1% and 0%]. There was no significant difference between two groups in regard to hospital stay, time to heal, time to return to work and patients' comfort after 6 months of follow-up. The use of electrocautery at the base of the wound is not recommended because it may obscure the exact extent of the pilonidal sinus and increase the rate of recurrences

Treatment of postoperative shivering with dexamethasone: a prospective randomized clinical trial

Postoperative shivering is an important and troublesome condition during recovery from general anesthesia. Corticosteroids have been recommended to facilitate recovery and diminish shivering after cardiac surgery. Previous studies recommended 0.6 mg/kg dexamethasone for reducing postoperative shivering in patients undergoing cardiac surgery. To test this assertion, we administered 0.15 mg/kg dexamethasone to patients undergoing routine surgeries, e.g., laparotomy, thoracotomy, and orthopedic, urologic and gynecological operations. A total of 200 patients undergoing elective operations were randomly selected and divided into two groups. To the first group 0.15 mg/kg dexamethasone and to the control group, a placebo was injected right after the induction of anesthesia and before making any skin incision. Patients did not have any coexisting diseases, e.g., diabetes, hypertension, ischemic heart disease, etc., nor were they on any specific medication. All patients received the same doses of diazepam, morphine, sodium thiopental, 50% O2, 50% N2O, and 0.5% halothane for the induction and maintenance of general anesthesia. Patients who had received dexamethasone had a significantly [p<0.001] lower incidence of postoperative shivering [12%] compared to the control group receiving placebo [31%]. Small doses of dexamethasone [0.15 mg/kg] could effectively decrease the incidence of postoperative shivering

Use of colchicine in reduction or prevention ot talc-induced intra-abdominal adhesion bands

Postoperative peritoneal adhesion bands are one of the most common complications caused by foreign material. To investigate the effect of colchicine on talc-induced peritoneal adhesion bands. Method: Adhesion bands were induced in 30 short hair England Guinea pigs by introduction of talc-saline solution [10 mL, 10%] into the peritoneal cavity. Afterwards, the pigs were randomly divided into two equal groups and colchicine was orally given to the experimental group. Finally, laparotomy was performed and the adhesion bands in both groups were classified using the Nair classification and compared with each other. Only four [23%] out of 15 Guinea pigs of the target group developed substantial adhesions, while the other 11 [75%] pigs developed only insubstantial adhesions [grade 0-1]. On the other hand, the entire control group developed substantial adhesions. Colchicine, at a dosage of 0.02 mg/kg, prevented and reduced formation and severity of adhesion bands [p<0.05]. Therefore, given the safety, low cost and acceptable side effects, colchicine may be a useful agent for prevention or reduction of adhesion band formation. Human studies on this subject are warranted