ABSTRACT
Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgeryMethods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded.Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery.Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.
ABSTRACT
Background: Treatment of chronic leg ulcer is not easy. Appropriate diagnosis and proper treatment are the cornerstone for successful outcome. To study the profile of patients with chronic leg ulcers.Methods: Hospital based observational study was carried out in 108 cases. All patients coming to surgery OPD in our set up with chronic leg ulcers of duration of more than 6 weeks were advised admission if they were willing for the same. Then detailed history was recorded. Detailed examination of venous system was done for varicosities, incompetent perforators, sapheno-femoral or poplitio-femoral junction incompetence. In case of patient’s peripheral vascular diseases, detailed examination of arterial system was done. Descriptive statistics like frequencies and percentage for categorical data, mean and SD for numerical data has been depicted.Results: Majority of study subjects were in age range of 60 to 70 years. percentage of male patient (76.9%) was higher than that of the female (23.1%). 43.5% of participants with ulcer on left side and 56.5% participants had ulcer on right side. 47% of participants had complaints between 7 to 8 weeks. main etiological factor was infective etiology in 38.9% patients. 54.1% ulcers were found in lower 1/3rd of the leg. About 88.9% cases had positive culture. The most common organism grown was of pseudomonas in 45.8% cases.Conclusions: The most common etiology of chronic leg ulcer in this study is infective followed by traumatic ulcer. The most common associated condition found in chronic leg ulcer is diabetes mellitus.