Unsterile techniques of intramuscular injection leads to abscess formation

Objectives: To assess the unsterile techniques of intramuscular [IM] injection leading to I abscess formation either in deltoid or gluteal region

Methods: In this study, all the patients with abscess formed after intramuscular injection at private clinics were included during the duration of 2 years. After consent patients were questioned regarding sterilization methods like use of spirit swab, exposure of injection area and also about co morbidities

Results: A total of 100 patients were admitted with abscess formation after lM injection. Mean age was 42.19 and most of the patients were female with deltoid to gluteal region abscess ratio is 1: 2. Sterile techniques like use of spirit swab were not used by 84 % of patients along. With ""9 injection site was also not exposed by 84% of patients. Diabetes was presents in 17 patients and 1 diabetes and hypertension were present in 16 patients

Conclusion: An unsterile technique leads to abscess formation after intramuscular Injection In our society. We should adopt proper guidelines for intramuscular injection

Long period vs short period drain placement in incisional hernia repair

Objectives: to assess the benefit of the long period drain placement after incisional Hernia repair and abdominoplasty for reducing the seroma complications

Methods: a total of 100 patients were included in this study which had been performed at services institute of medical sciences Lahore between January 2013 to December 2014. In these patients mesh repair of incisional hernia and abdominoplasty had been performed for their incisional Hernia and hanging abdomen. This patient had been divided into two groups, group [1] include 50 patients in which the drain had been left for 3 to 4 days, group[2] include 50 patients in which the drain had been left for 7 to 15 days

Results: we found that in the group [1], 20 [40%] patients had develop seroma collections and 8 [21.33%] patients had developed wound infection with this seroma and 5 [13.33%] patients developed hematoma collections. In group [2] we found that only 3 [9.33%] patients developed seroma collection and 1 [4%] patients developed wound infection with this seroma

Conclusion: there was significant difference in the incidence of seroma formation or surgical wound infection between the two groups. So we can place drain for long period to prevent seroma formation

Effect of 0.5% bupivacaine at the surgical bed after laparoscopic cholecystectomy

To evaluate the effect of 0.5% bupivacaine irrigated at the surgical bed on postoperative pain relief in laparoscopic cholecystectomy patients. This study included 80 patients undergoing elective laparoscopic cholecystectomy who were prospectively randomized into 2 groups. The placebo group [n=40] received 20cc saline without bupivacaine, instilled into the gallbladder bed. The bupivacaine group [n=40] received 20cc of 0.5% bupivacaine at the same surgical site. Pain was assessed at 0,6,12, and 24 hours by using a visual analog scale [VAS]. Asignificant difference [p=0.018] was observed in pain levels between both groups at 6 hours post operatively. The average analgesic requirement was lower in the bupivacaine group, but this did not reach statistical significance. The use of bupivacaine irrigated in the surgical bed was an effective method for reducing pain during the first postoperative hours after laparoscopic cholecystectomy

Exposed skin grafting in various surgical conditions

Background: A descriptive study was conducted at SIMS from December. 2002 to November 2005 to see the results of exposed skin grafting in various surgical conditions

Method: One hundred patients underwent exposed skin grafting. Most of the patients had surgical wound after excision of carbuncle, diabetic foot debridement, due to trauma and due to burn these wounds are dressed daily until they became clean, red granulation. We applied split thickness skin graft

Results: In this study 56 were male and 44 were female with a median age 42.6 years in male and 43.3 years in females. Thirty five percent [35%] had surgical wound after excision of carbuncle. Twenty five percent [25%] had surgical wound after debridement of diabetic foot and 25% had wound after trauma. Eleven percent [11%] had wound after burn. In all these patient we performed delayed exposed grafting and results are alright without any rejection. Early exposed skin grafting performed in 3% of cases after release of contracture and after mastectomy in 1 male patient. One patient after mastectomy had partial rejection

Conclusion: Exposed skin grafting is a simple and cheap method and can be done in both de/aye granulating wound and early surgical wound