ABSTRACT
The most common cause for mortality in burns worldwide is sepsis. American Burn association guidelines 2007 are followed till date. But the confirmation of the sepsis requires tissue/blood culture which takes a minimum of 48-72 hours. Adding Procalcitonin as an adjunct biomarker to the sepsis criteria enhances the predictability of sepsis. This prospective study has been carried first time with the help of Procalcitonin. The prospective study was performed between October 2019 to October 2021 in the department of burns and plastic surgery wherein we evaluated serum procalcitonin of 52 patients with (30 %to 60%) Total Body Surface Area burns within 24 hour of admission and at the time of burn sepsis suspicion as per American burn Association2007 guidelines .The Positive blood/tissue culture was taken as the confirmatory evidence of sepsis. Patients were divided in two groups, sepsis (Group A) and non sepsis (Group B). All the parameters for sepsis as per ABA guidelines were serially noted . The Sensitivity and specificity of the test was 89.29 % and 58.33 % respectively. 2.1 ng/ml was taken as the cut off value for diagnosing sepsis in burn patient with an area under the curve of 0.78 at 95% confidence interval. Elevated Procalcitonin concentrations correspond to the documented sepsis in 30 -60 % of burns which enhances the Predictability of diagnosing burn sepsis .Hence we recommend to add procalcitonin as an adjunct biomarker to diagnose sepsis in burn patients.
ABSTRACT
Background: Abdominal wound dehiscence is a commoncomplication of emergency laparotomy. Its prevention inimportant to reduce postoperative morbidity and mortality. Theaim of this study to compare the incidence and risk of burstabdomen, wound infection and sinus formation withPolydiaxanone (PDS II) versus Polypropylene (PPL) in midlinelaparotomy wounds.Materials and Methods: 60 patients undergoing laparotomythrough a midline vertical incision were randomized afterinformed consent, to either a Polydiaxanone (PDS II) versusPolypropylene (PPL) suture material. The incidence andrelative risk (RR) of burst abdomen, wound infection and sinusformation using Polypropylene (PPL) group as the referencecategory were calculated.Results: There was 1 burst abdomen (out of 30 cases, 3.3%)in Polypropylene (PPL) group and none (out of 30) inPolydiaxanone (PDS II). The RR of burst could not becalculated because of 0 in one arm. The incidence of woundinfection was 16.6% in Polypropylene (PPL) (5 out of 30 cases)compared to 10% (3 out of 30 cases) in Polydiaxanone (PDSII). The relative risk (RR) of wound infection was 0.60. Theincidence of suture sinus was 10% (3 out of 30 cases) inPolypropylene (PPL) as compared to 3.3% in Polydiaxanone(PDSII) group.Conclusion: The risk of burst abdomen, wound infection &suture sinuses is less with the use of Polydiaxanone (PDS II).