ABSTRACT
Introduction: Surgical site infection is a common postoperative problem causing significant post-operativemorbidity and mortality, prolonged indoor stay and addsbetween 10% and 20% to hospital cost. In India, rate ofsurgical site infections in various set-ups had been reportedto be 4.2-21%. Current study aimed to record the incidenceof surgical site infection in present set up in both elective andemergency cases and to assess the possible risk factors andanalyze the measures to prevent surgical site infection.Material and Methods: The present prospective study wasconducted in the post graduate Department of General Surgery,Rohilkhand Medical College, Bareilly, from 1 November 2017to 31 October 2018 to determine the incidence of surgical siteinfections and to assess the risk factors associated with thesurgical site infections. Samples were processed for microbialflora and antibiotic sensitivity.Results: Incidence of surgical site infections in present studywas 13%. In elective surgeries it was 7.1% while in emergencysurgeries it was 26.7%. Incidence was higher in patients withdiabetes, smokers and obese patients. Highest incidence waspresent in dirty wounds. Incidence was lower in patientswho have shorter pre operative hospital stay and underwentsurgery for shorter duration. In most of the cases surgical siteinfections occured on post-operative day 7. Patients with SSIhad longer mean duration of hospital stay as compared tothose who did not have SSI. Staphylococcus aureus was themost common organism isolated followed by E. Coli.Conclusion: We reported a significant association of SSIwith type of procedure (open and emergency), diabetes,obesity, smoking, duration of preoperative hospital stays,ASA physical grade, duration of surgery, duration of drainsand type of wound according to wound classification.
ABSTRACT
Aim: The study was conducted with an aim to suspect and diagnose “breast tuberculosis (TB)” cases early to avoid unnecessary delay in their treatment. Materials and Methods: For this purpose, the cases of breast complaints presenting in the Department of Surgery were clinically examined, investigated with fine-needle aspiration cytology (FNAC) or biopsy along with other relevant investigations. FNAC or biopsy positive for breast TB cases were further investigated by chest X-ray and/or sputum acid-fast bacilli for any evidence of pulmonary TB. Results: A total of 9 cases of breast TB were collected. Out of these 9 cases, 7 cases were adult females in the age group of 24-40 years. Cases 1, 2, 5, 6, and 9 were non-lactating, while Cases 3 and 7 were lactating. Case 4 was a 12-year-old girl and Case 8 was 25-year-old male. All the cases were involving the right breast except Case 5, which was involving both breasts, and Case 6, which was involving left breast. Case 5 was also having active pulmonary TB. Case 7 was showing Ziehl-Neelsen staining positive for AFB in breast tissue sample. We treated all cases with first-line four drugs (HRZE) for initial 2 months and two drugs (HR) for another 4 months except in Cases 1 and 5 where the continuation phase was extended to 6 months. Conclusion: Histopathological diagnosis is a more reliable and accurate as compared to the bacteriological diagnosis of tubercular mastitis. Four drugs therapy for 6 months is adequate. The majority of the cases will heal without major surgery, and mastectomy should be reserved for extensive breast destruction and unresponsive cases.