ABSTRACT
A descriptive study of 100 cases to compare the early intervention [within 6 hours] with late intervention in outcome of peripheral vascular injury conducted in Nishtar Hospital, Multan over a period of 2 years extending from December 2001 to December 2003. No age was found to be safe yet peak occurrence was noted in 21-40 years of age i.e. 66%. Out of 100 cases of peripheral vascular injuries 82 patients [82%] were male and 18 patients [18%] were male. Firearm injury was seen in 61 cases [61%] of peripheral vascular injury. Second common cause was road traffic accidents i.e. 25%. Most of the cases of peripheral vascular injury reached hospital within 6 hours. Cases of peripheral vascular injury from area were 70 [70%] whereas from urban areas only 30 [30%] cases were seen. Revascularization was restored within 6 hours in 50 patients and none of them required amputation. Forty-five reached hospital between 6-12 hours and 15 patients [33.3%] required amputation whereas 5 patients arrived hospital beyond 12 hours and 4 patients [80%] of them required amputation. All cases of peripheral vascular injuries should be surgically explored. Every effort should be made to achieve revascularization within 12 hours. Patients presenting late or with crush injury should undergo amputation
ABSTRACT
A comparative study of 50 cases to compare the number of complications after layered closure with mass closure in major abdominal operation conducted in surgical Unit-II, Nishtar Hospital, Multan extending over a period of 3 years from January 2000 to January 2003. In group-A 17 [70%] were male and 8 [30%] were female. In group-B 16 [64%] were male and 9 [36%] were female. Age of the patients varied from 13 years to 30 years. In group-A 11 [44%] patients were from elective laparotomies and 14 [56%] from emergencies, while in group-B 8 [32%] were from elective operation and 17 [68%] from emergency. In group-A 6 [24%] had midline incision while 19 [76%] had paramedian incision. In grup-A clean wound wee 12 [48%] and clean contaminated were 13 [52%]. In group-B clean wounds were 9 [36%] and clean contaminated were 16 [64%] patients. Group-A had 2 [8%] patients with chest infection and cough in 5 [20%], while in group-B had 1 [4%] patients with chest infection, 2 [8%] with hemorrhage. In group-A small bowel 8 [32%], stomach and duodenum 2 [8%], biliary tract 6 [245], major abdominal vessels 2 [8%], liver and spleen 1 [4%], colon 3 [12%] and miscellaneous 3 [12%]. In group-B the corresponding figures are small. In group-A wound dehiscence occurred in 2 [8%] patients out of 25 whereas in group-B the dehiscence occurred in none of 25 patients. Using non-absorbable monofilament polyprophylene [prolene] is better than the conventional layered closure with regard to gain of early and late wound strength
ABSTRACT
A retrospective study of 100 cases to describe the effect of perforation on operation interval on the prognosis of perforated duodenal ulcer was conducted in surgical wards of Nishtar Hospital, Multan. An overall mortality of 16% in 100 patients who under went surgery. Mortality occurred only in group-B and C. Interval between perforation and operation increases the hospital stay like group-A patients stayed in hospital for 8 days, patients of group-B who stayed in hospital for 10 days, whereas stay of group-C patients was 23 days. Number of complications in patients presenting with delay were much more than in patients presenting early. Morbidity also rises with delay. Patients with perforated duodenal ulcers should be operated as soon as possible. Simple closure of perforation is simple and safe wit hrelatively low mortality and short stay in hospital