efficacy of normal saline irrigation to prevent surgical site infection

The aim of the study was to evaluate the efficacy of normal saline irrigations to prevent surgical site infection [SSI]. A comparative study. The study was conducted at surgery and gynecology Dept CMH Chunian from 1[st] Jan 2012 to 1[st] Nov 2012. Two hundred clean surgical and gynecological cases were included in the study. Hundred cases which were randomly selected had their wound washed with warm normal saline for 60 sec and then mopped dry with clean swabs. Subcuticular Stitches were applied to all the 200 cases. The surgical wounds were examined on 3[rd] post operative day and then finally on 15[th] post operative day. Patients with wound infection developed pain at the operation site and fever on third post operative day. Wounds were examined for swelling, redness, discharge and stitch abscess. Routine investigations were done as per protocol. Wound swabs were taken for culture and sensitivity. The study was carried out on 200 clean cases [general and gynecological]. They were 130 females and 70 males. The 100 cases whose wounds were washed with normal saline only 1 patient developed wound infection while in the other group who did not had saline irrigations 8 patients out of 100 developed wound infection. The commonest infective organisms were staphylococcus aureus and the other organisms were streptococcus pyogenes, proteus, Klaebsiella, E coli and pseudomonas. No MRSA was detected. In our study washing the wound with warm normal saline for 60 seconds resulted in the wound being infection free. Wound infection is associated with delayed wound healing, prolonged hospital stay and increased economic pressure on the patient and on the state

Prevention of hypotension in caesarean delivery under spinal anaesthesia; the combination of modified supine wedged position, crystalloid co-hydration and prophylactic atropine

To evaluate the efficacy of a modified supine wedged position with table tilt, crystalloid co hydration and prophylactic intravenous atropine in the prevention of hypotension in caesarean delivery under spinal anaesthesia. Phase 2 clinical trial. Place and Duration of Study: PAF Hospital Masroor Karachi and PAF Hospital Rafiqi Shorkot Oct 2005 - April 2006. 40 parturients undergoing elective caesarean section under spinal anaesthesia were studied. Lactated Ringer's solution 10 ml/kg was administered over 10min.After Spinal in the sitting position with a 25-gauge Quincke needle using0.75% hyperbaric bupivacaine [12.75-15mg], the parturient was placed in the modified supine position with table tilt .Atropine 10microg/kg was given i/v. The baseline blood pressure and heart rate in each parturient before intervention [crystalloid co hydration, spinal, modified supine wedged position and i/v atropine] were taken as control and evaluated against the values after the intervention at different time intervals. Thirty nine out of forty patients completed the study. Mean upper sensory level was T4 at 6min post spinal. The mean spinal to delivery time was less than 12 min.5% of the parturients developed hypotension at 2 min post spinal. The mean heart rate was 96/min. The mean, systolic and diastolic blood pressures remained close to the base line values at 4, 6, 10, 12, 16 and 20 min post spinal. Modified supine wedged position with table tilt, crystalloid co-hydration and prophylactic i/v atropine is an effective combination technique which prevents spinal induced hypotension in caesarean delivery