ABSTRACT
Background: Various techniques for treatment of inguinal hernia have been studied. The use of a mesh is costly and has its own complications. In Desarda’s technique- external oblique muscle aponeurosis is placed in the form of an undetached strip for inguinal hernia repair. The objective of this study is to compare the outcomes of Lichtenstein’s repair versus Desarda’s technique.Methods: In this prospective study, 50 patients with inguinal hernia were enrolled at A. J. Institute of Medical Sciences and Research centre. 25 patients each were divided into two groups by randomization and were operated using Lichtenstein’s hernioplasty and Desarda’s technique. Patients were assessed for cost effectiveness, operation time, postoperative pain, hospital stay, foreign body sensation, return to non-strenuous activity, complications and recurrence rate in the postoperative period on day 1, 3, 5, 1 month and 6 months.Results: With regards to pain, foreign body sensation and duration of surgery Desarda’s repair was better than Lichtenstein’s repair (p<0.05). Mean hospital stay in Desarda’s group was comparable to the Lichtenstein group (p=0.16). Return to normal non-strenuous activity after 7-15 days in Desarda was 80% and 64% in Lichtenstein. No case of recurrence or chronic groin pain in either group was found.Conclusions: Based on the result, reduced cost of treatment, lesser post-operative pain and no mesh related complications authors can conclude that Desarda’s technique is equally effective as Lichtenstein’s repair for inguinal hernia and can consider it as the method of choice in treating inguinal hernia.
ABSTRACT
Background: Surgical wound infection is one of the most commonly occurring complications and its incidence has been lowest in clean surgical cases. Prophylactic antibiotics are routinely used in all surgical cases. But this is not indicated in clean surgical cases. Due to undue fear of infections, many practicing surgeons use antibiotics in clean surgical cases. Misuse of antimicrobials leads to drug toxicity, super infections, high health care cost and colonization of wards by highly resistant microbes. Objective of the study is to compare the frequencies of wound site infections in patients undergoing clean elective general surgery operations with no antibiotics and single dose prophylactic antibiotics.Methods: A comparative study of 100 patients undergoing elective clean surgeries at Victoria Hospital from November 2012 to October 2014 was undertaken. Data was collected by history taking, clinical examination, hematological and microbiological investigations and follow up.Results: Two cases in each group had post-operative infections noticed on the day 2 wound examination. All the four cases had culture positive with isolates being S. aureus in three and E. coli in single case.Conclusions: Post-operative wound infections noted in two cases in both the groups do not have any clinical and statistical significance; hence single dose of prophylactic antibiotics is not required in all the clean surgical cases. A simple size of large number is required in this area of research to conclude with statistical significance.