ABSTRACT
Objective: The objective of the study is to compare circumcision by plastibell and open method in terms of bleeding, infection and cosmesis
Study Design: Randomized clinical trial
Place and Duration of Study: Surgical ward, Combined Military Hospital, Kharian from Aug 2011 to Sep 2012
Material and Methods: All individuals fulfilling inclusion criteria underwent circumcision in the operation theatre of CMH Kharian as indoor patients, under local anaesthesia and aseptic measures. In group 1, circumcision was done using plastibell where as in group 2, circumcision was done by open method
Results: Mean age in plastibell group was 3.37 months [SD=1.77] and in open group was 3.12 months [SD=1.33] [p=0.100]
In plastibell group 18% had bleeding however in open group 4% had bleeding [p<0.001]. In plastibell group 4% patients had infection. However in open group 15% had infection [p<0.001]
In plastibell group 82% parents were satisfied whereas 18% had extra skin, whereas in open group 96% parents were satisfied, 1% had extra skin and 3% had less skin [p<0.001]
Conclusion: Circumcision being a commonest surgical procedure demands careful selection of the operative procedure because plastibell method is superior in terms of post-operative infection whereas open method is better in terms of cosmesis and post-operative bleeding
ABSTRACT
To compare laparoscopic and conventional open appendectomy in terms of operative time, hospital stay and frequency of surgical site infection [SSI]. Quasi-experimental study. Combined Military Hospital, Quetta from 6[th] Jun 2010 to 1[st] Sep 2011 and Combined Military Hospital, Multan, Pakistan from 2[nd] Sep 2011 to 5[th] Jun 2012 over a period of 2 years. A total of 417 patients underwent appendectomy during this period. 137 patients underwent laparoscopic appendectomy [group A] while 280 patients had open appendectomy [group B]. The sample includes all patients who were operated upon, between the time-span of June 2010 to September 2011. A chi square-test was performed to compare the data for statistical significance. Mean operative time for group A was 79.21 +/- 23.42 minutes whereas in group B, the mean operative time was 41.49 +/- 20.86 minutes. Group A patients had a shorter hospital, 1 stay [3.6 +/- 1 day] but in group B, it was [5.2 +/- 3 days]. Seven patients [5.1%] developed surgical site infection [SSI] in group A and 34 patients [12.14%] developed postoperative SSI in group B [p < 0.05]. Laparoscopic appendectomy is superior to open appendectomy because of shorter hospital stay and lesser post-operative SSI, but requires longer operative time