Safe electrosurgery use: knowledge, attitudes and practices of surgical trainees

To determine the knowledge, attitudes and practices of general surgical trainees regarding safe use of diathermy. In this cross-sectional Survey, 47 surgical trainees of the Civil Hospital Karachi, comprising PGY 1 through 4, were interviewed by questionnaires made up of five close-ended and three open-ended items. Majority of the trainees belonged to the first two years of training. More than 80% had no formal training in diathermy use. Most of them were found lacking in core knowledge and evidence-based practice of electrosurgery. There was a high level of ignorance regarding current and established principles of diathermy use among surgical trainees at the Civil Hospital Karachi

Laparostomy: three year experience in a tertiary-care unit

Laparostomy is a temporary measure to avoid abdominal compartment syndrome as well as allow repeated and ready access to abdomen for lavage. This study was conducted to identify the indications and analyze the outcome of laparostomy in a tertiary care surgical ward. This prospective study was conducted on laparostomy cases between March 2008 and February 2011. Data was analyzed for the indication, clinical course and final outcome. Results were expressed as frequency-percentage, means, procedural morbidity and overall mortality. A total of 16 laparostomies were performed during the study period. All 16 patients were operated in emergency. Burst abdomen with impending intra-abdominal hypertension was the most common indication followed by "grossly edematous bowel" which made primary closure impossible. A delayed deep tension closure was possible only in eight patients. Four patients died in the postoperative period. Persistent wound sepsis was the most common morbidity. Laparostomy is often necessitated by the desperate situations encountered in emergency surgery

Pilonidal sinus: following the Aristotelian middle!

Pilonidal sinus of the sacrococcygeal region is a fairly common malady. Many surgical and non-surgical methods have thus far been described with variable success rates. No standard operation is in practice, owing to discouraging rates of recurrence. A simple excision and primary repair is described with fairly good results. Thirty two patients with this condition were operated upon by the author between January 2003 and December 2007. A simple excision and primary repair were undertaken in all. Their retrospective data were tabulated from the respective files and analysed. Mean follow-up period was 11.7 months [range, 6-24 months]. Only two patients had partial dehiscence of the suture line that responded to conservative management. There was no full-fledged recurrence in the duration of follow-up. Simple excision and primary closure is a straightforward procedure with good results. A meticulous technique, including follow-up advice [hygiene, depilation etc.] can have a beneficial effect on post-operative outcomes