RESUMEN
Objective: To determine the frequency of tube thoracostomy in penetrating thoracic injuries at a tertiary care hospital
Study design: Cross sectional study
Place and Duration of study: Department of Surgery Unit III, Civil Hospital / Dow University of Health Sciences Karachi, from March 2012 to March 2014
Methodology: All patients who presented with penetrating chest injuries due to firearm, stabs etc were treated according to ATLS protocol. Tube thoracostomy was performed when indicated. Chest tube was passed under local anesthesia
Results: A total of 100 patients included in this study. There were 92 males and 8 females. Mean age of the patients was 30+7.29 year. Mechanism of injuries included gunshot injury [n=62], stabs [n=24] and shrapnel injury [n=14]. Pneumothorax was diagnosed in 39 patients, haemothorax in 35, sucking wound of the chest in 20 patients and major vascular injury in 4 patients. Associated extra thoracic injuries were present in 26 patients. Tube thoracostomy was performed in 78 patients. Twenty-two patients underwent thoracotomy
Conclusions: Majority of patients with penetrating chest injuries were managed by tube thoracostomy. No mortality occurred in this series
RESUMEN
Objective: To find out the frequency of seroma, wound infection and wound disruption in patients of ventral abdominal hernia operated with onlay and sublay mesh plasty
Study design: Cross sectional study
Place and Duration of study: Department of General Surgery Dow University of Health Sciences and Civil Hospital Karachi, from January 2010 - December 2014
Methodology: Ventral abdominal hernia patients were selected randomly for the procedure of onlay and sublay mesh plasty. Fifty patients each were operated with either of the techniques. Postoperatively patients were observed for the complications; seroma, wound infection and wound dehiscence. All patients were followed for a period of two weeks
Results: A total of one hundred patients were enrolled. Fifty of them had onlay and fifty underwent sublay mesh plasty for ventral abdominal hernia. There were 18 [18%] males and 82 [82%] females with male to female ratio of 1:4.5. Minimum age was 22 year and maximum 55 year. There were 55 [55%] para umbilical hernia, 14 [14%] umbilical, 14 [14%] epigastric and 17 [17%] incisional hernia. Maximum number of cases of wound infection were noted in onlay mesh plasty group [n=16, 16%] while in sublay group only six [6%] had this complication
Conclusion: Sublay mesh plasty technique for ventral abdominal hernia repair had less frequency of complications
RESUMEN
To evaluate the indications and outcome of small and large bowel stomas made during emergency intestinal surgery. Cross sectional study. Dow University of Health Sciences Civil Hospital Karachi, from January 2006 to December 2012. All emergency exploratory laparotomies performed for intestinal surgery, managed by stoma were included in this study. Decision for making stoma was based upon etiology, condition of the gut and judgment of the operating surgeon. Total numbers of patients were 200 [male 114, female 86] with mean age of 32.7 year. Trauma was the most common etiology. Firearm injury was the commonest mode [n=67, 33.5%] followed by stab wounds and blunt trauma [n= 12, 6.0%]. Patients also presented with perforation leading to peritonitis [n=65, 32.5%] and intestinal obstruction [n=52, 26%]. Tuberculosis was diagnosed in 5 [26.5%] patients, typhoid perforations in 35 [17.5%] and malignancy in 30 [15%] cases. The mortality in this series was 10%. Wound infection occurred in 42 [21%], burst abdomen in 10[5%] and enterocutaneous fistula and stoma retraction noticed in 6 [3%] patients. Stoma formation was a helpful adjunct surgical procedure performed in emergency intestinal surgery for various conditions with satisfactory outcome