Complete abdominal wound dehiscence incidence

This study was carried out on 690 patients with abdominal surgery excluding hernia operations, appendicectomy and minor procedures. This was carried out in Assiut University Hospital, Department of General Surgery in the period from April 1994 to April 1996. Twenty-two risk factors were checked for each patient [personal, general and local] to look for the significant factors and the relation between wound disruption and the total number of factors. It was found that with six factors or more disruptions is inevitable and when the number of factors reached eleven death is expected. These risk factors were arranged in the order of their significance in relation to disruption and death

six months evaluation of the trauma admissions in Assiut University Hospital

This study was done in Assiut University Hospital from January 1994 till the July 1st, 1994 and included all patients admitted in the trauma unit. The study aims at evaluation of the magnitude of this problem and proceeding to further evaluation of the needs of that center. This study included 1178 cases with 777 [66%] males and 401 [34%] females. The type of trauma varied, but it can be collectively classified into five categories. The major cause is falling from a height: 696 cases [59%], the second is road traffic accidents: 351 cases [29%], the third is fire injuries: 31 cases [2.6%], the fourth is stab wound injuries: 27 cases [2.3] and lastly other causes which account for 6.3% of the causes. Age and sex incidence varied in each type of trauma

Management of splenic trauma

This work included 90 patients with splenic trauma, 76 [84.4%] males and 14 females [15.6%]. Ages varied between 5 and 50 years with a median of 19.4 years. The highest peak lies between 11 and 20 years. On analysis of the cases of trauma, the patients were divided into 5 groups. Falling from a height accounts for the highest number of cases which was 32 [35.5%] followed by road traffic accidents [24 cases] [26.6%], stab-injuries due to civilian violence accounted for 12 cases [13.3%], fire-arm injuries were seen in 8 cases [8.8%]. Other causes including blunt violence [6 cases] and iatrogenic injuries [8 cases] had good participation. Diagnosis based on rapid history and clinical evaluation with ultrasound examination of all patients. Laboratory tests played a minor role for diagnosis. 28 patients underwent splenectomy. 16 patients were subjected to splenerrhaphy, partial splenectomy was done in 20 cases and splenic autotransplants [after splenectomy] was done in 26 cases. Early postoperative complications were minor and none of the patients died in the early postoperative period. All patients were followed every 3 months for detection of remanents of splenic tissue and for detection of post-splenectomy infection. Only one case of over-whelming post- splenectomy infection [OPSI] was picked-up [following splenic autotransplantation]. It was clear that splenic preservation techniques can be safely done. The impetus is the recognized risk of [OPSI] especially in the pediatric group

Darn repair in inguinal hernia

This study included 260 cases with inguinal hernia, the majority were males [255 cases], and the ages varied from 15 to 60 years. Right sided hernias were 170 cases [65.4%] and left sided hernias were 90 [34.6%]. Bilateral hernias were 21 but, only one side was considered for operation at a time. Indirect hernias were 230 [88.5%] and direct hernias were 30 [11.5%]. Out of the total number, 20 patients had huge hernias and 11 cases proved to be of the sliding variety, 28 patients had strangulated hernias and 30 cases were darned for recurrent hernias. All patients were subjected to general and local examination. Cases of chronic straining were of prime importance to be corrected before surgery. Anesthesia was general endotracheal inhalation type. Antibiotic prophylaxis was given as cefradin 1 g I.V. 1 hour preoperatively and 1 and 8 hours postoperatively. Antibiotics were further given only for cases with signs of wound sepsis. Follow up monthly for recurrence, hydrocele, paresthesia and testicular atrophy was performed. 12 [4.6%] cases showed wound sepsis. 14 [5.4%] cases had postoperative hydrocele and only 3 cases persisted and required further scrotal operation. Inguinal pain of moderate severity was noticed in 9 cases [3.5%]. Only 7 [2.7%] cases showed recurrence and 2 cases out of these had huge sliding hernias

Delorme's procedure for complete rectal prolapse

26 cases of complete rectal prolapse were operated upon by Delorme's procedure between January 1991 and December 1992 with a follow up for recurrence till December 1993. Age ranged between 23 and 82 years. There were 22 males and 4 females. Two cases of recurrence were seen [ages 58 and 76]; one of them was successfully reoperated and the other resorted to an abdominal procedure. Only one case developed mucosal prolapse which was treated by ligation excision. Four patients with associated incontinence to solid stools and gas were corrected for both by Delorme's procedure. This procedure proved to be easy and safe especially in debilitated patients