Fistulae in ano following anorectal abscesses

This study was carried out to determine whether primary fistulotomy should be performed at the time of incision and drainage of anorectal abscesses and what% age of patients would develop fistula-in-ano or recurrent abscess. The record of 77 patients was reviewed who underwent incision and drainage of anorectal abscesses. Out of 77 patients, thirteen [16%] developed recurrent abscesses and 26 [34%] developed persistent fistulain-ano, with combined recurrence rate of 51%. This supports the policy of fistulotomy in the second sitting especially to prevent any complications and also of the fact that 59% would not need it

Peripheral vascular injuries due to trauma: pims experience

Peripheral vascular injuries due to trauma are on the rise in Pakistan. Morbidity in the form of amputation is very high because of late presentation of the patients to a centre where facilities for vascular surgery are available. The purpose of this study was to identify the factors responsible for late presentation, and poor outcome of vascular repair in such cases. Clinical and operative details of 51 patients with peripheral vascular trauma, who underwent surgical intervention between 1994 to 1998 at PIMS, were reviewed. Type of injury, mode of presentation, time between injury and arrival to the hospital, methods of vascular repair, use of graft or vein, and outcome of the procedure were analyzed.Patients with late presentation, combined arterial and venous injuries involving the popliteal artery and its branches were associated with high amputation rate, There were 45 arterial and 6 isolated venous injuries. After surgical repair, 9 [17.5 percent] patients required amputation due to various reasons. Time is the key factor in determining the final outcome of vascular repair. The delay can be avoided by rapid transfer of such patients to a major hospital

Liechtenstein's repair

Inguinal hernia is a common surgical problem. In this study one hundred patients of inguinal hernia operated in our department from January 1991 to August 1992 are evaluated and hernioplasty using Gore Tex patch and prolene mesh is compared with various techniques of herniorrhaphy

Parenteral sulbactum and ampicillin in general surgery

Thirty six patients [24 males, 12 female; mean age 42 years] hospitalized to undergo incision and drainage for documented or suspected surgical infections were treated with a combination of sulbactam and ampicillin. Mean daily dose employed was 1.25 gm sulbactam and 2.5 gm ampicillin given intravenously for a mean treatment period of 10 days. A clinically satisfactory response [cured plus improved] was achieved in 78% of patients with a response rate of 100% in cases of non-perforated appendicitis, sepsis traumatic wound infections and cellulites. Ninety two percent of the pathogenic bacteria isolated from infecting sites in 11 patients, were found sensitive to sulbactam/ampicillin. Complete to partial elimination of bacteria was recorded at the end of study in 82% of these patients. The results of this study indicate that sulbactam/ampicillin is an effective and well tolerated agent for the treatment of surgical infections requiring parenteral antibiotic therapy