Fascial slings: a new adjunct to Brachiobasilic Fistula Elevation fascial slings

Objective: To introduce a new technique of fascial slings created from fascia over biceps muscle as an adjunct to Brachiobasilic fistula elevation contributing in the ease of cannulation and position of arm for both nursing staff and the patient

Study Design: Retrospective study

Place and Duration of Study: This study was carried out in Combined Military Hospital Rawalpindi, form Jan 2016 to Apr 2017

Patients and Methods: The demographic and outcome data of the patients, who underwent Brachiobasilic Elevation using fascial slings, were collected and analyzed retrospectively

Results: A total of 89 [60 males, mean age 44.2 +/- 14 years and 29 females mean age 42.6 +/- 12 years] patients underwent brachiobasilic fistula elevation. The distance of fistula vein from skin incision at mid arm was found to be consistent from the per op measurement till the last assessment at 6 months. In our study it was 5 +/- 0.7 cm. Slinged vein was found to be easy to cannulate in first prick as per dialysis nursing staff. Fistula maturation rate was 91 Percent. A total of eight [9 Percent] fistulae were never put on dialysis because of thrombosis. The mean maturation time was 40 +/- 14 days. Fifteen [16 Percent] patients had arm edema, and twelve [13 Percent] had infections. Patients had similar ease of arm position as of brachiocephalic AVF during dialysis

Conclusion: Considering the consistent post op distance of fistula vein from scar site, ease of cannulation for the dialysis staff and comfort of arm position for the patient during dialysis after fascial slings it is concluded that fascial slings are good adjunct to basilic vein elevation technique

Polydioxanone vs prolene closure for midline abdominal incisions: to compare postoperative wound dehiscence

The objective of this study was the comparison of Polydioxanone and Prolene for midline abdominal closure in terms of postoperative wound dehiscence. Randomized control trial. This study was conducted at Department of Surgery, Sheikh Khalifa Bin Zaid AlNahyan Hospital Rawlakot Azad Kashmir from 20-12-2012 to 25-12-2014. We studied 106 patients for midline closure of abdominal surgery. We made two groups [Group A consisted patients in whom abdominal closure was done with Polydioxanone no. 1 and Group Bcontained patients who underwent closure with Prolene no. 1. The outcome variablewas wound dehiscence. The average of age for 106 patients was 36.88 +/- 13.28 years. In group A, the wound dehiscence was seen in 4 [3.8%] patients while in group B it was seen in 12 [11.3%] patients. Wound dehiscence was considerably high in group B as compared to groups A, [p-value < 0.05]. Polydioxanone is a synthetic absorbable suture which retains its strength for longer than other absorbable materials. According to our experience Polydioxanone causes less wound dehiscence as compared to Prolene in midline abdominal wound closure

Postoperative wound infection after midline abdominal incisions

Objectives: The objective of this study was to compare postoperative wound infection rate after abdominal closure with Polydioxanone and prolene for midline incisions

Study Design: Randomized control trial

Place and Duration of Study: This study was conducted at the department of Surgery Sheikh Khalifa Bin Zaid Hospital Rawlakot Azad Kashmir from 09-05-2013 to 28-05-2015

Materials and Methods: Total of 106 patients undergoing elective and emergency laparotomies. In this randomized control trial conducted at Sheikh Khalifa Bin Zaid Al Nahyan Hospital Rawlakot Azad Kashmir Department Of Surgery, we studied 106 patients for midline closure of abdominal surgery. We made two groups [Group A consisted patients who underwent abdominal closure with Polydioxanone no. 1 and Group B contained patients who underwent closure with Prolene no.1]. The outcome variable waswound infection

Results: The average age of 106 patients was 36.88 +/- 13.28 years with range of 49 years. Statistically the post operative wound infection was present in 25 [23.6%] patients, in which 7 [6.6%] were from group A and 18 [18%] were from group B. The percentage of wound infection was statically higher in group B as compared to group A [p-value < 0.05]

Conclusion: Polydioxanone is inert in tissues if we compare it with other absorbable materials. According to our experience, Polydioxanone causes less wound infection as compared to Prolene in midline abdominal woundclosure