Surgical Management of Cases Presenting with Diabetic Foot in Kosi Region of Bihar.

Introduction: The major complication of diabetes is the foot ulcer with a poor tendency to heal thus leading to complications. The outcome of the complications of a patient with diabetic foot can be favorable if proper and timely surgical intervention is provided by the attending surgeon by means of regular dressing, wound debridement, amputation, and use of proper antibiotics supported by sensitivity report. Aim: The aim of the present study was to undertake different surgical treatments available in management of diabetic foot. Materials and Methods: A total of 100 diagnosed cases of diabetic foot were studied over a period of 3 years in the Department of General Surgery at Katihar Medical College with emphasis on surgical modalities of treatment of diabetic foot and its complications. Results: Males are more prone to surgical complications 3 times than females because of more outdoor activities. It is more prevalent in the age group 51-60 years (36%). In the treatment schedule, 38 patients were managed by daily dressing and wound debridement and slough excision, 20 patients with a split skin graft, 16 patients under went incision and drainage for an abscess. 16 patients with gangrene of toes and phalanges underwent disarticulation. Transmetatarsal amputation was done in 4 cases, below the knee amputation in 4 cases and above knee amputation in 2 cases. In the course of treatment, the minimum stay in hospital was 1 week and maximum 96 days. Conclusion: Diabetic foot has varied presentation as shown by this study. Good results can be obtained by adopting a multidisciplinary approach for diabetic foot lesions. The patient education for care of feet such as pairing of nails, wearing proper footwear, and prompt reporting to doctor in case of early lesion in foot is important as diabetic foot is very prevalent in Kosi region of Bihar.

Repair of extrahepatic biliary duct

A new technique is reported for repair of extrahepatic biliary tract injury at the confluence of right and left hepatic and common bile duct. This is an experience of 03 cases of such an injury. We used T-tube, angulated in such a way as to make a Y-tube with short limbs for right hepatic duct and left hepatic duct

Progeressive hair coil strangulation of penis

Strangulation of penis by hair strands is a well-known, but uncommon clinical entity. We report two cases occurring in circumcised boys causing progressive painless disfigurement of penis with strands of hair coiled around the penile shafts, strangulating the penis. Primary repair was done in one case and delayed primary repair was done in the other, both with satisfactory results