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Background: Gastric cancer (GC) is a heterogeneous, multifactorial disease. It endangers human physical and psychosocial wellbeing, causing a significant public health and economic burden in developed and developing countries. To compare the early postoperative outcome between linear cutting stapling device gastro-jejunostomy & traditional hand sewn gastro-jejunostomy for gastric cancer. Material & Methods: The study was a Prospective observational study which was conducted in Department of Surgery, Dhaka Medical college & Hospital, over Six months period after approval of protocol using a semi-structured questionnaire through face to face interview. Data were analysed using a computer programme SPSS 24.0 version. Results: Total 40 patients were enrolled in this study among them 20 patients underwent traditional hand sewn gastro-jejunostomy (Group-A) and 20 patients underwent Linear Cutting Stapling Device gastro-jejunostomy (Group-B). The mean age of the total participants was 57.45±7.04 years where in Group A mean age was 57.30±7.14 years and in Group B mean age was 57.60±6.83 years. The overall mean BMI of the patients was 21.94±1.61 kg/m2. Among all the respondents 25% had comorbidity. Operation time and time for anastomosis were significantly higher in Group A than Group B but no significant difference was found in relation to hospital stay and post-operative blood loss. About 15% had Anastomotic hemorrhage, 10% had Anastomotic leak, 5% had Intra-abdominal abscess and 5% had bowel obstruction in Group A beside 5% had Anastomotic hemorrhage, 5% had Anastomotic leak and 5% had SSI in Group B. Among all 10% needed blood transfusion in Group A and 5% needed blood transfusion in Group B. No significant difference has been found with post-operative complications between both groups. Conclusion: Observed advantages of Linear Cutting Stapling Device Gastro-Jejunostomy in this study were the significantly reduced operation time and anastomosis time.
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Surgical site infection is more prevalent in open gastrointestinal surgery which will affect hospital stay and morbidity and mortality of patients.In our study,we are comparing the factors which will directly or indirectly causes SSI.By knowing the factors which causing SSI,We can decreases the incidence of surgical site infection.
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We herein report a patient who complained persistent exudate at navel in spite of adequate antibiotics therapy after laparoscopic cholecystectomy was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. senkinnaitakusan is still unknown, but this formulation has been used for persistent infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and exhibit anti-inflammatory function. There have been no reports of Kampo therapy for the superficial incisional site infection associated with laparoscopic surgery. The authors propose that Kampo medicine is another promising option in the management of surgical site infection (SSI).
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Background: Breast malignancy is one of the highest ranked malignancy occurring among Indian females, overall incidence being 25 per 1, 00,000 females varying across different states. Breast cancer surgeries are one of the commonest surgeries being conducted which is considered to be a clean procedure pretending to be at lower risk of complications. However it is has been observed that patient develops surgical site infection at an increased rate approximately 19% which leads to poor quality of life, increased hospital stay and delay in commencement of adjuvant therapies. The aim is to Co-relate risk factors for surgical site infection in patients undergoing surgery for carcinoma of breast. The objective of this study was to observe the relation of surgical site infection and its associated risk factors in the patient undergoing surgery for carcinoma breast.Material & Methods:We analyzed 50 patients diagnosed with carcinoma breast and operated for the same in Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh. Patients were divided into two groups, Group A who develop surgical site infection and Group B who don抰 develop surgical site infection. All the predisposing factors including age, BMI, Addiction, co morbidity, Neo-adjuvant therapy, preoperative total leucocyte count were recorded. An observation was done with above mentioned risk factors and correlated with development of surgical site infection.Results:In our study we found that the risk factors associated with surgical site infection post breast cancer surgeries were age, BMI, co morbidity, Addiction and Neo-adjuvant therapy.Conclusions:Patients of Age more than 50years or who underwent Mastectomy or having associated co-morbidity with co-relation to Smoking & BMI more than 30, with Increased TLC count or who have received Neo-adjuvant chemotherapy are associated with increased risk of SSI following breast surgery which has led to increased hospital stay. There are many other studies who also concluded the relation of above factors with development of SSI post breast surgery, however further research is needed to elucidate the effect of prior manipulation and radiation therapy in development of SSI.
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Objetivo: determinar el número de pacientes que desarrollaron una infección postquirúrgica, posibles agentes etiológicos y complicaciones.Métodos : se realizó un estudio retrospectivo observacional que incluye a todos los supervivientes de las cirugías electivas y de emergencia de los servicios de Cirugía I, II y III del Hospital Universitario de Caracas durante el año 2019. Los datos fueron recopilados a través de la revisión de historias médicas. 48 historias cumplieron los criterios de inclusión, en estas se analizaron distintas variables como: días de hospitalización, síntomas, resultados de laboratorio, cultivos microbiológicos y tratamientos. A partir de estas se elaboraron tablas de frecuencia y análisis bivariado (Chi-cuadrado de Pearson) con el programa IBM SPSS Statistics 26.Resultados : la prevalencia de las infecciones postoperatorias fue de 4,69% CI 95% = (2,79-7,16%) en los servicios de Cirugía (I, II y III) del hospital durante el año 2019, la mayoría ocurrieron tras cirugías de emergencia (87,50%) tales como: apendicectomías (45,83%) y colecistectomías (10,41%). Solo al 22,91% de estos pacientes se les realizó cultivo microbiológico donde se encontró:E. coli (10,50%), Enterococcus sp. y Klebsiella pneumoniae (6,24%), Morganella morganii (2,1%) y Streptococcus pneumoniae (2,1%). Conclusión : las infecciones del sitio quirúrgico siguen siendo una de las principales causas de morbi-mortalidad y aumento de la estadía hospitalaria en los servicios de cirugía, son de diversa etiología bacteriana y están mayormente asociadas a cirugías abdominales, de emergencia(AU)
Objective: to determine the number of patients that developed a surgical site infection (SSI), possible etiologic agents and complications.Methods : an observational and retrospective study that includes every patient that underwent and survived a surgical procedure at the general surgery I, II and III services at the University Hospital of Caracas between January and December 2019. The study data were collected through the review of the medical records. 48 medical records that met the inclusion criteria and different variables were analyzed, including: days of hospitalization, symptoms, laboratory results, microbiological cultures and treatments. From those variables, frequency tables and bivariate analysis (Pearson's Chi-Square) were created with the IBM SPSS Statistics 26 program.Results : the SSI prevalence was 4,69% CI 95%= (2,79-7,16%) including the three surgery services (I, II and III) at the University Hospital of Caracas during 2019. Most of these occurred after emergency surgeries (87,50%) among which stand out: appendectomy (45,83%) and cholecystectomies (10,41%). Microbiological cultures were performed only in 22,91% of these patients and the following bacteria were isolated:E. coli (10,50%), Enterococcus sp. plus Klebsiella pneumoniae (6,24%), Morganella morganii (2,1%) and Streptococcus pneumoniae (2,1%). Conclusion : Surgical Site Infection (SSI) continues to be one of the main causes of morbimortality and increased hospital stay in surgical services in the hospital. These infections have a diverse bacterial etiology and are mostly associated with abdominal or emergency surgeries(AU)
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Humanos , Masculino , Feminino , Infecção da Ferida Cirúrgica/etiologia , Hospitais de Ensino , Sinais e SintomasRESUMO
Background: Conventional antibiotic therapy during operation not only increases the financial burden on patient, not only increases chances of adverse reactions among them but also not effective in reducing the infection rate after surgery. Single dose prophylactic antibiotic or maximum 24 hours dosing during or before surgery was found to be equally effective. Objective was the to study utility of single shot antibiotic prophylaxis in patients undergoing surgeryMethods: This prospective study includes 100 clean elective surgical cases randomized to groups of 50 each. Single dose prophylactic antibiotic was given to cases in the study group and conventional antibiotic therapy was given to cases in the control group. Study group cases received Injection Ceftriaxone in the dose of 2 gm intravenously. This was given at induction or half an hour before the incision was given. Second dose was given if there was delay in starting the surgery for more than three hours. Dose of the antibiotic was adjusted for children, underweight and obese persons. For cases in the control group. Injection ceftriaxone 1 gm was given intravenously twice a day for three days. Surgical site infection incidence was recorded.Results: Both the groups were comparable for age, sex, diagnosis and hence the type of surgery performed. The incidence of fever, redness, swelling and wound discharge which are the signs of surgical site infection after surgery was not found to be statistically significantly different. Management protocol was also not significantly different after the surgery.Conclusions: Single shot antibiotic before surgery is equally effective in reducing the incidence of surgical site infections (SSIs) compared to conventional antibiotic therapy.
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Introduction: Surgical site infections (SSIs) are one of themajor causes of morbidity and mortality in developing countriesdespite recent advances in aseptic techniques. The SSIs dueto emerging multidrug resistance (MDR) bacteria isolates areconsidered as grave threats to the public health worldwide.Each hospital has specific type of microbial flora from whichinfection initiates. In such condition microorganism showsunique type of antibiotic susceptibility and resistance pattern.In this study we report on the microbiological spectrum ofSSIs and the antimicrobial susceptibility pattern with a viewto provide guide to the clinicians for making rational decisionover the choice of antibiotics in the management of surgicalsite infection.Material and Methods: This cross-sectional study wascarried out in a tertiary care hospital and the 560 sampleswere collected, processed in the microbiology laboratory andevaluated for the study.Results: Out of 376 growth positive samples, Gram NegativeBacilli (GNB) were isolated from 271 (72%) samples andGram Positive Cocci (GPC) were isolated from 105 (28%)samples. Among the isolated GNB, only 5 to 10% weresensitive to third generation Cephalosporins. Sensitivity toFluroquinolones (Ciprofloxacin and Levofloxacin) was alsolow (Only 5% to 10% were sensitive). Only 3 to 15% of theGNB were found sensitive to Co-amoxiclav and 6.5% to 23%were sensitive to Ampicillin-Sulbactam. About 60% of thePseudomonas aeruginosa and about 40% of the Klebsiellaspp and Acinetobacter baumanii were found resistant toMeropenem.Conclusion: Gram Negative Bacilli predominated overGram Positive Cocci in surgical site infections in our setup. Very low sensitivity to 3rd generation Cephalosporins,Ampicillin, Co-amoxiclav and Fluroquinolones was notedamong GNB isolates and an increasing pattern of resistanceto Aminoglycosides and Carbapenems was also noted amongMDR Pseudomonas aeruginosa and Acinetobacter baumaniiisolates. More than 50% of the MDR Acinetobacter spp.were was found sensitive to Ampicillin- Sulbactam andMinocycline.
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Introduction: Professional medical education needs hardwork, good physical and mental health. In previous studiesthere is no scientific consensus that a relationship existsbetween the ABO blood group and personality traits. In thiscurrent study we tried to find out association between differentblood groups and different type of stressors like physical,environmental, interpersonal and academic in young medicalstudents.Material and methods: This Descriptive Cross sectionalstudy was conducted at Rashid Latif Medical College Lahorefrom April to May 2019. A modified pre structured, valid andreliable questionnaire SSI was used to access the physical,academic, environmental, interpersonal stress, blood groupand gender of 1st year and 2nd year MBBs students. Initially220 (91 male and 129 female) were enrolled.Results: A total of 216 medical students filled in the survey outof 220 students, 126 students (n=126) were female and (n=90)were male who completed the questionnaire; the response ratewas 98.18%. Out of 216 students blood group A was 32, ABwas 42, B was 92 and O was 50. A greater variation in theresponse was observed in the physical category (St: deviation10.40), while the least variation was observed in the categoryof interpersonal (St: deviation 5.27), respondents while thevariation tends to increase in environment (St: deviation 6.78)and academic (St: deviation 7.20).Conclusion: All variables stressors like Physical, academic,environment and interpersonal are found to have negativeand insignificant relationship with dependent variable bloodgroup.
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Surgical site infections (SSI) are the most common nosocomial infection and frequently cause morbidity and mortality among inpatients of hospitals. The aim is the analysis of the risk factors for Surgical Site Infections. Methods: In this study, 100 surgically operated cases were taken with age group between 15-60 years. Study was done in surgery department of District Hospital Sikar from January 2015 to December 2015. All cases were registered fulfilled the inclusion criteria. Results: Out of 100, 20 patients had surgical site infection. The SSI rate was 1% in clean surgeries, 9% in clean contaminated ones, 30% in contaminated ones and 60% in dirty surgeries. The SSI rate was significantly less in patients who received pre-operative antibiotic prophylaxis. Most common organism involved was staphylococcus aureus. Conclusion: The incidence of SSI is high in our setup. Elderly age group, diabetic, immunocompromised have more chances to have SSI than others.
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Presence of haematoma, serous fluid, and dead space in a wound increase the risk of infection as they act as a culture media. Multiple options had been mentioned to reduce these risks. We tried to assess the incidence of SSI following placement of closed suction drains following elective surgeries. Methods: A prospective observational study was conducted in the Department of General Surgery, IPGMER & SSKM Hospital, Kolkata from January 2016 to June 2017. Patients who were given a subcutaneous suction drain after an elective general surgical procedure were included in the study. Patients unwilling to take part in the study, patients from paediatric age group, on steroids, with Class 4 wounds and those underwent Laparoscopic Surgery were excluded. Outcome was measured in the form of presence or absence of SSI and data was analysed. Results: No statistically significant decrease of incidence of SSI was found in terms of different age, sex, socio-economic status, duration of hospital stays, smoking or alcoholism. Increased incidence of SSI was detected among Diabetics even after using closed suction drainage. Conclusion: Placement of closed suction drain did not significantly reduce incidence of SSI following elective general surgical procedures.
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Introduction: Surgical site infections are most commonhospitals acquired infections and are an important cause ofmorbidity and mortality. The objective of our study is toconclude the causative bacteria and antimicrobial sensitivityof surgical site infections.Material and methods: A total of 275 various clinicalsamples received in Microbiology Laboratory, GovernmentMedical College, Bettiah (West Champaran) Bihar andAssociated Hospital. from March 2018 to April 2019. Atotal 101 Staphylococcus aureus isolated, were identifiedby standard biochemical methods. Antibiotic susceptibilitytesting was performed by Kirby Bauer Disc Diffusion method.Methicillin resistance was detected by using cefoxitin (30µg)disc diffusion method as per CLSI guidelines 2016.Result: Out of the 275 aerobic bacteria which were isolated,144 were gram positive cocci (52.37%) and 131 were gramnegative bacilli (47.63%). The most common pathogenfollowed by Staphylococcus aureus 101 (36.36%). Otherorganisms were Escherichia, Pseudomonas, Klebsiella,Citrobacter, Proteus, and Enterococcus. The Antimicrobialprofile of 101 Staphylococcus aureus isolates among MRSA,resistance those they were 100% sensitive to linezolidand vancomycin, with moderate sensitivity (71.14%) tocefuroxime, gentamicin and least sensitivity to (23.81%)doxycycline, (20.95%) ciprofloxacin.Conclusion: Isolation of MRSA patients and carriers in thehospitals, regular surveillance, and monitoring of antibioticsusceptibility pattern of the hospital and community of thatregion regularly and formulation of antibiotic policy may helpin reducing the treatment failures.
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Objective : Risk factors for SSI after open heart surgeries were evaluated in relation to a bundle of SSI preventive measures. Methods : Research design is a retrospective cohort study. The study population was 1,579 patients who had received open heart surgeries at Kobe City Medical Center General Hospital from January 2008 to December 2010 (Period I : when standard infection prevention measures were implemented) and from January 2014 to December 2016 (Period II : after a relocation of the hospital to a new campus and enhanced infection prevention measures were implemented). Factors associated with SSI were determined using univariate modelling analysis followed by multi-variate logistic regression analysis. The Center for Disease Control and Prevention definition of SSI was used for case determination. Results : Overall SSI incidence was 4.5%. SSI incidence decreased significantly from 6.6% in Period I to 2.9% in Period II (p＜0.001). Significant improvement in adherence to the recommended preventive measures was observed in Period II in selection of appropriate antibiotics, discontinuation of prophylactic antibiotics within 72 h after surgery and glucose control on post-operative Day 1 and 2 (p＜0.001). A univariate analysis showed statistical significance in surgical procedure, surgical period, surgical duration, post-operative day 2 morning glucose level, administration of prophylactic antibiotics within 1 h before incision, 100% compliance with the Bundle. Complex surgery (odds ratio 2.5 ; 95%CI 1.3～4.8) were identified as a risk factor by multiple logistic regression. Surgical period (Period II, odds ratio 0.41 ; 95%CI 0.28～30.71) and administration of prophylactic antibiotics within 1 h before incision (odds ratio 0.57 ; 95%CI 0.33～0.97) reduced SSI risks. Conclusion : The study demonstrated administration of prophylactic antibiotics within 1 h before incision was particularly important for SSI prevention. Higher compliance with SSI bundle and a special attention to patients receiving complex surgery were also warranted.
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Background: Wound infection is the common and most troublesome disorder of wound healing. With new advancement in medicine, it is now possible to prevent and control infection. The use of antiseptics is considered to be a mile stone for safe surgery. Methods: Total 100 patients were included in this study which was divided in two groups that is group A & group B. This comparative study conducted in the Dept. of Surgery, LBKMCH, Saharsa. Results: Escherichia coli (52.3%) most common organism were found in post-operative wound infection followed by Staphylococcus aureus (28.5%), CONS (9.5%), Klebsiella spp(4.7%).,Pseudomonas spp. (4.7%). Conclusion: This study conclude that, prophylactic Antibiotics should be given in a justified manner as these play a major role in reducing the post-operative wound infections.
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Background: Surgical site infection is a common cause of morbidity for the operated patients. Hence a cost effective and simple method was formulated and studied on cases of laparotomy and appendicectomy patients which can be categorized as dirty and contaminated wounds. Materials and methods: 25 cases and adequately matched controls were selected from patients who underwent laparotomy or appendicectomy which can be categorized as dirty or contaminated wounds. Cases were given local application Inj. Amikacin over the subcutaneous plane preoperatively and for the subsequent three post-operative days through a subcutaneously placed feeding tube along with systemic iv antibiotics. The control patients only received systemic IV antibiotics. ASEPSIS scoring was used to grade the post-operative surgical site infection in the cases and the corresponding controls, at the end of the first and second week after surgery. Various criterions were specifically evaluated such as the isolation of microbe from the wound site or the requirement of change of antibiotic at the end of the 1st or 2nd week and the tendency of prolonged stay in the hospital for more than 2 weeks. Results: It was observed that the cases that received the local Amikacin application as an adjuvant to systemic antibiotic showed significantly lesser incidence and/ or grading of SSIs in the first week and A.K. Rajendran, C. Arun Babu, Gnana Sezhian. To evaluate efficacy of local Amikacin therapy as an adjuvant to parenteral antibiotics in control of surgical site infection compared to parenteral antibiotic alone in a tertiary care centre. IAIM, 2018; 5(2): 64-71. Page 65 also lesser, but not statistically significant reduction of SSIs in the second week. The incidence of antibiotic change, hospital stay and isolation of microbe from the wound site was statistically found be to lesser in the study group compared to their controls. Conclusion: It is observed that the local therapy as an adjuvant is cost effective and without any significant local or systemic adverse effects in the prevention of SSIs in dirty and contaminated patients. But it was also observed that it did not have sustained effect for prolonged period beyond its time of administration (as evidenced by its lesser effect in the second week after surgery). It may be suggested that a further combination of suction drainage of the subcutaneous DT along with local antibiotic treatment may have added advantage in further preventing SSIs.
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PURPOSE: The aim of this study was to investigate the relationship between the elapsed time from hospital visit to operation and perforation risk and surgical site infection (SSI). METHODS: We conducted a single-center, retrospective cohort study using 986 patients who underwent appendectomy between Jan. 2009, and Dec. 2013. We divided hospital visit-to-operation time into multiple sessions and analyzed the statistical differences in univariate and multivariate analysis. RESULTS: Nine-hundred and ninety-six patients were admitted due to appendicitis and 986 (98%) patients underwent an appendectomy. Perforation occurred in 13.2% (n=130) of these patients. Patients with greater than 12 hours of elapsed time between their visit to hospital and surgery demonstrated a higher perforation rate than those who underwent surgery within 12 hours from their visit to the hospital. Upon logistic regression analysis, appendectomy timing was a predictors of appendiceal perforation (adjusted odds ratio, 1.04; 95% confidence interval, 1.00~1.07; p=0.04). The SSI rate of the patients who underwent appendectomy within 12hrs was lower than those who underwent surgery more after than 12 hrs, but hospital visit-to-operation time was not a statistically significant predicting factor of SSI (adjusted odds ratio, 0.99; 95% confidence interval, 0.93~1.05; p=0.796). CONCLUSION: A delay more than 12 hrs between the visit to a hospital and surgery was significantly associated with an increased risk of perforation of the appendix. However, it was not associated with an increase in the risk of SSI. Prompt surgical treatment is needed to decrease the risk of perforation.
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Humanos , Apendicectomia , Apendicite , Apêndice , Estudos de Coortes , Modelos Logísticos , Análise Multivariada , Razão de Chances , Estudos Retrospectivos , Infecção da Ferida CirúrgicaRESUMO
Background: Caesarean section (CS) wound infections represent a substantial burden to the health system and the prevention of such infections should be a healthcare priority in developing countries. Aim and objectives: Prospective study aimed to evaluate all postoperative wound sepsis or fever cases at KGH, VSP during 6 months period of time January and June 2017. Materials and methods: All postoperative cases with wound sepsis were evaluated. Detailed clinical data, investigations, bacteriological evaluation, sensitivity to antibiotics noted. Results: A total no of 1000 cases with postoperative sepsis in a 6months period of time was followed and results were analyzed. Conclusion: All postoperative cases with wound sepsis and fever were analyzed for etiological factors, associated co morbid factors and their sensitivity to antibiotics noted.
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Objective To evaluate the effect of obesity on the incidence of surgical site infection (SSI) in patients with inguinal hernia after tensionless repair and its treatment.Methods Clinical data of 628 cases with inguinal hernia undergoing tensionless repair from Sep.2008 to May.2016 were retrospectively analyzed.The 628 patients were divided into obesity group (n=150) and non-obesity group (n=478),or SSI group (n=9) and non-SSI group(n=619).The effect of obesity on SSI after inguinal hernia and its treatment was analyzed.Re sults Among the 628 patients,SSC happened to 9 patients and the incidence was 1.43％.The rate of SSI in obesity group and non-obesity group was 4.00％ (6/150) and 0.63％ (3/478),respectively (x=6.960,P=0.002).BMI was 30.92±3.03 and 26.24±3.79 respectively in SSI group and non-SSI group (t=3.686,P=0.000).The difference has statistical significance.Factors such as diabetes,age,sex,albumin levels,American society of anesthesiology (ASA),type of hernia,method and duration of operation had no significant difference between SSI group and non-SSI group (P＞0.05).Conclusion By analyzing the risk factors of SSI after tensionless hernia repair,we find that patients with obesity are more likely to have SSI.Strengthening prevention and early treatment is a key measure to prevent postoperative infection in these patients.
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Rice (Oryza sativa L.) is the most important cereal crop and a major staple food for majority of the human populations worldwide. Rice crop is sensitive to salinity. In spite of large number of studies on salinity tolerance of rice, our knowledge on the overall effect of salinity on rice seedling growth is limited. Improvement in salt tolerance of crop plants remains indescribable, largely due to the fact that salinity is a complex trait which affects almost every aspect of the physiology, biochemistry and genomics of plants. The present investigation was conducted to establish the relationship between various morphological, physiological traits and stress indices. A set of 131 rice accessions was evaluated in two levels namely, non-stress (EC ~ 1.2 dS/m) and saline stress (EC ~ 10 dS/m) in hydroponics at seedling stage. Root length and shoot lengths were reduced by 52 and 50%, respectively in saline stress compared to non-stress conditions. There was a significant correlation between various morphological and physiological parameters in non-saline in addition to saline stress as well as non-stress. The effect of the increased Na+ concentration in the medium is detrimental to root length and shoot length as observed by reduction in root length and a concomitant reduction in shoot length. Increased concentration of Na+ led to augmented Na+/K+ ratio with increased stress in the medium and decreased expression of traits. A significant positive correlation (r=0.60) was noticed between stress tolerance index (STI) of root and shoot length. The stress susceptibility index (SSI) for root length was expressed significant positive correlation with SSI for shoot length (r=0.43). SSI for K+ content was registered significant negative correlation with STI for Na+ content (r=-0.43). The three accessions namely, IC 545004, IC 545486 and IC 545215 were found to be the best performers adjudged on the morphological and physiological criteria in saline stress situation. These three rice accessions could be used as a donor parent or for genotypic studies in future breeding programs.
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Background: It is still a matter of debate whether delayed primary closure (DPC) of contaminated abdominal incision reduces surgical site infection compared with primary closure (PC ).The rate of wound infection for dirty abdominal wound is approximately 40%, but the optimal method of wound closure remains controversial. Aims and objectives: To determine whether delayed primary skin closure of contaminated and dirty abdominal wounds reduces the rate of surgical site infection (SSI) compared with primary skin closure. Method: Patient diagnosed as acute peritonitis and posted for exploratory laparotomy during the period of October 1 2013 to September 1 2015 were included. The study was conducted at Shri B M Patil Medical College and Hospital, Bijapur. In this series a total of 100 patients were included and were divided in two groups. Each group had 50 patients. For primary closure group, wounds were closed with monofilament interrupted suture. For Delayed primary closure, skin and subcutaneous tissue are left open and packed with 10 % (betadine) povidone iodine soaked gauge, which was changed daily to prevent excessive collection of exudates. The outcome of wound was assessed on post –operative days. Result: In this entire series, wound infection developed after incision closure was 33% .The primary group had a higher rate of wound infection 54% and delayed primary closure was 12% (P<0.001) and longer length of hospital stay 19.4days in primary closure group and 16.5days in delayed primary closure group (P<0.002). Conclusion: Laparotomy wound complications are multifactorial, it depends on many factors. A strategy of DPC of dirty abdominal wound, clinically appears to decrease the rate of wound infection, when compared with PC without increasing the length hospital of stay.
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Objetivo: Fazer a adaptação transcultural e a validação do Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (Profad-SSI-SF), questionário que avalia os aspectos subjetivos dos sintomas da síndrome de Sjögren primária (SSp), para a língua portuguesa brasileira. Método: Foi avaliada a equivalência conceitual, de item, semântica e operacional. A versão brasileira do Profad-SSI-SF foi aplicada a 62 mulheres com SSp conforme consenso europeu-americano de 2002 para avaliar a equivalência de mensuração. Foi usado o α-Cronbach para consistência interna; coeficiente de correlação intraclasse (ICC) para reprodutibilidade intraobservador; e coeficiente de correlação de Spearman para validade em comparação com o Patient Global Assessment (PaGA), Eular Sjögren’s Syndrome Patient Reported Index (ESS-PRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (Facit-F) e EuroQOL(EQ-5D). Resultados: A consistência interna do Profad, do SSI e da pontuação total foi de 0,80, 0,78 e 0,87, respectivamente. A reprodutibilidade intraobservador do Profad total foi de 0,89; do SSI total de 0,86 e da pontuação total de 0,89. Na validade, o Profad apresentou correlação significativa com o PaGA (r = 0,50), Facit-F (r = 0,59), Esspri (r = 0,58) e todos os domínios do EQ-5D, com exceção da mobilidade. Já o SSI apresentou correlação significativa com o PaGA (r = 0,43), Facit-F (r = 0,57), Esspri (r = 0,55) e a maioria dos domínios do EQ-5D. A pontuação total do Profad-SSI-SF só não obteve correlação estatisticamente significante com o domínio mobilidade e escala 1 a 100 do EQ-D5. .
Objective: To perform a cross-cultural adaptation and validation of the Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF) questionnaire assessing the subjective aspects of the symptoms of primary Sjögren syndrome (pSS), for the Brazilian Portuguese language. Method: Conceptual, of the item, semantic and operational equivalences were evaluated. The Brazilian version of PROFAD-SSI-SF was administered to 62 women with pSS according to the European-American consensus 2002 to assess measurement equivalence. α-Cronbach was used for internal consistency; intraclass correlation coefficient (ICC) for intraobserver reproducibility; and Spearman correlation coefficient for validity by comparing with Patient Global Assessment (PaGA), EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) and EuroQOL(EQ-5D). Results: The internal consistency of PROFAD, SSI and total score was 0.80; 0.78; and 0.87, respectively. The intraobserver reproducibility of total PROFAD was 0.89; of total SSI was 0.86; and total score was 0.89. In terms of validity, PROFAD correlated significantly with PaGA (r = 0.50), FACIT-F (r = 0.59), ESSPRI (r = 0.58) and all domains of EQ-5D, with the exception of Mobility. On the other hand, SSI correlated significantly with PaGA (r = 0.43), FACIT-F (r = 0.57), ESSPRI (r = 0.55) and most domains of EQ-5D. The total score of PROFAD-SSI-SF had a nonstatistically significant correlation only with Mobility domain and with 1–100 range of EQ-5D. .