Management of Fistula-In-Ano with Special Reference to Ligation of Intersphincteric Fistula Tract.

CONTEXT: The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT) technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status. AIMS: LIFT in the management of patients of fistula-in-ano of cryptoglandular origin. SETTINGS AND DESIGN: Prospective study. MATERIALS AND METHODS: This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. RESULTS: A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11%) patients. Thirteen patients (28.88%) had a recurrence. No patient reported any subjective decrease incontinence after the procedure. CONCLUSIONS: LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence.

Diabetic Foot Ulcer Complications and Its Management-a Medical College-Based Descriptive Study in Odisha, an Eastern State of India.

The aim of this study was to prepare a profile of diabetic foot ulcer (DFU) complications and its management and to assess the outcome of the surgical interventions. A prospective study was carried out in 60 patients with DFU during the period of January 2009 to October 2010 to categorize them based on Meggit-Wagner system and to find out the complications, management, below knee amputation rate, and mortality rate. Majority of the patients (30 %, n = 18) presented with Wegner grade 3 DFU. Only three patients (5 %) presented with grade 0 DFU. Split skin grafting was the most frequently done intervention, comprising 29 % of the time. Below knee amputation was required in 10 % of cases and mortality rate was 12 %. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to occurrence of DFU at an age earlier than that seen in other studies.