Comparison Of Intraoperative Wound Irrigation With Aqueous Povidone-Iodine Solution To Normal Saline In Preventing Surgical Site Infections.

BACKGROUND: A surgical site infection (SSI) is a wound infection caused by pathogens, particularly bacteria, that occurs within 30 days of the surgery. Various methods have been employed to minimise infection rates of infection one of which is intra-operative wound irrigation. This study aims to compare the frequency of surgical site infections after wound irrigation of contaminated and dirty wounds with normal saline and aqueous povidone-iodine solutions. METHODS: This randomized controlled trial was carried out in the surgical department of Federal Government Polyclinic Hospital from January to December 2022. A total of 180 patients were randomly divided into two equal groups using blocked randomization. Group A had normal saline irrigation while Group B had aqueous povidone-iodine irrigation before surgical incision closure. Patients were followed till 30th post-operative day. Data was collected, entered and analyzed using SPSS 20.0. RESULTS: A total of 180 patients were recruited in this study, equally divided into Group A and Group B with 90 patients each. Fifty-three patients (58.9%) from group-A and 58 patients (64.4%) from group-B were having contaminated wounds and 37 patients (41.1%) and 32 patients (35.6%) had dirty wounds respectively. Surgical site infection was found in 29 patients (32.2%) of group-A and 26 patients (28.8%) of group-B (p=0.627). there was no significant difference between the two groups concerning surgical site infection. CONCLUSIONS: Irrigation of surgical wounds with aqueous povidone-iodine solution before primary closure was statistically similar to normal saline in preventing surgical site infections in contaminated and dirty wounds.

Comparison of fine needle aspiration cytology with excision biopsy of breast lump.

OBJECTIVE: To evaluate the results of fine needle aspiration cytology (FNAC) of breast lump by histopathology of excision biopsy specimen in the same group of patients. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of Surgery, Federal Government Services Hospital, Islamabad from October, 2000 to March, 2001. MATERIALS AND METHODS: There were 50 patients in the study, who were subjected to fine needle aspiration cytology with a needle of 22G mounted on 20 cc syringe. Smears were fixed on the slides with 95% alcohol and later stained with hematoxylin and eosin stain. After FNAC, all the patients were subjected to excision biopsy. The specimen were reported by the Histopathologist and results evaluated and compared. RESULTS: All patients were among the total number of 61 FNAC performed, conclusive malignancy (C5) was found in 20(40%) patients and in 1(2%) patient, malignancy was suspected (C4). Conclusive benign lesions (C2) were found in 26(52%) patients and 2 patients had atypia i.e. (C3). Inadequate specimen (C1) was found in 2(4%) patients. On excision biopsy, 22(44%) patients had malignant lumps and 28(56%) benign. FNAC was able to detect 20 malignant lumps with sensitivity of 90.90%. All of them were also reported malignant on excision biopsy with specificity of 100%. False positive were zero and false negative were 9.1%. CONCLUSION: FNAC is simple, quick, safe, tolerable, cosmetically acceptable, reliable and cost-effective method of determining histology of breast lumps. The absence of false positives conclusively confirmed its place not only as a complimentary adjunct but also a substitute of excision biopsy in majority of instances.