International journal of surgery
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Randomized Controlled Trial Comparative Study
Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study.
By Evidence Based Medicine (EBM) principles, several meta-analyses concluded that use of mesh is superior to the non-mesh operations in inguinal hernia surgery. Wound infection is a potential complication of all hernia repairs and deep-seated infection involving an inserted mesh may result in chronic groin sepsis. In the event of incarcerated or strangulated hernias, however; placement of prosthetic material is presumed to increase that risk of infection. ⋯ The use of Lichtenstein "tension-free" technique in emergency treatment of strangulated inguinal hernia is safe, effective with an acceptably low rate of postoperative complications and without recurrence.
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This review summarizes the microbiological aspects and management of soft tissue and muscle infections. The infections presented are: impetigo, folliculitis, furunculosis and carbuncles, cellulitis, erysipelas, infectious gangrene (includes necrotizing fasciitis or streptococcal gangrene, gas gangrene or clostridium myonecrosis, anaerobic cellulites, progressive bacterial synergistic gangrene, synergistic necrotizing cellulitis or perineal phlegmon, gangrenous balanitis, and gangrenous cellulitis in the immunocompromised patient), secondary bacterial infections complication skin lesions, diabetic and other chronic superficial skin ulcers and subcutaneous abscesses and myositis. ⋯ These infections may occasionally lead to serious potentially life-threatening local and systemic complications. The infections can progress rapidly and early recognition and proper medical and surgical management is the cornerstone of therapy.
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To study the management of complete renal artery occlusion in multiple trauma patients so as to develop a management algorithm. ⋯ Conservative management is advised in the treatment of unilateral complete blunt renal artery thrombosis. These patients need close follow-up for the risk of hypertension. Blunt renal artery thrombosis in multiple trauma patients indicates severe injury. Surgeons should critically assess the added risk of mortality against chances of recovering the renal function.
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Review Comparative Study
Laparoscopic versus open appendicectomy in pregnancy: a systematic review.
Acute appendicitis is the most common non-obstetric indication for surgical intervention in pregnant women. The benefits of a laparoscopic over an open approach to appendicectomy are well established in the non-pregnant population. Data on the optimal surgical approach to acute appendicitis in pregnant women are conflicting. ⋯ Laparoscopic appendicectomy in pregnancy is associated with a low rate of intra-operative complications in all trimesters. However, LA in pregnancy is associated with a significantly higher rate of fetal loss compared to open appendicectomy. Rates of preterm delivery appear similar or slightly better following a laparoscopic approach. Open appendicectomy would appear to be the safer option for pregnant women for whom surgical intervention is indicated.
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This article reviews the important developments, recent and historical, in burn fluid resuscitation. Modern managements, debates, and research directions are discussed, with a key question of how to transcend the current therapeutic plateau.