Local Wound Complications Research Articles

Managing Wound Complications After Osteosarcoma Resection: Stopping Adjuvant Therapy and Performing Secondary Closure.

Purpose Adjuvant chemotherapy (AC) following limb-sparing surgery with endoprosthesis is the gold standard treatment for osteosarcoma (OS). However, AC can impair wound healing, leading to endoprosthesis exposure, making the decision to continue or pause AC important. We propose standard guidelines for managing this situation. Methods This observational retrospective study analyzed local findings, AC courses, wound complications, and overall survival of 22 patients who underwent resection of primary OS. Results Of nine patients with wound complications (41%), two achieved secondary healing before starting AC while the other seven patients had wound deterioration during AC. Six patients had temporary suspension of AC, followed by debridement and secondary closure, and the completion of AC, one had temporary suspension of AC with conservative therapy, but could not complete AC due to too long suspension of AC. No recurrence or metastasis was recorded. Comparing these nine patients with the other 13 patients without wound complications, the number of days from the operation to the end of AC was 150 days and 144 days respectively, and no statistical differences were observed (p=0.648). Conclusion Managing wound complications after OS resection requires balancing the completion of AC with effective limb salvage strategies. Deciding on temporary suspension of AC without delay and secondary closure is important.

A study of functional outcome of intertrochanteric fractures operated with intraheal proximal hip stabilizing nail-multicentric study

Background: Modalities of fixation in intertrochanteric fractures have been a topic of debate since times immemorial. Our special aims at comparing the functional outcome of Intraheal™ proximal hip stabilizing nail (PHSN, GPC Medical Limited) fixation in 200 patients of intertrochanteric fractures. Methods: 200 patients of intertrochanteric fracture fulfilling the inclusion criteria were included in our study. Preoperative AP and Lateral views of hip joint were taken for all patients. In post-operative period, the patients were reviewed at 2 weeks, 1 month, 3 months, 6 months, and 12 months by the operating surgeon. Functional assessment, radiological assessment of bony union and complications were evaluated in follow up period. Results: 200 patients underwent Intraheal™ proximal hip stabilizing nail fixation. They were followed-up the patients at 2 weeks, 1, 3, 6 and at 12 months postoperatively AP and lateral pelvic X-rays were obtained at each follow-up, and implant position changes, all complications, and fixation failures were recorded. We included a total of 200 patients meeting the criteria in this study and follow up was done till 12 months postoperatively. Intra-operative complications, time of hospital stay, Varus fixation and fracture displacement were assessed. Conclusion: Advantages noted with PHSN fixation were excellent Harris hip score, lesser screw cutout, early union rate. However, PHSN had greater incidence of anterior thigh pain at all intervals of follow-up. There were no significant local wound complications or duration of hospital stay.

Not just tachycardia: A pilot study examining wound‑healing complications associated with the dose and volume of lignocaine in skin cancer excisions.

General practitioners excise many suspected skin cancers using local anaesthetics such as lignocaine, but the relationships between the dose and volume of the local anaesthetic and wound complications are unclear. This pilot study considers an association between the dose and volume and complications. An audit was conducted of patient records from two timeperiods: one before and one after an education intervention. Data extracted included lignocaine (volume and dose), wound complications (dehiscence and infection) and the demographics of patients and clinicians. Both the dose and volume of lignocaine administered were significantly associated with complication rates (P=0.0084 and P=0.0209, respectively). In the post-intervention period, clinician behaviour changed, witha reduction in the volume and dose of lignocaine administered (P<0.001 and P<0.001, respectively) withoutepisodes of inadequate analgesia. This pilot study reported a relationship between lidocainedose and volume and rates of complications. Shortcomings of this study limit attribution of findings toclinical practice. However, the results justify further rigorous research.

(077) ASSESSMENT OF SEXUAL FUNCTION IN PATIENTS UNDERGOING PARTIAL PENECTOMY

Abstract Introduction Malignant neoplasms of the penis are a rare condition in most of the world, especially in least developed countries. With poor genital hygiene conditions as the most prevalent etiological factor, it is a illness that can affect men of all age groups, with the diagnosis occurring in individuals under 60 years of age in around 60% of cases, therefore in a sexually active age group. Despite organ-sparing treatment modalities, anatomical disfigurement of the penis and consequent impacts on quality of life and sexual function may be inevitable, making this subject an important topic of discussion within the scientific community. Objective Assess the impact of partial penectomy on sexual function and satisfaction in penile cancer patients. Methods The study analyzed patients who underwent partial penectomy at two tertiary hospitals in northeastern Brazil in the years 2022 and 2023. Patients completed the International Index of Erectile Function (IIEF-5) after the procedure, which consists of four items assessing erectile dysfunction (ED) and one item on satisfaction with sexual intercourse. ED severity was categorized based on total score in: severe (1-7), moderate (8-16), and mild (17-21). Results Nineteen patients who underwent partial penectomy were included, with a mean age of 57 years, ranging from 43 to 78 years. In the sample, 21% of pacients underwent bilateral lymphadenectomy. One patient received systemic treatment and radiotherapy prior to surgical intervention. There was no difference in the surgical technique used, and the extent of penile segment removed varied based on clinical manifestations and staging of each case. Approximately 79% of patients experienced some degree of ED postoperatively, with 47% showing moderate dysfunction and 53% severe dysfunction. Those with severe dysfunction had an average age of 60 years, did not have others comorbidities, and didn’t undergo systemic therapy or radiotherapy. Common complaints among patients with severe ED included changes in their relationships with partners post-procedure, with the lowest scores in sexual satisfaction with intercourse. Around 21% of patients made no attempts at sexual activity following the surgical procedure. No systemic complications occurred postoperatively, but some patients reported resolved local wound complications during follow-up. There were no deaths related to the disease or to others causes during the follow-up period. Conclusions Despite methodological limitations of the study, the impact of diagnosis and surgical treatment on sexual function of penile cancer patients was evident. However, some satisfaction can be maintained post-partial penectomy, especially with partner support. Assessments of sexual results after partial penectomy can be useful in therapeutic planning and preoperative counseling, to preserve the patient’s sexual function and satisfaction. Disclosure No.

Risk Factors for Pfannenstiel Incisional Hernia Following Cesarean Delivery and Outcomes after Laparoscopic and Open Surgical Repair

Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index &gt;25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p &lt; 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p &lt; 0.01 and p &lt; 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.

Our Experience of Distal and Total Urethrectomies in Post Irradiated Vulvar Malignancies in Low Resource Settings: A Single Centre Study.

At diagnosis, women with vulvar cancer often present in locally advanced stage especially in developing countries, owing to the associated ignorance and social stigma. Generally tumour is seen involving adjacent organs, like the vagina, anus, and urethra. Damage to the sphincter system leads to urinary incontinence. Available evidence regarding urethral resections, subsequent lower urinary tract dysfunction and neo-meatus reconstruction in radical vulvar surgeries is scarce and conflicting. Considering, the lack of literature on outcomes of partial and total urethrectomies post chemoradiation in advanced vulvar malignancies from India, in the current study, we analysed our experience of such cases that have been operated post chemoradiation over a span of 2years (from January 2019 to January 2021). DFS ( disease free survival) of more than 6months was seen in 5 of our patients, however in view of local wound complications after primary closure, we recommend reconstruction with myocutaneous flaps. Also in view of incontinence observed in two of our patients who had undergone more than 1⁄2 of urethral resection, as a result of failed suprapubic catheterisation, further plan of urethral reconstruction should be considered especially in patients who have received prior radiation. Our small group of patients represents a unique cohort of patients in whom surgery was attempted after radiation therapy. We have seen that surgery is a feasible option after radiotherapy in patients with advanced disease.

Comparison of pre-operative and post-operative radiotherapy in patients with localized myxoid liposarcoma.

Myxoid liposarcoma is more radiosensitive than other soft tissue sarcomas, and radiotherapy has been reported to reduce tumour size. This study was performed to compare the rates of local recurrence, survival and wound complications between pre- and post-operative radiotherapy for localized myxoid liposarcoma. From the Japanese Nationwide Bone and Soft Tissue Tumor Registry database, 200 patients with localized myxoid liposarcoma who received pre- (range, 30-56Gy) or post-operative (range, 45-70Gy) radiotherapy and surgery were included in this retrospective study. Propensity score matching was used to adjust for background differences between patients who received pre- and post-operative radiotherapy. Local recurrence occurred in five (5.0%) and nine (9.0%) patients in the pre- and post-operative radiotherapy groups, respectively (both n=100). The median follow-up time from diagnosis was 40.5months (IQR, 26.3-74). Univariate analysis showed a similar risk of local recurrence between the pre- and post-operative radiotherapy groups (5-year local recurrence-free survival 94.9% [95% CI 87.0-98.1] vs. 89.0% [95% CI 79.6-94.3]; P=0.167). Disease-specific survival was similar between the pre- and post-operative radiotherapy groups (5-year disease-specific survival 88.1% [95% CI 75.5-94.6] vs. 88.4% [95% CI 77.3-94.5]; P=0.900). The incidence of wound complications was similar between the pre- and post-operative radiotherapy groups (7.0% vs. 12.0%; P=0.228). There was no difference in local recurrence, survival or incidence of wound complications between pre- and post-operative radiotherapy for localized myxoid liposarcoma. Therefore, pre-operative radiotherapy for myxoid liposarcoma provides clinical results equivalent to post-operative radiotherapy.

Efficacy of Flap-based Posterior Trunk Reconstruction after Vertebrectomy and Radiation Therapy: A Retrospective Cohort Study.

Adjuvant radiation therapy following vertebrectomy is a major risk factor for local wound complications such as dehiscence, infection, and skin necrosis. In selected cases, well-vascularized coverage and modification of tension forces on the wound might reduce the risk of postoperative complications and reoperations. We aimed to demonstrate a reduction in general and specific complications in patients undergoing vertebral resection and flap coverage compared with vertebral resection alone. We retrospectively analyzed and collected data from patients diagnosed with a tumor involving the spine and requiring a total or partial posterior vertebrectomy between January 2012 and October 2022, referred to a single tertiary-level orthopedic and trauma center. We included only patients in whom primary closure of the wound was possible but judged to be under excessive tension. A total of 145 patients underwent partial or total vertebrectomy for oncological reasons at our tertiary-level trauma hospital. Among these, 73 patients were eventually included according to the inclusion and exclusion criteria: 53 in the orthopedic group and 20 in the orthoplastic group. Considering only patients undergoing radiation therapy, the orthoplastic group showed significantly lower rates of overall complications (33% versus 69%) than the orthopedic group. Primary flap coverage, especially in patients receiving RT, reduces the risk of postoperative complications and avoids a second reconstructive operation, consequently reducing patient discomfort, length of hospital stay, and healthcare costs.

Is High Body Mass Index Protective or Detrimental in Surgical Fixation of Hip Fractures?: A Spline Regression Analysis of 22,388 Patients.

We aimed to characterize the association between BMI as a continuous variable and 30-day postoperative outcomes following hip fracture surgery through:1)30-day readmission and reoperation; 2)local wound-related; and 3)systemic complications. The National Surgical Quality Improvement Program(NSQIP) database(January 2016-December,2019) was queried for patients undergoing hip fracture ORIF. Baseline patient demographics, comorbidities, and patient outcomes were recorded. Multivariable regression models accounted for baseline demographics, comorbidities, and fracture patterns. Significant associations were analyzed using spline regression models to evaluate the continuous association between BMI and the aforementioned outcomes. Spline models demonstrated a U-shaped curve for the odds of 30-day readmission and 30-day reoperation with nadirs at the BMI of 27.5Kg/m2 and 22.0Kg/m2. The odd ratios of superficial infection, deep infection, any wound complication, and inability to weight bear on POD 1 rose progressively starting at a BMI of 25.6Kg/m2, 35.5Kg/m2, 25.6Kg/m2, and 32.7Kg/m2 respectively. Odds of 30-day mortality, transfusion, pneumonia, and delirium were greatest at the lowest recorded BMI (11.9Kg/m2). BMI has a U-shaped association with 30-day readmission and reoperation. Conversely, the highest risk of mortality and systemic complications (transfusion, pneumonia, and delirium) were within the lower BMI range, with diminishing risk as BMI increased. Local wound complications and systemic sepsis exhibited a third unique pattern with progressive rise in odds as BMI increased. The odds of any-complications demonstrated a U-shaped pattern with a nadir in the overweight to obese I categories, suggesting patients may be at lowest risk within this range. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Biosynthetic Mesh Reconstruction after Abdominoperineal Resection for Low Rectal Cancer: Cross Relation of Surgical Healing and Oncological Outcomes: A Multicentric Observational Study.

Local wound complications are among the most relevant sequelae after an abdominoperineal resection (APR) for low rectal cancer. One of the proposed techniques to improve the postoperative recovery and to accelerate the initiation of adjuvant chemotherapy is the mesh reinforcement of the perineal wound. The aim of the current study is to compare the surgical and oncological outcomes after APR performed with a biosynthetic mesh reconstruction versus the conventional procedure. From 2015 to 2020, in two tertiary centres, the surgical outcomes, the wound events (i.e., surgical site infections, wound dehiscence and the complete healing time) and the oncological outcomes (i.e., time length to start adjuvant chemo-radiotherapy, an over 8-week delay in chemotherapy and the recurrence rate) were retrospectively analysed in patients undergoing APR reinforced with biosynthetic mesh (Group A) and conventional APR (Group B). Results Sixty-one patients were treated with APR (25 in Group A and 36 in Group B). Patients in Group A presented lower time for: healing (16 versus 24 days, p = 0.015), inferior perineal wound dehiscence rates (one versus nine cases, p = 0.033), an earlier adjuvant therapy start (26 versus 70 days, p = 0.003) and a lower recurrence rate (16.6% vs. 33.3%, p = 0.152). In our series, the use of a biosynthetic mesh for the neo-perineum reconstruction after a Miles' procedure has resulted in safe, reproducible results affected by limited complications, guarantying a rapid start of the adjuvant therapy with clear benefits in oncological outcomes. Further randomized clinical trials with long-term follow-up are needed to validate these results.

To patch, or not to patch a common femoral artery, that is the question.

There is no strong evidence to support or reject the use of patch angioplasty (PA) after femoral endarterectomy (FE). The current study aimed to assess early postoperative complications and compare primary patency (PP) rates after FE in patients treated with PA versus direct closure (DC). This is a retrospective study of patients admitted during 06/2002-07/2017 with signs and symptoms of chronic lower limb ischemia (Rutherford categories 2-6). Patients with angiographically confirmed stenoses or occlusions of the common femoral arteries (CFAs) and managed with FE with or without PA were included in the study. Early postoperative wound complications were assessed. The PP analysis was based on imaging-confirmed data. The impact of PA on the patency was evaluated in a confounder-adjusted Cox regression model. PP rates were compared with log-rank between the PA and DC groups using Kaplan-Meier survival analysis in the propensity score-matched (PSM) cohorts. A total of 295 primary FEs were identified. The patients' median age was 75years. A total of 210 patients were managed with PA and 85 with DC. Altogether, 38 (12.9%) local wound complications were registered, 15 (5.1%) of which required re-interventions. There were 9 (3.2%) cases of deep wound infection, 20 (7.0%) seromas, and 11 (3.9%) cases of major bleeding, with no significant difference between the PA and DC groups. All of the infected patches were made of synthetic material, and 83% of them were removed. The PP analysis was performed on 50 PSM patient pairs with a median age of 74years. The median imaging-confirmed follow-up lengths were 77months (IQR = 47months) for the PA patients and 27months (IQR = 64months) for the DC patients. The preoperative median diameter of the CFA was 8.8mm (IQR = 3.4). The 5year primary patency rates of CFAs with a minimum diameter of 5.5mm managed with PA or DC exceeded 91%, p > 0.05. Female sex was associated with the loss of PP, odds ratio 4.17, p = 0.046. Wound complications after FE with or without patching are not uncommon and often lead to reoperations. The PP rates of CFAs with a minimum diameter of 5.5mm and accomplished with or without patching are comparable. Female sex is associated with the loss of patency.

STUDY ON THE CLINICAL PROFILE AND OUTCOME OF PATIENTS WITH SURGICAL DRAINS FOLLOWING ELECTIVE ABDOMINAL SURGERIES

Aims And Objectives- To determine the surgical prole and outcome of patients with surgical drains following MATERIALS AND METHODS- Study design: observational study Period of study: december 2020 to January 2022 sample size :79 .All patients undergoing elective abdominal surgeries w INCLUSION CRITERIA: EXCLUSION ith drain placement CRITERIA: 1.Age &lt;18yrs 2.Patients with pre-existing infection at surgical site 2.Patients with pre-existing infection at surgical site Results &amp; Conclusion-Obese patients undergoing elective laparotomy suffer from local wound complications such as seroma, hematoma, pain at wound site, wound dehiscence, and surgical site infections. These complications occur because of increased subcutaneous fat thickness, poorly controlled bleeding points in subcutaneous plane. These will lead to increased morbidity for the obese patients and prolonged hospital stay. In this study, we have observed that there is positive correlation between SSI and BMI, with the Rate of SSI was seen more in BMI &gt;25 as compared to BMI &lt;25, there is increased wound complication associated with increase in age because of varied factors mentioned above. We observed less wound complications in female patients compared to males due to the probable benecial effect of estrogen on wound healing. Also we observed that patients with higher BMI are more prone for wound complications thus further increasing their length of hospital stay

Immediate and long-term results of Lichtenstein hernia repair

More than 20 million inguinal hernioplasties are performed annually worldwide by various methods [1]. The Lichtenstein operation recommended by the European Society of Herniologists as the "gold standard" in open inguinal hernia treatment, despite its leading position in the world, has a number of disadvantages. According to the studies of some surgeons, the introduction of implants has a correlation with the development of local wound complications and chronic pain syndrome in the postoperative period. And the percentage of recurrences after Lichtenstein hernioplasty ranges from 0.8 to 8% [2]. Some authors have noted an increased frequency of pain syndrome when using the ligature method of fixation of mesh implants. Their frequency ranges from 7 to 12% [3,4]. However, the issue of fixation is still controversial [5,6,7]. Aim of the study: to compare the results of Lichtenstein inguinal hernioplasty using self-fixing implants and implants requiring ligature fixation.

Prospective Randomized Controlled Trial Comparing Laparoscopic Palomo Surgery versus Scrotal Antegrade Sclerotherapy in Adolescent Varicocele.

Varicocele is a common condition in adolescence and the most common correctable cause of infertility. This study aimed to analyze and compare the outcomes of scrotal antegrade sclerotherapy (SAS) and laparoscopic Palomo surgery (LPS) in a tertiary referral centre. Patients with left grade 3 varicocele indicated for surgery were prospectively enrolled and randomly allocated to the SAS and LPS groups, with their respective contralateral normal testes taken as controls. The primary outcome measures were clinical varicocele recurrence, testicular catch-up growth, and post-operative hydrocele. All patients were evaluated clinically and using Doppler ultrasound by radiologists. From 2015 to 2020, 113 patients completed the study and were statistically analyzed (SAS, n = 57; LPS, n = 56). All patients had significantly smaller testes pre-operatively that the testicular volume differences with control testes were -23% in SAS and -19% in LPS. At 12-month follow-up, there were no statistical significant difference in clinical recurrences between the 2 groups (SAS = 5.3% vs LPS = 5.4%, P>.05, non-inferiority test). Testicular catch-up growths were observed in both groups, the mean testicular volume difference between the treatment and control testes reduced from -23% to -8.1% in SAS (P<.001) and -19% to -9.3% in LPS (P<.001) at 12-month follow-up. There was no post-operative hydrocele in SAS compared to 7 in LPS (0% vs 13%, P = .006). Both SAS and LPS are safe and effective procedures for treatment of adolescent varicocele with significant positive effect on testicular catch-up growth. SAS is not inferior to LPS in terms of clinical recurrence rate and with significantly less post-operative hydrocele.

Outcomes of plastic surgical reconstruction in extremity and truncal soft tissue sarcoma:Results from the US Sarcoma Collaborative.

This study aimed to define how utilization of plastic surgical reconstruction (PSR) affects perioperative outcomes, locoregional recurrence-free survival (LRRFS), and overall survival (OS) after radical resection of extremity and truncal soft tissue sarcoma (ETSTS). The secondary aim was to determine factors associated with PSR. Patients who underwent resection of ETSTS between 2000 and 2016 were identified from a multi-institutional database. PSR was defined as complex primary closure requiring a plastic surgeon, skin graft, or tissue-flap reconstruction. Outcomes included PSR utilization, postoperative complications, LRRFS, and OS. Of 2750 distinct operations, 1060 (38.55%) involved PSR. Tissue-flaps (854, 80.57%) were most commonly utilized. PSR was associated with a higher proportion of R0 resections (83.38% vs. 74.42%, p < 0.001). Tissue-flap PSR was associated with local wound complications (odds ratio: 1.81, confidence interval: 1.21-2.72, p = 0.004). Neither PSR nor postoperative complications were independently associated with LRRFS or OS. High-grade tumors (1.60, 1.13-2.26, p = 0.008) and neoadjuvant radiation (1.66, 1.20-2.30, p = 0.002) were associated with the need for PSR. Patients with ETSTS undergoing resection with PSR experienced acceptable rates of complications and a higher rate of negative margins, which were associated with improved LRRFS and OS. High tumor grade and neoadjuvant radiation were associated with requirement of PSR.

Radiation Therapy Techniques in the Management of Locally-Advanced, High-Grade, Soft-Tissue-Sarcoma

<h3>Purpose/Objective(s)</h3> Assess which prognostic factors affect local recurrence (LR) rates and wound complications of locally-advanced, high-grade, soft-tissue-sarcoma (STS). <h3>Materials/Methods</h3> Retrospective analysis was performed on patients 2005 to 2018, with high-grade STS of extremity or trunk, >5cm, histology specific, with central pathology review. Wide-excision was performed in 100 patients along with radiation, whose radiation fields and dose plans were available for review, of which 31 also received Ifosfamide-Doxorubicin, with a minimum follow-up of 1-year. Multi-variable-analysis (MVA) of prognostic factors were calculated to see which variables affected LR, and nonhealing wound rates. <h3>Results</h3> Median follow-up was 5.8 years. Univariate analysis revealed that trunk location, proximal, distal, and radial clinical-target-volume (CTV) margins of 1.5cm had higher rates of LR vs ≥2cm or presence of fascial boundary. MVA of these prognostic factors revealed that trunk location (p=0.048), and radial CTV of 1.5cm (p=0.006) independently predicted for higher LR, as 10 of 15 LR were at the edge of the radial margin. Bolus did not affect LR. The odds ratio for nonhealing wounds at 3 months were higher for T2a disease, larger tumor size, proximal CTV ≥2cm, wider field size, use of chemotherapy, and bolus technique. <h3>Conclusion</h3> Proximal/distal CTV margins of 3cm seem adequate, but high-grade STS ≥ 5cm may benefit from increased radial CTV margins of 2-2.5cm in the absence of a fascial boundary, although larger CTV may increase nonhealing wound rates. Bolus techniques lead to higher wound complications in T2a-b STS, and should be avoided.

Initial Experience With Two Active Transcutaneous Bone-Anchored Hearing Implants.

To analyze our institutional experience with two active transcutaneous bone-anchored hearing aids. Retrospective cohort study. Tertiary academic otology-neurotology practice. Patients with conductive or mixed hearing losses meeting criteria to receive active transcutaneous bone-anchored hearing aids. Implantation with one of two active transcutaneous bone-anchored hearing aids. Operative time, dural exposure and decompression, use of lifts, implant position, ease of use, qualitative patient satisfaction, complication rates. Ten patients received Implant 1 and 11 patients received Implant 2. The most common underlying etiologies of hearing loss were chronic suppurative otitis media in 33.3%, atresia/microtia in 23.8%, and cholesteatoma in 23.8%. Average operative times were 99.3 minutes for Implant 1 and 80.9 minutes for Implant 2 ( p = 0.263). Implant 1 required lifts in 60%, dural exposure in 50%, and dural compression in 30%. Overall, placement was difficult in 47.6% of cases. There were no intraoperative complications. There were higher rates of issues with sound quality (27.3% versus 0.0%, p = 0.123) and poor cosmesis (36.4% versus 10.0%, p = 0.360) with Implant 2. Functional gain was not recorded, but all patients derived qualitative benefit from their implant. Three patients had local wound complications that self-resolved or were treated with antibiotics. One patient implanted at an outside institution required explant because of multiple infections. There were no statistically significant differences in outcomes comparing Implants 1 and 2; however, Implant 2 had much higher rates of issues with audio quality and poor cosmesis. Placing Implant 1 often required special techniques.

“SUBCUTICULAR (POLYGLECAPRONE 3-0) VERSUS THREE MATTRESS (POLYPROPYLENE 3-0) SUTURE TECHNIQUE FOR SKIN CLOSURE OF LOW TRANSVERSE INCISION IN OBG SURGERIES”

“SUBCUTICULAR (POLYGLECAPRONE 3-0) VERSUS THREE MATTRESS (POLYPROPYLENE 3-0) SUTURE TECHNIQUE FOR SKIN CLOSURE OF LOW TRANSVERSE INCISION IN OBG SURGERIES”

Ultrasound method for assessing the severity of local wound complications after surgical interventions on the abdominal organs

Background. The ultrasound method of examination is often used to detect liquid formations of a postoperative wound. For this reason, the search for new criteria for assessing the course of the wound process is currently relevant.&#x0D; Aim. To study the possibility of using the ultrasound method of research to determine the severity of postoperative wound complications according to the ClavienDindo classification and further optimal tactics, diagnosis and treatment.&#x0D; Material and methods. 255 patients after surgery for various urgent diseases of the abdominal organs, as well as patients with elective surgeries were examined. All patients underwent complex clinical, laboratory and instrumental studies. Continuous values that do not have a normal distribution were processed using non-parametric methods the values were presented in the format Me [Q1; Q3], the difference in unrelated groups was assessed by the MannWhitney U test, and in related groups, by the Wilcoxon test.&#x0D; Results. The postoperative period in 58 (22.7%) of 255 patients was complicated by postoperative wound complications, which had I, II, III severity according to the ClavienDindo classification. On the 5th day of ultrasound examination of the surgical site with the III degree of severity of postoperative wound complications, there was a statistically significant increase in the echogenicity width of tissues in the area of the wound defect compared with the III severity of complications.&#x0D; Conclusion. The ultrasound method of research allows to evaluate the effectiveness of reparative processes in damaged tissues and the development of complications, as well as to determine the severity of their course in the postoperative period for planning further surgical tactics.

Role of Subcutaneous Drainage Can Reduce Such Complications in Patients Undergoing Elective and Emergency Abdominal Surgery

Prophylactic drainage of wounds is aimed to reduce the wound complications and thereby morbidity. Obese patients are at more risk. Wound management is a basic practice in surgery, especially after an elective abdominal surgery. Our task after surgery is to avoid and thereby to reduce the adverse effects of wound complications. Objective: To determine whether subcutaneous drainage can reduce such complications in patients undergoing elective and emergency abdominal surgery. Materials and Methods: It is a prospective open comparative study carried out Department of obstetrics and gynecology, in two hospitals Al-Hera Hospital, Mawna, Chowrasta, Sreepur, Gazipur and Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh over a period of six (6) months August 2021 to January 2022. Patients were randomized before surgery and divided into two groups by systemic random sampling. Total sample size 150 with 75 in each group. All patients will receive same preparations. Results: Wound complications observed in 2 patients with subcutaneous drain which forms 8% of the total patients with subcutaneous drain. Wound complications observed in 25 patients without subcutaneous drain which forms 33.3% of the total patients without subcutaneous drain. Comparing these two data found to be statistically significant with P value &lt; 0.05. Thus the incidence of wound complication is low in those with subcutaneous drain than those without drain. Conclusion: Subcutaneous drain when kept in obese individuals with more subcutaneous fat thickness who undergo elective abdominal surgeries had lesser incidence of local wound complications and lesser hospital stay when compared to those patients without subcutaneous drain.