Asian J Surg
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Randomized Controlled Trial Comparative Study
Combined subfascial and subcutaneous bupivacaine instillation for inguinal hernia wounds.
To determine if combined subfascial (SF) and subcutaneous (SC) bupivacaine is more effective than SC bupivacaine only in decreasing postoperative pain and opioid requirement for hernia wounds. ⋯ SF combined with SC instillation of bupivacaine during wound closure prolongs the first time to analgesia, reduces early postoperative opioid requirements and lowers pain in males undergoing open hernia repair.
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Comparative Study
Pitfalls in paediatric appendicitis: Highlighting common clinical features of missed cases.
Missed cases of paediatric appendicitis lead to a delay in diagnosis and increased complications during the subsequent surgery. We aim to identify the common clinical features of such cases at the time of first hospital attendance. ⋯ The paucity of symptoms and signs in the right lower quadrant does not exclude appendicitis. Gastroenteritis and colic constipation are the greatest masqueraders of paediatric appendicitis. A high index of suspicion, therefore, is necessary to avoid wrongful discharge altogether.
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Randomized Controlled Trial
Use of vacuum-assisted wound closure to manage limb wounds in patients suffering from acute necrotizing fasciitis.
An effective regimen to treat patients suffering from acute necrotizing fasciitis requires surgical removal of devitalized tissues, systemic administration of broad antimicrobials and ameliorating underlying systemic disease processes. The task of managing wounds consequential to surgical debridement, on the other hand, can be difficult. We had the opportunity of using a vacuum-assisted wound closure (VAC) technique in 12 patients with non-healing wounds in either the upper or the lower limb because of acute necrotizing fasciitis. The usefulness of the device was assessed by comparing with the conventional approach of wet dressing technique of wound care. ⋯ The VAC technique of wound closure was found to be effective in managing non-healing limb wounds consequential to surgical treatment for patients suffering from acute necrotizing fasciitis. Although the cost of the VAC device was high, morbidity was much lower when compared to the CWD technique.
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Comparative Study
Comparative study of tailor-made mesh plug herniorrhaphy versus Lichtenstein herniorrhaphy versus Bassini operation: a prospective clinical trial.
Operations to cure inguinal hernia are among the most common surgical procedures. However, the most effective surgical technique for inguinal hernia repair is unknown, and the recurrence at 5 years varies between 1% and 10%. Surgical techniques and implanted materials are crucial to the result of and costs associated with hernia repair. The objective of this study was to determine whether the tailor-made mesh plug for inguinal hernia repair was as effective and safe as other methods of herniorrhaphy. ⋯ Tailor-made mesh plug herniorrhaphy is a safe operation. The mesh plug material (Mersilene) was cheap. The recurrence rate was lower with tailor-made mesh plug herniorrhaphy than with the Bassini operation, but equal to that with Lichtenstein herniorrhaphy. Postoperative complications did not differ among all operations.