Aim: To compare partial nail avulsion followed by matricectomy either with phenol (80-88%) or with electro cautery for Stage 2 & 3 ingrown toenails for early and late postoperative complications. Methods: This study was conducted at department of surgery Nawaz Sharif social security teaching hospital Lahore for one year from 01-01-2018 to 31-12-2018. One hundred patients full filling inclusion criteria were included in the study and divided into two equal groups A and B. Partial nail avulsion done in both groups followed by chemical matricectomy with phenol (80-88%) in group A and patients in group B matricectomy done with electrocautry. Results: The mean age in group A is 19.7± 8.08 years and in group B is 20.20± 6.9 years, both groups comparable p-value (0.74).In early post-operative complications in group A 17(34%) patients and 14(28%) patients in group B experienced mild pain p-value is (0.66). 6(12%) of group A patients and 6(12%) of group B patients experienced moderate pain p-value (01). 1(2%) of group A patient and 2(4%) of group B patients experienced severe pain p-value (01). 02(4%) patients of group A and 02(4%) patients of group B had serous discharge p-value(01). 1(2%) of group B patients have purulent discharge, however, no patients in group A patients have purulent discharge p-value (01). 1(2%) patients of group A and 2(4%) patients of group B had recurrence at three months follow up p-value (01). 2(4%) patients of group A and 4(8%) patients of group B had recurrence at six months follow up p-value (0.68). Conclusion: Partial nail avulsion followed by matricectomy either with Phenol 80-88% or with electrocautry are comparable in early and late complications. Keywords: Ingrown toenails, partial matricectomy

Objectives: To determine the frequency of delay in case of suspected acute appendicitis and to determine the frequency of complications in patients of acute appendicitis having delay secondary to pre-operative imaging. Study Design: Descriptive study Place and Duration of Study: Department of General Surgery Unit-2, University of Lahore Teaching Hospital, Lahore 1st January 2020 to 31st March 2021. Methodology: Three hundred and eighty five patients, between 18-40 years of age of both genders presenting with clinically appendicitis were included. All the patients were operated under general anesthesia by a consultant surgeon having minimum of 5 years of experience. Results: The mean age was 28.746±5.25 years. Majority of the patients were between 26-30 years (42.6%). Body mass index of the patients were ˃25kg/m2 in 57.7%. Delay was seen in 155 (40.03%) cases, peri-appendiceal abscess was seen in 10 (2.6%) and peritonitis was seen in 13. Complications due to delay was pri-appendiceal abscess 8 and peritonitis 13 with p value ˂0.05. Conclusion: Delay in the appendectomy due to pre operative imaging has shown significant impact on complications rate and therefore suggests that delaying appendectomy is unsafe. Keywords: Appendectomy, Peri-appendiceal abscess, Peritonitis

Aim: To determine the effectiveness of redivac drain in primary closure of pilonidal sinus. Study Design: Comparative study Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st January 2020 to 31st December 2020. Methods: Ninety patients of both genders were presented in this study. Patient’s details demographics age, sex and BMI were recorded after taking written consent. Patients were divided into two groups; group I and group II. Group I had 45 patients and underwent for redivac drain and group II was without redivac drain and had 45 patients. Complete follow up was done in duration of 6 months. Outcomes wound healing, infection of wound and recurrence of pilonidal sinus in both groups were observed. Results: Majority of the patients 66 (73.33%) were males and 24 (26.67%) were females. Mean age of the patients in group I was 28.52±6.88 years with mean BMI 24.16±7.33 kg/m2 and in group II mean age was 29.68±7.45 years with mean BMI 25.14±3.16 kg/m2. In group I 36 (80%) cases showed complete healing, partially healing was observed among 7 (15.55%) and 2 (4.44%) showed non-recurrence and in group II complete healing was among 26 (57.8%) patients, partially healing was found in 14 (31.11%) and non recurrence was among 5 (11.11%) patients. Rate of recurrence in group I was 3 (6.67%) less than that of group II (8.9%). Conclusion: The redivac was more effective as compared to primary closure of pilonidal sinus without redivac. Keywords: Redivac drain, Primary closure, Pilonidal sinus, Recurrence

Background: A surgical incision in the abdominal cavity (laparotomy surgery) is the most common procedure in surgical departments. Post-operative wound irrigation is very helpful method for surgeons to diagnose the surgical infections and to decrease the length of stay at hospital. Objectives: To determine the prevalence of deep surgical site infections in patients treated laparotomy procedure with or without post-operative wound irrigation. Study Design: Comparative control trial, observational study. Setting: Ghulam Muhammad Mahar Medical College Hospital, Sukkur. Period: 1st January 2016 to 31st December 2017. Material and Methods: Three hundred and thirty patients of both genders who had treated laparotomy because of intra-abdominal cavity and due to perforated appendix, examined TB, typhoid history, clinical treatments were included. All patients were divided into two groups with or without post-operative wound irrigation to examine the frequency of DSSIs in patients at third and seventh day of laprotomy treatment. Results: There were 180 (54.55%) were men and 150 (45.45%) patients were women. 50 (15.15%) patients having ages of <20 years, 110 (33.33%) patients were aged between 20 to 29 years, 130 (39.39%) patients were aged between 30 to 39 years, 25 (7.58%) patients having ages of 40 to 49 years and 15 (4.54%) patients were ages >49 years. Hospital stay of patients was recorded from 2 to 10 days, 237 (71.82%) patients having stay at hospital were 2 to 4 days, 63 (19.09%) patients stay were 5 to 7 days while 30 (9.10%) patients stay were >7 days. Out of all the 330 patients, 47 (14.24%) patients found surgical site infections on 3rd days, 43 (13.03%) found DSSIs on 5th day and 45 (13.64%) patients had deep surgical site infections on 7th day after laparotomy treatment. DSSIs on 3rd days was noted in 23 (6.97%) patients with Postoperative wound irrigation and 24 (7.24%) without PO wound irrigations, 22 (6.67%) found DSSIs with wound irrigations and 21 (6.37%) without wound irrigations, while on 7th day 21 and 24 patients had observed deep surgical site infections after operation. Conclusion: There is no major difference observed in prevalence of DSSIs whether performing post operative wound irrigation or do not performing PO wound irrigations after laparotomy procedure. Thus we concluded that the PO wound irrigations is not useful method to decrease the rate of DSSIs on 3rd, 5th and seventh day of after operation.