Background: Wound dehiscence/burst abdomen is a very serious post-operative complication associated with high morbidity and mortality. The need for this study is to highlight the risk factors for wound dehiscence and remedial measures to prevent or reduce the incidence of wound dehiscence. This will certainly reduce mortality and morbidity in the form of prolonged hospital stay, increased economic burden on health care resources.Methods: This is a prospective and observational study involving all those who have developed abdomen wound dehiscence after initial surgery, an elaborative study of these cases with regard to date of admission, clinical history regarding the mode of presentation, significant risk factors, investigations, time of surgery and type of surgery postoperatively, study of diagnosis and day of diagnosis of wound dehiscence is done till the patient is discharged from the hospital. The collected data is analysed and statistics were made according to need.Results: The incidence of abdominal wound dehiscence is more common in male patients in 4th to 5th decade. Patients with peritonitis due to duodenal perforation, complicated appendicitis, pyoperitoneum and intestinal obstruction and carried higher risk of abdominal wound dehiscence. Abdominal wound dehiscence was more common in patients operated in emergency. Patients with intra-abdominal infection, anaemia, hypoalbuminemia, jaundice had higher incidence of wound dehiscence.Conclusions: Wound dehiscence can be prevented by improving nutritional status of patient, proper surgical technique, controlling infections and correcting co-morbid conditions.

Background: Post-operative Pulmonary Complications (PPCs) form a significant chunk of post-operative morbidity. Their incidence varies from 2.7-23% in multiple studies. Pre-disposing factors can be divided as: pt. related: >60yrs, ASA class≥2 and COPD; procedure related: long surgeries (≥3hrs), emergency surgeries. Till now, most of the studies have focused on elective surgeries. In this study, I have studied morbidity and risk factors of PPCs in emergency abdominal surgeries.Methods: It is a retrospective case control study, carried out in 50 patients in M.B. Government Hospital, Udaipur over 1 year. Cases comprised of those patients who underwent emergency laparotomy and developed PPCs. Controls were selected from group who didn’t develop PPC.Results: Incidence of PPCs in emergency abdominal surgeries was found to be 2.9%. Elderly patients had more chances of developing PPCs. Smoking was found to be twice as common in case group. Those who quit smoking ≥1 year before surgery benefitted the most. Pre-OP chest x-ray abnormalities were 3 times more common in case group. Upper abdomen surgeries were 20% more common in Case group. Surgeries lasting for ≥ 3 hours had increased chances of PPCs. Total hospital stay was 21.7 days in cases (12.5 in control), total ICU stay was 8.5 days (1.4). 28% of the PPCs patients could not be saved.Conclusions: Pre-operative chest examination, cheat x-ray and regular SpO2 monitoring helps in diagnosing PPCs earlier. Early mobilization and deep breathing exercises should be encouraged.

Background: Osteomyelitis in the neonatal age group is a rare entity. Its presentation and progression are quite different from osteomyelitis in adults, adolescents, and even children. Due to vague clinical features and the late appearance of changes on X-rays, the diagnosis often gets missed. Additionally, there is a risk of permanent damage to bones and joints. Case Presentation: Our experience of 3 such interesting cases showed the diagnostic dilemma involved in neonatal osteomyelitis. All 3 cases presented as cellulitis or subcutaneous abscess initially as x-ray changes appeared late (7-10 days after onset of disease). All the babies needed surgical debridement. The average duration of antibiotics given was 35.5 days. No residual sequelae were reported for up to 2 years. Conclusion: Neonatal osteomyelitis needs a high index of suspicion especially in late-onset neonatal sepsis or prolonged septicemia. This case series emphasizes the need for a low threshold for suspicion and early treatment to avoid permanent disability.