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HighlightsSweat gland carcinoma is very rare with a reported incidence of less than 0.005% of all tumour specimens resected surgically. Due to limited availability of literature, the diagnosis as well as management of these tumours is quite difficult.Presented to us with a solitary swelling over the left chest wall since two month. We managed the case with wide excision of the swelling with segmental excision of the involved segments of the ribs with pleura followed by a Delto-Pectoral fasciocutaneous flap with insertion of an intercostal drain.Histopathology report confirmed an eccrine carcinoma with involvement of the ribs. The tumour cells immunohistochemical study showed that tumour cells were positive for pancytokeratin/CK7/Calretinin with focal luminal immunoreactivity for CEA.

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The aim of this investigation was to determine the bacterial load on used instruments and to evaluate the relationship between the bacterial load and holding time prior to cleaning. Forty six sets were evaluated to establish the average number of bacteria per square centimeter. For the experimental study, three different bacteria were prepared in sheep blood and used to contaminate sterile stainless steel pieces with surface area of 10cm 2 . After incubation at room temperature for 2, 4,6,8, 12, 24, 36 and 48 h, colonies were counted as compared to time zero. Bacterial counts were between 20 and 320 CFU/cm2, depending on the operation site. Bacterial load was found to have increased after 6 hrs. An increase of 3log10 CFU/cm2 was measured after 12 h. It is imperative to clean surgical instruments in the first 6 h to ensure effective disinfection and sterility. KEYWORDSSurgical Instruments, Bacterial Load, Bioburden, Holding Time, Contamination. HOW TO CITE THIS ARTICLE:Mohite ST, Mahesh Reddy S, Kshirsagar AY, et al. Effect of holding time on the bacterial load of surgical instruments.

Background: Perianal fistulas remain a surgical treatment challenge in colorectal practice due to high recurrence rates and the risk of postoperative wound infection and incontinence. Anal fistula represents one of the most frequent anorectal diseases.Methods: This is a randomized comparative prospective study of 30 cases of fistula-in-ano presenting at the surgical OPD of Almeen Medical College and Research Institute from 1 September 2017 to 31 june 2018.Results: In our study the age of the patient varied from 25-60 years, patient’s wound healed in 3-4 weeks in those who underwent open fistulectomy, whereas in the primary closure method the wounds healed in 1-2 weeks. Recurrence of fistula occurred in 5 patients.Conclusions: The primary closure method of fistulectomy is a safe and feasible method and more effective in the management of fistula-in-ano.