Background: Post-operative wound infections have been a problem since surgery was started as a treatment modality. Post-operative infections were responsible for 70-80% of deaths until Ignaz Semmelweis and Joseph Lister, in middle of 19th century, introduced methods of infection control by use of antiseptics. Objective was to study the incidence of postoperative infection in tertiary rural hospital.Methods: A hospital based cross sectional study was carried out at Department of General Surgery, SRTR Rural Government Medical College from September 2015 to August 2016 among 1250 patients. Detailed history, complete and thorough clinical examination was carried out for each and every individual included in the present study. The patients are assessed pre operatively and post operatively.Results: It was found that the maximum cases belong to the age group of 26-35 years i.e. 28.32% followed by age group of 36-45 years (25.68%). The proportion of males was slightly more than females. The most common surgical procedure done was inguinal hernioplasty in 24.96% of cases followed by internal appendectomy in 22.24% of cases. Maximum study subjects had clean surgical procedure in 62.08% of cases. The highest incidence (19.46%) was found in the age group of above 56 years followed by age more than 56 years in 19.46% of cases. It was found that the incidence of SSI was more among females than males. It was found that the incidence of SSI was more among those with some co-morbidity than among those who doesn’t have any co-morbidity.Conclusions: Surgical infections particularly, surgical site infections, have always been a major complication of surgery and trauma. The overall prevalence of surgical site wound infection in the surgical ward was 10.4%.

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

Lymphangioma, soft tissue tumor was originally reported by R. Backer in 1828 and “cystic hygroma” name was first given by Wernker in 1834. It can occur in the head, neck, axilla, cervico-facial regions and below tongue. Although it is well recognized in children, it may present in adulthood. Cystic hygroma neck is traditionally removed via an overlying incision near or over the swelling. The resultant scar can be displeasing to an adult. Various endoscopic approach present in literature for excision are via neck, anterior chest, combined or robotic assisted. We here, are reporting transoral endoscope excision of cystic hygroma via vestibular approach. A 51 year old female with swelling over anterior aspect of neck, trans-illumination positive, diagnosis confirmed on CT neck, of size ~4×4 cm was our case. We decided for transoral endoscopic vestibular approach for excision, first of its kind with no assisted approach. Patient discharged after 3 post-operative days (PODs). There was mild seroma which resolved within a week. Transoral endoscopic excision of cystic hygroma via vestibular approach without any assisted approach can be applied in adult. Various approach present in literature for excision of cystic hygroma are via neck, anterior chest or combined or robotic assisted. Hence this approach can be an excellent choice for adult cystic hygroma patients who desire to avoid a neck incision. Transoral endoscopic excision of cystic hygroma via vestibular approach was successfully performed. Patient was satisfied with good cosmosis. It results in good cosmesis and better dissection. Hence can be a new method of excision of cystic hygroma in adult.

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