Objective The purpose of this study is to analyze and evaluate the incidence, prognostic value, and impact of swirl sign on the outcome of patients who underwent surgical treatment for epidural hematoma. Materials and Methods A retrospective analytical study on 307 acute epidural hematoma (AEDH) patients with and without swirl sign was conducted at our hospital between 2015 and 2019. All the patients in this study were treated initially as per the protocols of advanced trauma life support and surgically treated by craniotomy and evacuation of epidural hematoma. Patients with other concomitant intracerebral injuries such as subdural hematoma and contusion and those who were managed conservatively were excluded from the study. Various factors such as age, sex, mechanism of injury, Glasgow Coma Scale (GCS) score at admission, time from injury to surgery, preoperative mydriasis, location of bleed, midline shift, location of fracture, volume of hematoma, duration of stay in the hospital, and GCS score at discharge were taken into consideration and compared in between patients with and without swirl sign. Outcomes were assessed at the end of 6 months using the Glasgow Outcome Scale. Results Of the 307 patients who were operated for epidural hemorrhage, 92 had swirl sign (29.96%) and the rest had no swirl sign. Univariate analysis revealed a significant correlation between the presence of swirl sign and age, preoperative mydriasis, and time from injury to surgery. The patients with the swirl sign had an unfavorable outcome at the end of 6 months which was statistically significant. Conclusion It can be concluded that those patients with swirl sign in AEDH had an unfavorable outcome compared to those without swirl sign. Therefore, aggressive treatment and early surgery play an important role in the outcomes of the patients.

Background: Chronic wounds, particularly non-healing wounds, are one of the most prevalent surgical disorders that a surgeon may see. The characteristic of a chronic wound is that it does not heal despite daily dressings and costly local treatments. Aims of the study to investigate the healing effects of recombinant human epidermal growth factor (hEGF) on non-healing ulcers and to assess the effectiveness, acceptability, and safety of a new epidermal growth factor (EGF) wound dressing.Methods: On 60 patients with chronic non-healing ulcers, a randomized, prospective, and comparative research was conducted in the department of general surgery, SVS medical college and hospital, Mahbubnagar. These 60 patients were separated into two groups, each with fifteen patients. The EGF was applied to group A, whereas normal saline was given to group B.Results: The 60 patients who agreed to participate in the trial were separated into two groups (30 each) that were equal and comparable. Patients who received topical EGF 0.01% gel dressings were assigned to the trial, whereas those who received standard antiseptic wound dressing were assigned to the control group. Six of the fifteen patients in the test group were men, whereas eleven were males and four were females in the control group. When the two groups were compared, the test group had a substantial reduction in ulcer area compared to the control group (p<0.001)Conclusions: EGF is a superior alternative for treating chronic non-healing ulcers because of its cost effectiveness, availability, reduced hospital stay, and simplicity of administration.