To assess patient satisfaction and outcomes in polytraumatized patients in EL-Demerdash hospital. Background: This is the first study that assessed patient satisfaction with a tertiary hospital in Egypt. Ain Shams University Surgery Hospital, which is one of the largest hospitals in Egypt and serves millions of patients each year, was the site of the study. Methods: A version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to query 361 patients from November 2015 until July 2018 Survey questions were divided into the following categories: communication with doctors, responsiveness of hospital staff, cleanliness of the hospital environment, quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of the hospital, and willingness to recommend the hospital. Results: A total of 361 patients were interviewed. The results showed both positive and negative levels of satisfaction. The positive results included no delay in admission, friendly staff including nurses and doctors, better patient outcomes regarding pain management and adverse side effects, and the overall rating of the hospital was good, which reflected patient satisfaction. The negative findings were lack of proper communication between the medical staff and patients. Patients indicated they did not get a satisfactory explanation of their prescribed drug doses and drug adverse effects. In addition, they did not get enough instruction on what to do after being released from the hospital. Conclusion:The medical staff at Ain Shams University Surgery Hospital should focus more on the patient's own preferences and communicate better with patients. We recommended that the hospital organize regular communication skills courses for medical students, physicians, and nurses. Patients should understand the discharge report and indications and side effects of the medications before leaving the hospital.

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Rectovaginal fistula (RVF) is a major problem following mainly an obstetric trauma with high rate of recurrence inspite of different techniques of repair. The need for routine diverting stoma is another matter of debate. Aim of the work:To evaluate the outcome of RVF repair using Martius flap with and without diverting stoma.Patients and Method: Twenty six patients with RVF were divided into 2 groups, one without colostomy (group A) and the second with (group B).Results: Postoperative wound infection was 33% in group A & 9% in group B. Early failure in group A was 13% and 0% in group B, whereas late failure was 6.6% & 9%, in group A & group B, respectively. Conclusion:It is advised to perform pre-repair diverting stoma to improve the outcome in RVF with large defects, presence of vaginitis, or postradiation.