Abstract:Currently, laparoscopic appendectomy is widely practiced for the management of acute appendicitis. It is not clear whether open or laparoscopic appendectomy is more appropriate. Our aim was to compare the safety and the advantages of laparoscopic versus open appendectomy in a prospective study. 102 patients were participated in this study. The group 1 patients were subjected to laparoscopic appendectomy [LA], whereas the group 2 patients were subjected to open appendectomy [OA]. 46 patients included in LA group and 54 patients in OA group. The mean operative time for LA and OA was 84.4 (45-220) minutes and 59 (30-180) minutes respectively. Although LA was associated with a shorter hospital stay [LA-3.5 days versus OA-5 days] but duration of operation is prolong in LA than OA and the postoperative wound infection is significantly higher in OA than LA. LA is safe and superior to OA in respect to an early discharge, lesser postoperative pain; decreased post operative wound infection, early return to work and a better cosmetic scar.

Post-surgical wou  infection is a crucial factor in surgical practice. Prolong use of postoperative antibiotic is common practice in our surgical world. This causes financial burden to our patients a antibiotic resistance. But international journals a  literatures suggest using antibiotics as prophylaxis only at the time of operation a  no further postoperative antibiotic is needed in clean contaminated surgery. This comparative cross-sectional study was done at the department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total number of 100 patients of clean-contaminated elective laparotomy were selected. Patients were ra omly divided into two groups, in Group-I (got single dose preoperative Inj. Ceftriaxone) a  in group-II (got single dose preoperative Inj. Ceftriaxone followed by Inj. Ceftriaxone for 2 days a  then Cap. Cefxime for next 5 days). There is no statistically significant difference in outcome between two groups. So, single dose preoperative Inj. Ceftriaxone (1gm) is sufficient as a prophylaxis of surgical site infection in clean-contaminated elective surgery.Faridpur Med. Coll. J. Jan 2016;11(1): 6-10

:Closure is a crucial factor in laparotomy wound. Fascial layers provide the major tensile strength in wound closure. Poor wound healing and development of wound infection in incisional wounds are the common complications of open abdominal surgery. Continuous fascial closure commonly practiced and the interrupted closures are also practiced by some surgeon with an assumption that it causes less pain and less wound infection. The aim of this study was to determine the rate of postoperative wound infection and severity of wound pain following interrupted and continuous abdominal wound closure. A comparative cross-sectional study was done at the Department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total 100 patients of clean-contaminated elective laparotomy were selected. The patients were randomly divided into two groups. Every odds number was included in group-I (interrupted suture) and every even number was included in group-II (continuous suture). Total 14% wound infection was detected in interrupted suture group where as wound infection was 18% in continuous suture group of wound closure. Though the wound infection is higher in group-II but the difference of wound infection is not statistically significant between two groups. The wound pain assessed in seven postoperative days was higher in continuous closure group than interrupted group but the difference was not significant. There is no significant difference of wound infection and wound pain between interrupted and continuous suture group in clean-contaminated laparotomy.