Background: Chronic non-healing wounds pose a remarkable challenge to health professionals and drain our resources. In recent years, prevalence of diabetic foot ulcers is growing at epidemic proportion in India and worldwide. There are various modalities available for wound debridement. In present study, authors have compared two debridement methods, one which we use regularly in their hospital, wet to dry normal saline dressing and enzymatic debridement with papaya.Methods: This was a randomized, comparative interventional study of 100 patients carried out in Kilpauk Medical College Hospital from August 2013 to August 2014 to compare to efficacy of papaya dressing over normal saline dressing in chronic non-healing wounds.Results: The mean reduction in slough/necrotic tissue in at time of inclusion in study and four week after the study was assessed. In saline dressing, mean reduction was 13.156, standard deviation 3.4558. The mean reduction in slough/necrotic tissue in papaya dressing 10.5, standard deviation 0.7071. There was significant difference in percentage reduction in slough/necrotic tissue within the two groups. Similarly, for the cases with active ulcer, the size assessment at the time of inclusion in the study and three week after was again analysed using student t-test and the mean ulcer size in papaya dressing 2.5062 and standard deviation 1.504. Mean ulcer size in normal saline dressing 2.1564 and standard deviation 1.2961.Conclusions: Present study concluded that favourable and significant ulcer healing rate with improvement and reduction in clinical severity suggests that enzymatic debridement with papaya dressing plays an important role in management of chronic non-healing ulcers.

Background: Thyroidectomy is one of the most commonly performed surgeries throughout the world which has an extremely low morbidity rate. Nowadays with the advent of newer techniques the duration of surgery and complications have decreased. Conventionally Thyroidectomy was done by suture knot tying technique which needs large number of surgical ties and also time consuming. It decreases healing as well as increases wound infection, injury to neighboring structures and foreign body reaction.Methods: In this study, I selected 50 patients with thyroid swelling attending the surgery outpatient department from February 2015 to August 2015. Thyroid surgery was done using bipolar cautery. The results were analyzed.Results: This study shows most of the patients belong to 30-40 years followed by 40-50 years. The male: female ratio is 1:25. Time duration varies from 50 minutes to 135 minutes. The longer duration of surgery compared to other studies is attributed to learning curve. We started using bipolar diathermy since 2013. The blood loss ranges from 25-50 ml. Complication rates are also less with bipolar thyroidectomy, 2% had postoperative hemorrhage, 2% developed temporary RLN palsy, 2% developed minor degree of wound infection, and 6% developed signs and symptoms of hypocalcemia. The mean duration of hospital stay was 4 days.Conclusions: Thyroidectomy using bipolar cautery is safe and effective method and also less time consuming. The cost of the bipolar cautery is less compared to harmonic scalpel and LigaSure. Bipolar cautery is available in our government hospital. Blood loss using Bipolar Cautery is less compared to conventional Knot–tying technique. The post-operative complications are less with bipolar cautery.