Background: Commonest approach in emergency open abdominal surgeries remains to be midline laparotomy because it is simple, saves time and causes minimal blood loss. Optimal technique for laparotomy wound closure has been a topic of debate since long. Risk factors for development of incisional hernia and burst abdomen are wound infection, systemic illnesses of patient and closure technique. Factors related to patients like age, gender, body mass index (BMI), systemic illnesses are not modifiable when an emergency laparotomy is the only option. Hence closure technique is one factor where surgeon has total control, which can bring down the incidence of burst abdomen and incisional hernias.Methods: Prospective study conducted in 150 patients who underwent emergency midline laparotomy from December 2014 to February 2016 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India with 6 months’ follow-up after surgery.Results: Most of patients in the study belonged to 30-40-year group and were males (78%). Gastrointestinal perforation peritonitis (52%) was the single most common indication for emergency midline laparotomy. In the continuous and interrupted groups, post-operative wound infection was found in 54.6% and 34.6%, wound dehiscence was found in 16% and 6.6% and incisional hernia in 14.4% and 4% respectively.Conclusions: Interrupted suturing is superior to continuous technique in emergency midline laparotomy wound closure in terms of complications and post-operative morbidity.

Background: After decades of debate and controversy, the short-term benefits and at least equivalent long-term outcomes of laparoscopic colon surgery compared to open surgery has now been well established. Methods: In this article, short- and medium -term outcomes of patients undergoing laparoscopic colorectal surgery for cancer in a tertiary care hospital is analysed. A retrospective analysis of prospectively collected data of all patients who had laparoscopic management of colorectal cancer (CRC) for 3 years was done. Patients were followed up for 2 years after treatment. The prospectively collected data was analysed to find out the incidence of complications, local or distant metastases and the survival rates. Results: There were 65 patients who underwent laparoscopic surgery among 120 patients who had treatment for colorectal carcinoma in the study period. The 26 patients underwent low anterior resection followed by 14 patients   and 13 patients undergoing left colonic and right colonic resections respectively. While abdominoperineal resection was carried out in 6 patients, 3 each patients were treated by ultra-low anterior resection and subtotal colectomy. Morbidities of varying grade according to Clavien Dindo classification was less for laparoscopic surgery. Recurrence occurred in 14.8% at 2 years follow up. The 2-year survival rate was noted to be 87.7%   among the study group who underwent laparoscopic surgery. Conclusions: Judicious selection of patients and the appropriate selection of technique help to achieve good short-and long-term results without compromising on oncological outcome in laparoscopic surgeries for colorectal malignancies.

Background: Diabetic foot ulcer is a very common condition encountered in surgical practise. Wound management pose a good challenge for a treating surgeon due to its physical, mental and social implications. The devitalised necrotic tissue present in ulcer does not favour the wound healing as it increases the chance of infection and delays appearance of granulation tissue. Hence debriding of devitalised tissue plays a key role in wound care. In present study ,we used papain urea based preparation in dressings which is a autolytic agent. This study was conducted to evaluate the effectiveness of use of papain urea based preparations compared with regular conventional dressing in diabetic foot ulcer management.Methods: This was a prospective study conducted in K. R. Hospital, Mysore, Karnataka, India. 60 eligible subjects with diabetic foot ulcers were selected and subjects were randomly allocated into two groups Group A and Group B with 30 subjects in each group. Subjects in Group A underwent dressing with papain urea based preparation and in Group B underwent regular conventional dressing. Results were assessed with respect to percentage decrease in necrotic tissue, incidence of infection, appearance of granulation and hospital stay.Results: Among Group A subjects percentage reduction of necrotic tissue was more, granulation appeared early and the hospital stay was less compared to Group B subjects which were statistically significant. However, there was no significant difference with respect to incidence of infection in both groups.Conclusions: Papain urea based preparation is effective in diabetic foot ulcer care.