Background: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. Aim: To evaluate total extraperitoneal repair with direct telescopic dissection and mesh hernioplasty for inguinal hernias.Methods: This study was conducted at General Surgery department the period of 1 year on 30 patients having inguinal hernia.Results: This prospective study included 30 adult patients with primary unilateral inguinal hernia, all of them were males. Age of study patients ranged from 22 to 64 years old. Intraoperatively, 6 patients were presented to have direct inguinal hernia (20%) while 21 patients had indirect inguinal hernia (70%). In 3 patients, combined direct and indirect hernia defects were present (10%). Mean operative time was 99.30±25.13 min. Mean time for analgesia was 3.62±1.57 days. Hospital stay mean was 1.43±0.62 days. The mean time until return to work was 14.1±3.13 days, the mean time of follow up was 7.1±2.2 months. Intra operatively 5 (15%) and post operatively 8 (26.6%)complications were observed.Conclusions: Laparoscopic TEP repair is an excellent alternative to open preperitoneal repair of inguinal hernia. Complication rate was average with other studies while there was no hernia recurrence during the period of follow up.
Background: The infection of a wound is defined as the invasion of organisms through tissues following a breakdown of local and systemic host defences, leading to cellulitis, lymphangitis, abscess and bacteraemia. Southampton criteria and the centers for disease control and prevention criteria for the diagnosis of surgical site infections are used now for severity assessment. There is still controversy existing on the multifactorial causal relationship.Methods: Longitudinal Observational study with nonrandom purposive sampling carried out in the patients in OT, Casuality, ICU and Wards, in our hospital having clean contaminated abdominal operations for one-year period starting from November 2015 determine the factors responsible for surgical site infections following clean contaminated abdominal operations with prophylactic antibiotics(n=150).Results: Diabetes mellitus (odds ratio of 1.9) and emergency procedure (12.6%) were the most important risk factors for development of SSI. E. Coli (45%, n= 9) was the most common organism. Midline incision (n=6/22 = 27.27%) showed highest rate. Other high-risk factors are obesity, malnutrition, anemia, old age and prolonged duration of surgeries.Conclusions: Various host factors like malnutrition, obesity, patients knowledge about hygiene, presence of co-morbidity etc. coupled with environmental factors such as condition of the wounds, delay to initiate operation, duration of operation, prolonged exposure of peritoneal cavity to environment, prophylactic use of antibiotics and factors associated with surgery like type of incision, type of operation and experience of operating surgeon greatly contribute to occurrences of SSI. So, quality of surgical care including immediate assessment of patients, resuscitative measures, adequate preparation of patients and aseptic environment are important for control of SSI. Moreover, in absence of highly advanced surgical amenities, preoperative resuscitative units, modern operation theatre facilities and sophisticated sterilization procedure it is necessary to use prophylactic antibiotics to encounter the various types of micro-organisms responsible for surgical site infection, particularly E. coli.
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