Background: The aim of the present study was to study the morbidity status of patients of small bowel perforations undergoing ileostomy. To study the intra operative findings determining the construction of type of ileostomy and the effectiveness of various ileostomy appliances in maintaining skin integrity after ileostomy. Methods: The study population consisted of 60 patients of surgically verified ileal perforation in which ileostomy was made. Patients were studied for etiology, site, operative technique, appliance used and complications if any. All the data was presented in the observation tables, analysed and interpretation was done. Results: In our series maximum number of perforations occurred in third decade of life. The youngest patient was 7 years old and oldest patient was 80 year old. Mean age is 29.75 years. The Male: Female ratio is 1.6:1.Abdominal pain was the most prominent symptoms and was found in all patients. Etiologically, typhoid accounts for 63.3% of all perforation cases, with tuberculosis and traumatic perforation sharing 10% and 6% cases each respectively. Out of 60 cases, in which ileostomy was made, 31 patients (51.6%) had solitary ileal perforation. Out of 30 patients in whom the Romson's bag was applied, skin excoriation was present in 23 patients (76.6%). Out of 30 patients in whom the Hollister's bag was applied, only 12 patients (40%) had skin excoriation. Conclusion: There is a definite reduction in the mortality of the patients of small bowel perforation after ileostomy as compared to primary closure of perforations. Early diagnosis and meticulous surgical interventions of the cause of small bowel perforation and proper post op care is mandatory.

Introduction: Intracapsular fracture of neck femur usually present with severe swelling, difficulty in walking reduced length of affected limb. The most common Risk factors are old age, osteoporosis, taking excessive medications, alcohol, smoking and cancer. Diagnosis can be done by using X-rays, CT scan and MRI. Materials and Methods: It is a prospective study consists of all the patients admitted to JSS hospital with intracapsular fracture neck femur treated with unipolar or bipolar endoprosthesis. Results: The selected patients were randomized and divided into two groups, Group one (I) and Group two (II). Patients were suction tube is used are categorized into Group I and in those were suction tube is not used are categorized into Group II. These two groups were studied and observed for the following, fall in haemoglobin and PCV at 48 hours post-operatively. Complications are Persistent discharge, serous discharge from the wound for more than 10 days. Discussion: When the doctors are in doubt, then they need to insert a drain was countered by Halsted (1898). Now days in orthopedic cases, closed suction drains are being commonly used to decrease the complications. Blood accumulation in and around the tissue site will raise the tissue tension and thereby reduces tissue perfusion in and around the surgical wound site. Conclusion:We consider that there is ample evidence that closed suction drains is of no benefit in primary uncomplicated hemiarthroplasty. The advantage of the drains in orthopaedic surgeries should be debated as non use of drains drastically reduces anemia and requirement of blood transfusion after surgery. In a developing and under-developing countries, the cost increases because of the blood transfusion needs and costs of drain device which will outweigh any advantages of putting a drain.

Aim An increasing proportion of knee arthroplasties are performed using robotic-assisted surgical techniques. While these techniques are associated with shorter lengths of stay, better patient outcomes and lower revision rates, the increase in intra-operative time and requirement for extra instrumentation, such as array pins, may lead to an increased risk of infection. Therefore, this review reports summary rates of surgical site infection (SSIs) in robotic-assisted knee arthroplasties. Method The protocol for this review was prospectively registered on PROSPERO. Embase, PubMed/MEDLINE, Cochrane and CINAHL databases were searched from 2004 to November 2020 to reflect modern robotic surgical practice. The primary outcome was overall number of SSIs that occurred within one year of the primary operative procedure, which was sub-classified into either deep or superficial and pin-site infections. Risk of bias was assessed via the Cochrane RoB2 tool. Conventional Q and I2 tests for heterogeneity were performed with subsequent meta-analysis using a DerSimonian-Laird random-effects model. Results From 1052 studies identified, 17 were included, of which 13 were deemed to have an overall ‘low’ risk of bias. This review included 4400 unicompartmental and 1883 total knee arthroplasties. The summary rate of overall SSIs within one year of primary robotic knee arthroplasty was 0.568% (SE=0.183, 95% CI=0.209–0.927). This rate fell to 0.154% (SE=0.069, 95% CI=0.018–0.290) for deep infections and 0.347% (SE=0.109, 95% CI=0.133–0.561) for superficial and pin-site infections. Conclusions The rates of surgical site infection were found to be low in robotic knee arthroplasty, however, further research is required to compare outcomes with conventional knee arthroplasty.