Introduction: Pilonidal sinus disease (PSD) is a chronic inflammation and infection of the sacrococcygeal area with swelling, discomfort and seropurulent discharge among the ain symptoms. Studies show the disease to be an acquired condition. Among the treatments offered are excision and secondary intention healing, marsupialization, excision and primary closure, and different kinds of excision followed by flap repair, commonly being Karydakis flap and Limberg flap. The surgical outcomes of both the types of flaps is compared in this study. Aim and Objectives: To assess the surgical outcome between Karydakis flap and Limberg flap in pilonidal sinus. Materials and Methods: It was an observational study conducted at department of surgery, in patients with pilonidal sinus between the age of 15 to 65 yrs. A total of 30 patients were included after obtaining the informed consent, with group A as 15 patients undergoing Karydakis flap procedure and group B as 15 patients undergoing Limberg flap procedure. Results: The mean age of patients was found to be 33.10±11.57yrs of age, male preponderance (80.0%) was seen. Male to female ratio was 4:1. Mean operative time was 45.1±3.0 and 57.7±3.7mins for Karydakis flap and Limberg flap method respectively. Significant lower blood loss was seen among the Karydakis flap method. Lower duration of hospital stay was seen among the Karydakis flap group (4.9±1.2days), Limberg flap group (5.2±0.7days). Overall, 6 patients presented with recurrence who underwent the Karydakis flap method. Conclusion: Comparative results seen between both Karydakis flap and Limberg flap however, Karydakis flap procedure showed shorter operative time, lower blood loss. Patient's with Limberg's flap had lesser early post operative complications, early pain-free toileting and nil recurrence and was recommended to other patients. Hence, Limberg flap is still a better option to the patients as compared to Karydakis flap procedure.

Background: Layered closure of the abdomen has been considered to be ideal until recently however single layer mass (retention) closure technique, in which all the layers of the abdominal wall are closed in single layer is being increasingly used by surgeons. We conducted this study to analyze outcome measures in patients in whom wound closure was done by retention closure and layered closure.Methods: This was a prospective comparative study in which 60 patients undergoing elective or emergency laparotomy were included on the basis of a predefined inclusion and exclusion criteria. In 30 cases (50%) layer closure was done whereas in remaining 30 (50%) patients retention closure technique was used. Major outcome measures studied were time required for wound closure and post-operative complications.Results: Out of 60 studied cases there were 42 (70%) males and 18 (30%) females with M: F ratio of 1: 0.42.The time required for closure in layered suture group (group A) was 26.76±3.36 whereas in case of retention closure suturing it was 19.36±4.35. The difference was found to be statistically highly significant (p<0.0001). The complications rates were found to be statistically significantly higher in layer suturing (Group A) as compared to retention suture group (Group B).Conclusions: We conclude that retention suturing is preferable as compared to layered suturing in patients undergoing midline laparotomy in terms of time required for closure of wound and post-operative complication rates.

Background: The cochlear implant procedure is one of the efcient surgical options for the management of patients suffering from severe bilateral sensorineural hearing loss.Cochlear Implant exposure is one of the commonly reported complications.With an increase in the number of cochlear implant surgeries there is bound to be an increase in the number of complications. Cochlear implant extrusion, which is a common complication of cochlear implants, is generally repaired by a well visualized soft-tissue ap. Herein, we report our experience in the management of patients with cochlear implants complicated by implant exposure. Methods: In our prospective study -based case series of 12 patients with exposed cochlear implants requiring soft tissue coverage who were referred to plastic surgery care. These patients underwent their CI procedures at a tertiary care hospital specializing in ear, nose, and throat, after which they were referred for plastic surgery care at our hospital for reconstruction after exposure. Each patient was managed through different surgical techniques based on the size, site, and condition of the surrounding tissue with dual vascularised ap cover. Results: Twelve patients with exposed cochlear implants were treated with different surgical techniques with dual ap. During the 2-year follow- up period, the patients made an uneventful recovery with fully functional cochlear implants. Conclusions: In conclusion, this case shows that the cochlear implant exposed scalp defect could be reconstructed in a relatively easy and safe way with dual vascularised ap cover, in a short period of time, by using a TPFF or pericranial or gaeleal ap with minimal donor morbidity and anatomical proximity to the cochlear implant site combined with second vascularised scalp skin ap for the defect.