Kailash Mogal ¹, Datta Sonwane ¹

Affiliations
1 Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Adgaon - 422003, Nashik, Maharashtra, IN

Abstract

Introduction: Negative pressure wound therapy (NPWT) provides a novel option for wound treatment. Negative pressure wound therapy is a wound treatment method that subjects the wound bed to negative pressure by means of a closed system. Negative pressure wound therapy gives a moist wound healing environment that is essential for wound healing. Materials and Methods: The study was held in the surgery department of a tertiary care centre with total 50 numbers of patients of age 18 years and above. Patients were examined clinically, and necessary investigations done. Results: The difference in the rate of wound contraction was apparent since 5^th day and by the time of discharge/intervention, means percentage of wound contraction was 90.9% in Negative pressure wound therapy as compared to 74.54% in conventional group patients. Mean hospital stay was significantly more in similar cases managed by conventional dressing as compared to Negative pressure wound therapy (17.23 vs 11.13 days). Conclusion: Present study showed that Negative pressure wound treatment appears to be a better option to conventional chronic wound dressings with early development of granulation tissue, rapid wound contraction and reduced hospital stay.

Keywords

Chronic Wounds, Negative Pressure Wound Treatment, Vacuum Assisted Closed Dressing.

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Kailash Mogal ¹, Vedanti Patil ², Shrikant Palekar ³

Affiliations
1 Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003

Abstract

Introduction: Head injury or traumatic brain injury is defined as non-degenerative, non-congenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions. It is a leading cause of morbidity, mortality, disability, and socio-economic losses in India and other developing countries. Young males are affected more than females and road traffic accident is the commonest cause of head injury. Materials and Methods: We studied patients who presented with head injury to a tertiary health care centre from ages 18 years to 60 years. Clinical profile was studied which included clinical examination and CT scan of brain. Severity of head injury was evaluated on admission by Glasgow Coma Scale (GCS) and functional outcome was assessed by Glasgow Outcome Scale (GOS) at 10th day, 1 month and 3 months after injury. Results: Study was conducted with 200 patients. Most of the patients with head injury were males (79.5%) and peak incidence was in the age group 31–40 years. The commonest cause of head injury was road traffic accidents (72.5%). Most common presentation was loss of consciousness (49%). On admission, GCS score was found to be mild, moderate, and severe in 77%, 9%, and 14.5% patients. Severe GCS score was mostly associated with subdural hematoma in 21.5% patients and also contributes to 82.5% mortality. Fractures (43%) were the commonest CT finding. 12.5% were treated with surgery. Overall mortality was 12.2%. GOS was calculated on 10th day, at the end of 1 month and at the end of 3 months. At the end of 3 months, 87% patients showed complete recovery, 0.5% patients showed moderate disability, 0.5% showed severe disability, 0% showed vegetative state and 12.2% was the mortality. There was considerable improvement in GOS scores with respect to disability and recovery from 10th day to follow-up at 3 months post trauma. Conclusion: GCS score on admission and the type of CT lesion are both important factors in determining the outcome, and both must be considered when describing severely head injured patients. GOS is a good modality to predict functional outcome of these patients and assess their recovery and disability.

Keywords

Glasgow Coma Scale, Head Injury, Subdural Hematoma, Traumatic Brain Injury

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Kailash Mogal ¹, Mohammed Mithi ², Jyotsna Kulkarni ³

Affiliations
1 Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN

Abstract

Introduction: Ureteric stents have become one of the most basic and valuable tools in the urological practice. Indwelling ureteral stents provide direct drainage of the upper urinary tract to the bladder without the need for external diversion. The indications for insertion of stents into the urinary tract has expanded significantly during the last decade. However, their use is not free of complications and problems. The present study was designed to observe the clinical profile of patients presenting with obstructive uropathy at a tertiary care centre requiring DJ stents and to study the complications of indwelling DJ stents. Material and Methods: Data collection by meticulous history taking and clinical examination, appropriate laboratory and radiological investigations, operative findings, and follow-up of cases. Results: Study was conducted with 50 patients. nodule was 23%. Mean age of the subjects was 44.32 year. Overall male predominance was seen in present study with 70% males. Obstructive uropathy forms the major indication for DJ stenting followed by upper urinary tract infections (10%). Associated Complications were noticed in 46% of cases. Most common associated complication of DJ stenting was dysuria (24%) and increased frequency (22%). Urinary tract infection, haematuria, and stent migration was seen in 12%, 8% and 4% cases. Conclusion: Double stenting is an easy and effective procedure for the management of obstructive uropathy. However, we recommend that their use must be strictly restricted to selected cases and routine use should be avoided, as they are not free of complications. Moreover, close follow up of stented patients is essential for early detection of complications and a lot of stress should be paid on the counselling of the patients regarding stents complications and their timely removal in order to avoid stent encrustation/migration which could otherwise be highly fatal for the patient.

Keywords

Double J, JJ/DJ Stent, Obstructive Uropathy, Ureteric Stents

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