European Journal of Cardiovascular Medicine

Large wounds with heavy exudate are known to cause moisture related skin damages that can be distressing to the patient especially when he has pain that disturbs his sleep and other activities. Honey, known to be used to treat wound in ancient era, has antimicrobial properties, is anti- inflammatory and is known to promote wound healing. This case report demonstrates the efficacy of Indian medical grade honey in high exuding wound with peri wound skin damage.

Background and objectives: The present study evaluates the effect of essential oils of Rosmarinus officinalis and Populus alba on experimentally cutaneous heat-induced burn injury in rat.Materials and Methods: For this purpose, the acute toxicity test was carried out on Wistar rats that received intraperitoneally gradual doses (0.5to 7 ml /Kg) of the both essential oils. Then, Second-degree burn wounds were induced in five groups (N=5 in each). The percentage of wound healing were assessed on 5, 10, 15, 20 and 25 days. In the other hand, wound surface was monitored and photographed during the period of treatment. Results and Conclusion: The essential oil of Populus alba and even Rosmarinus officinalis have no acute toxicity in rats.

Background: "Hypertrophic scars" are excessive scars in which the dense fibrous tissue does not extend beyond the borders of the original wound or incision. They tend to be wider than necessary for normal wound healing to occur. Histologically, hypertrophic scars have more organized collagen fibers than keloids, and scant mucoid matrix. Hypertrophic lesions are characterized by randomly distributed tissue bundles consisting of uni-axially oriented extracellular matrix and cells. Materials and methods: This is a prospective and single centre study conducted in the Department of Plastic Surgery, Tertiary Care Teaching Hospital from November 2021 to October 2022. Males and females in the age group between 18 and 60 years were included in this study. The split thickness skin graft was harvested from a normal thigh where no skin graft had been harvested earlier. Indications for skin grafting were both elective and emergency. Result: Better Aesthetic and symptomatic outcome in Triamcinolone injected skin graft donar areas. Conclusion: Injection of Triamcinolone into skin graft donar areas will reduce hypertrophic scarring significantly

Background:   Bactibilia, or the presence of bacteria in bile from the gallbladder, may contribute to the development of septic complications. It has been related to increased rates of surgical site infection after cholecystectomy. Laparoscopic cholecystectomy is the definitive treatment for cholelithiasis and cholecystitis. Advanced age, acute cholecystitis, ERCP, and gallstones are important risk factors for the development of bactibilia. This study aims at showing the effect of bactibilia on the course of laparoscopic cholecystectomy. Materials and methods: This are a prospective case-control study to be conducted at Govt. General Hospital, Vijayawada at Dept. of General Surgery over 1 year on 50 patients. Patients with asymptomatic Cholelithiasis of age 18-60 are included in the study and patients with hemoglobin < 10 gm%, hypoalbuminemia < 2.5 gm/dL, patients in acute sepsis, patients with HbA1c >6.5%, hypertension (>139/89 mm of Hg) and BMI > 30 and patients in an emergency setting and patients who have not consented for the study were excluded from the study. None of the patients received pre-operative antibiotics. Intra-operatively, bile is collected from the gall bladder and sent for microbiological culture in aerobic and anaerobic media for 3-5 days. Patients are divided into: Group A - Microbiological culture positive for microbes and Group B - Microbiological culture sterile. Both groups will be analyzed for the duration of hospitalization after surgery, post-operative wound infection, and any other complications encountered. Results: Out of the 50 patients, 32 were males and 18 were females. The mean age of the patients was 43.5 ∓ 9.6 years. The mean BMI was 27.1 ∓ 4.7. Of the total 25 samples positive for bile culture, 11 were E.coli, 7 were Klebsiella, 3 were Enterobacter spp., 2 were Acinetobacter spp., and the remaining were 2 Viridans streptococci. All the bacteria were sensitive to Amikacin. All except Acinetobacter were sensitive to gentamycin and imipenem. All except one case of E.coli were susceptible to ciprofloxacin. The incidence of port site infection, prolonged fever, intra-abdominal abscess, pneumonia, wound healing duration, and hospital stay were significantly higher in group A compared to group b (p-value < 0.05). Conclusion: Bactibilia affects the outcomes of laparoscopic cholecystectomy in terms of prolonged hospital stay, increased incidence of wound infection, duration of wound healing, and fever.

Background: Wound Healing is the summation of a number of processes that follow injury. Despite immense advances in the technique of wound creation and closure, there continues to be an important percentage of patients undergoing abdominal operations, suffering from delayed wound healing and partial wound failure. The aim of this study is to assess the various factors influencing post laparotomy wound healing. To identify the pre-operative, operative and post operative risk factors in patients having poor wound healing. Material and Methods: All adult male and female patients undergoing laparotomy for various indications were included in the study. This descriptive, non-interventional case study was conducted in the Departments of General Surgery in Veer Surendra Sai institute of medical science and research burla sambalpur. (Minimum of 100 cases). Results: This prospective study was conducted in VIMSAR hospital, burla, sambalpur. A total of 100 patients undergoing laparotomies were studied .40 patients were found to have delayed wound healing. The strongest association for delayed healing was found to be wound infection, followed by smoking, chronic cough, poorly controlled diabetes and alcohol. Conclusions: The incidence of delayed healing was found to be higher in our study with increased incidence of wound infection. It was found that emergency laparotomies were associated with an increased incidence of wound infection and thereby delayed healing. Poor wound healing is also associated strongly with poor nutrition and uncontrolled diabetes. These factors should be taken into account and efforts have to be made to correct the risk factors pre or post-operatively.

Introduction: Surgical site infections (SSIs) continue to be one of the most common complications in conventional surgery. Various risk factors for the development of poor wound healing have been identified. An SSI is defined as an infection occurring within 30 days of surgery that meets the following criteria: (1) the diagnosis consists of the infection of an anatomic plane by one of the following manifestations: collection, inflammatory signs (pain, edema, tenderness, redness), dehiscence, or positive culture; and (2) classification according to the anatomic plane as follows: superficial incisional SSI, infection of the skin and subcutaneous tissue; deep incisional SSI, infection of the deep soft tissue (fascia and muscles); and organ/space SSI, infection of the organ/space. Objectives: A) To compare the incidence of superficial SSI in surgical incisions closed with coated polyglactin 910 suture with triclosan versus incisions closed with coated polyglactin 910 suture without triclosan. B) To study the time frame between surgery and development of SSI. C) To determine which bacteria is commonly associated with SSI after surgical closure. Material and Methods: This is a Randomized, prospective, open, single centre controlled study was conducted in the Department of General surgery, B.J Government Medical College and Sassoon general Hospital, Pune over a period of 1 year. Institutional Ethical Committee permission was obtained prior to commencement of the study. Intra-operative data was collected. It included the method of painting and draping, duration of the surgery, antibiotics received during surgery. intra-operative findings, wound class and subcutaneous tissue sutured with coated Polyglactin 910 suture with/without triclosan. Results: Mean age of case in Non-TCS group was 37.9 years, whereas mean age of TCS group was 36.8 years. P value of 'Student's t test for comparison of age distribution in Non-TCS and TCS groups was not significant. This assured the age matching of the two groups. 40 males and 33 females were included in Non-TCS group: 34 males and 30 females were included in TCS group. The Chi-square test was applied to observe the sex matching in two groups. P value was not significant, assuring the sex matching of two groups. Maximum number of case (40%) operated in Non-TCS group were Class II wounds, whereas maximum number of case (42%) operated in TCS group were Class I wounds. Least number of case, i.e., 9% in Non-TCS group and 8% in TCS group belonged to Class IV wounds. Conclusion: In our study, the incidence of Superficial SSI rate after surgery has been observed to be reduced with the use of triclosan coated suture (coated Polyglactin 910 suture with triclosan), but it was not totally eliminated. The pathogens cannot be completely eliminated from the site of surgery, but they can be minimized. Antimicrobial coated suture is a promising novel method to achieve the goal of least Surgical Site Infection (Superficial SSI) rates. Large scale trials are needed to further demonstrate the evidence of efficacy of antimicrobial (triclosan) coated suture material (coated Polyglactin 910 suture with triclosan) in reducing SSIS. More research is needed together with improved compliance with already established measures.701-706701-706

Background:  The prevalence of chronic leg ulcers is increasing at a rapid pace due to lifestyle disorders like diabetes, atherosclerosis. Treatment of chronic leg ulcers is expensive. For a proper treatment of patients with leg ulcers it is important to be aware of the large differential diagnosis of leg ulceration and to effectively manage the conditions Materials and methods: 250 patients with chronic ulcers over leg who presented to the Department of Surgery, Government General Hospital, Guntur, from Sept 2021 to Oct 2023 were included in the study.  Results:  Males were predominant than females and most of the patients were middle to elderly age group. Diabetic foot ulcers were the majority of ulcers, followed by ulcers due to venous insufficiency and arterial occlusion.  Conclusion: A correct diagnosis is neccessary to avoid inappropriate treatment that may cause deterioration of the wound and delay wound healing. With increasing medical technology, newer modalities of treatments for patients with chronic leg ulceration are emerging, so that they can have better quality life.

Background: Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. Materials and Method: A prospective study, for a period of 3 years at Department of Paediatrics, Tertiary care Teaching Hospital was conducted after obtaining ethical committee clearance of the institute. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. An informed consent was taken from parents, detailed history was recorded with particular emphasis on symptoms suggestive of anaemia such as weakness and easy fatiguability, breathlessness on exertion, pica. A thorough clinical examination of every child was done. Results: The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion: In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour

INTRODUCTION Pediatric anemia is one of the major health burden in India and in major parts of the world, as it results in reduced exercise tolerance, slower rate of growth, impaired development and delayed wound healing. Anemic children are also at a higher risk of death due to complications associated with malnutrition and infection. Prevalence rate of anemia is an essential indicator of the nutritional status within the pediatric population. In the United States, around 18% of the children and in the developing countries about 82% of the children are anemic. Because of these factors, the study of the etiopathogenesis of anemia in infancy and childhood has attracted wide attention in the recent years in India. MATERIALS AND METHODS A prospective study, for a period of 1 years at Department of Pathology, Chalmeda AnandRao Institute of Medical Sciences was conducted. The children who were admitted in the hospital with sign of Pallor were selected as per inclusion criteria into the study. Routine Investigations for anaemia and its causes were done. Anaemia was classified morphologically based on peripheral smear findings. Packed-cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) were determined by automated cell counter. Hemoglobin was estimated by Sahli’s method and expressed in gm%, peripheral smear was stained by Leishman’s stain. Reticulocyte count was done by brilliant crystal stain method, serum iron determination was done by Ramany’s dipyridyl method, Total iron binding capacity was determined by Ramsay’s method, serum vitamin B12 and folic acid was determined by architect method. Results The present study comprised of 400 subjects, out of which 58% were males and 42% were females. Dimorphic, Macrocytic, Microcytic Hypochromic, Normocytic Hypochromic and Normocytic Normochromic Anaemia were reported in 12%, 4%, 50%, 4% and 30% of the subjects respectively. Maximum cases were of Microcytic Hypochromic type. The distribution of anemia according to Vit. B12 and Folic acid. Total 50 patients were studied. 12 cases of macrocytic anemia, 12 had Vitamin deficiency (8 with reduced Vit B12, 3 with reduced Folic acid and in 1 case both were reduced) i.e. 22.2%. In 28 cases of Dimorphic anemia, 38 had Vitamin deficiency (19 with reduced Vit. B12, 10  with reduced folic acid and in 2 cases both were reduced) i.e. 72.2%. Conclusion In the current study, the preschool children are found to be the most affected. Hence, it is recommended that, this age group is compulsorily screened for anemia. A uniform definition of screening criteria and an effective system to respond to abnormalities is the need of the hour. The current study was taken up, keeping this need in view

Background: Diabetic foot ulceration (DFU) is a devastating complication of diabetes that is associated with infection, amputation, and death. Dressing is mostly used in wound care for both the protection of the wound as well as its healing. Silver ions were identified as a highly efficient potent of antibiotics of different classes. The study aims to investigate the efficacy of silver nano gel in wound healing among patients with diabetic foot ulceration. A prospective study was over a period of six months (July 2023-December 2023) among 60 patients who were randomly allocated into two equal groups. The conventional dressing (group-B) was compared with silver nano gel (group-A) dressing through evaluation of wound condition at the time of admission, 4^th and 8^th week. The data was analyzed using Jamovi v 2.3.28 software. The results showed that wound size was reduced in group A in the 4^th and 8^th week of admission which is statistically significant with a p-value of 0.001 also healthy granulation tissue was noted in seventy percent of the patients in group A, whereas only fifty-five percent in group B. Employing nano-silver gel for the management of diabetic foot ulcers was much more effective than using conventional dressing techniques.

Background: Sucralfate serves as a cytoprotective medication that is predominantly used to treat ulcers of the gastrointestinal tract, such as duodenal, gastric, and gastritis ulcers. Recent studies suggest sucralfate can be implemented topically to open wounds and has positive effects for treating persistent ulcers. The study aims to investigate the efficacy of sucralfate in wound healing among patients with diabetic foot ulceration. A prospective study was over a period of six months (July 2023-December 2023) among 60 patients who were allocated into two equal groups. The conventional dressing (group-B) was compared with sucralfate (group-A) dressing through evaluation of wound condition at the time of admission, 4th and 8th week. The data was analyzed using Jamovi v 2.3.28 software. The results showed that wound size was reduced in group A in the 4th and 8th week of admission which is statistically significant and also healthy granulation tissue was noted in higher proportion among the patients in group A. Topical application of sucralfate can be proven to be more effective, safe, and facilitate wound healing than conventional dressings.

Background: Deep sternal wound infections (DSWI) following median sternotomy are initially treated by the cardiothoracic surgeons and are referred to a plastic surgical unit late in the course of time. Materials and methods: A retrospective study was conducted in the Department of Plastic Surgery at GMC NAGPUR from January 2023 to December 2024 and the data of 12 patients who had DSWI out of 214 patients who underwent median sternotomy. We defined early referral as < or equal to 15 days from presentation and late referral as > 15 days. Both groups were compared with respect to multiple parameters as well as early and late postoperative course, postoperative complications, and mortality. Result: The early group had 5 patients, while the late group had 7 patients. The number of procedures done by the cardiothoracic team before referral to the plastic surgery unit is significant ( p = 0.001). The average duration from the presentation of DSWI to definitive surgery was found to be 16.28 days in the early group and 88.36 days in the late group.  Conclusion: There is no statistical difference between early and late referral to plastic surgery in terms of mortality and morbidity. Yet, early referrals could lead to highly significant reduction in total duration of hospital stay, wound healing, and costs

Background:  Post-surgical inflammatory responses significantly influence wound healing and overall surgical outcomes. Understanding the pathological mechanisms underlying these inflammatory processes is crucial for optimizing patient recovery and minimizing complications. This study aims to assess the intensity and characteristics of post-surgical inflammatory responses and their implications for wound healing and surgical outcomes. Materials and Methods: A prospective study was conducted involving 60 patients undergoing elective surgeries across various surgical specialties. Blood samples and tissue biopsies were collected at baseline (pre-surgery), 24 hours, 72 hours, and 7 days post-surgery. Histopathological analysis, inflammatory biomarker assays (C-reactive protein, IL-6, TNF-α), and wound healing assessments were performed. Inflammatory response scores were calculated based on cellular infiltration, edema, and tissue necrosis. Statistical analysis was conducted using ANOVA and Pearson's correlation to determine associations between inflammatory markers and wound healing efficiency. Results: Patients exhibited a significant elevation in inflammatory biomarkers post-surgery, with peak levels recorded at 24 hours (CRP: 35.2 ± 6.1 mg/L, IL-6: 90.4 ± 12.5 pg/mL, TNF-α: 65.7 ± 8.9 pg/mL). Histopathological analysis revealed substantial neutrophil infiltration and tissue edema within the first 72 hours, gradually transitioning to macrophage-dominant infiltration by day 7. Patients exhibiting lower inflammatory marker levels (CRP < 25 mg/L, IL-6 < 70 pg/mL, TNF-α < 50 pg/mL) demonstrated superior wound healing scores (P < 0.05) compared to those with higher levels. A positive correlation was observed between elevated inflammatory markers and delayed wound healing. Conclusion: The intensity of post-surgical inflammatory responses plays a pivotal role in determining wound healing efficiency and surgical outcomes. Elevated levels of inflammatory biomarkers are associated with delayed healing and increased complication rates. Targeted interventions to modulate inflammation may improve surgical recovery and patient outcomes.

Background: Complex surgical wounds pose significant challenges in postoperative care due to delayed healing, infection risks, and prolonged hospital stays. Negative Pressure Wound Therapy (NPWT) has emerged as a promising modality that accelerates wound healing by promoting granulation tissue formation, enhancing perfusion, and reducing edema. This study aims to evaluate the clinical effectiveness of NPWT compared to conventional wound management techniques in patients with complex surgical wounds. Materials and Methods: A prospective study was conducted on 60 patients with complex surgical wounds, randomly divided into two groups: Group A received NPWT, and Group B underwent conventional dressing. Parameters assessed included wound size reduction, duration to complete granulation, infection rate, and patient satisfaction. The treatment duration was 21 days with evaluations conducted at baseline, Day 7, Day 14, and Day 21. Results: Group A (NPWT) showed a significantly greater reduction in wound size (average 65%) compared to Group B (35%) by Day 21 (p < 0.01). Complete granulation was achieved in 80% of NPWT patients versus 45% in the control group. Infection rates were lower in the NPWT group (10%) compared to the control group (30%). Additionally, patient-reported satisfaction scores were higher in Group A (mean 8.4/10) than in Group B (mean 6.1/10). Conclusion: Negative Pressure Wound Therapy is an effective and reliable method for managing complex surgical wounds. It significantly enhances wound healing, reduces infection rates, and improves patient satisfaction when compared to traditional dressing techniques

Background: Seroma formation remains the most common postoperative complication following breast and head and neck cancer surgeries involving flap elevation. It is attributed primarily to lymphatic disruption during surgery, resulting in fluid accumulation under skin flaps or in axillary spaces. Seromas may lead to infection, delayed wound healing, flap necrosis, prolonged hospital stay, and delayed initiation of adjuvant therapies. Quilting or flap suturing techniques aim to minimize dead space, thus potentially reducing seroma formation and related complications. Material and Methods:A randomized controlled study was conducted in the Department of Surgery, MGM Medical College and MY Hospital, Indore, over a 1-year period. A total of 50 patients undergoing Modified Radical Mastectomy (MRM) or head and neck surgeries with skin flap elevation were enrolled and randomized into two groups: quilting (interventional) and non-quilting (control). Patients were assessed for operative time, seroma formation on postoperative days 1, 3, and 7, total drain output, duration of drain retention, and surgical site infections. Data were analyzed using standard statistical methods, and significance was set at p<0.05. Results: The quilting group demonstrated significantly reduced seroma volumes on Day 1 (p=0.001) and in total cumulative seroma volume (p=0.013). Drain removal occurred earlier in the quilting group (mean 7.5 days vs. 9.59 days; p=0.043). The incidence of seroma (2 vs. 8 cases) and postoperative hematoma (1 vs. 3 cases) was also lower in the quilting group, while rates of flap necrosis remained comparable. No statistically significant differences were observed between groups based on age, tumor stage, or laterality of breast involvement. Conclusion: Quilting sutures during flap closure in breast and head and neck cancer surgeries significantly reduce early seroma formation, total drain output, and facilitate earlier drain removal. These benefits contribute to shorter hospital stays and quicker initiation of adjuvant therapy. Further large-scale studies are warranted to confirm the long-term benefits and generalizability of flap suturing techniques in various surgical settings.

Background post-operative sore throat (POST) and hoarseness of voice are very common complaints from patients undergoing endotracheal intubation, the incidence of which has been estimated to be approximately 14.4% to 50%.  Budesonide is an inhaled corticosteroid (ICS), commonly used to reduce all these complications. It is a corticosteroid with potent glucocorticoid and weak mineralocorticoid activities. Metered dose delivery of budesonide is considered simple and less time-consuming but with high patient acceptability. It would obviate the need of additional equipments like nebulisers or atomisers and reduce the assistance of nursing staff. Side-effects like fluid retention, delayed wound healing and glucose intolerance are comparatively less as compared to intravenous corticosteroids.² Methods: The present study was conducted in the Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak in a prospective, randomised and unblinded manner after obtaining approval from the institutional ethical committee and patients’ written, informed consent. The study included 100 patients of either sex of age 18-60 years, belonging to American Society of Anesthesiologists Physical Status (ASA PS) of I and II with Mallampatti Grades (MPG) of 1 and 2, undergoing surgeries under general anaesthesia. Patients were randomly allotted to one of the two groups equally, labelled A and B, 50 patients each irrespective of gender, using random number table as follows: Results: The incidence of post-operative sore throat, cough and hoarseness of voice grades were found significantly higher in the Group B than in Group A at 2 hours after extubation of the patients (74%, 56% and 40% versus 22%, 18% and 28%). There were significantly higher grades of POST, cough and hoarseness of voice in Group B than in Group A. The incidence of POST and hoarseness of voice grades were found to be significantly higher in Group B than in Group A (27%, 38% versus 12%, 16%) at 6 hours post-extubation. Though the incidence of cough was higher in Group b than in Group A, it was not statistically significant. Higher grades of all three categories were seen in Group B. In Group B higher incidence of POST, cough and hoarseness of voice were seen as compared to Group A (28%, 28%, 18% versus 10%, 8%, 4%) at 12 hours post-extubation. There were higher grades of POST, cough and hoarseness of voice in Group B. Conclusion: we concluded from our study that Budesonide is a very safe inhalational corticosteroid that can be used frequently during general anaesthesia using endotracheal tube. It has been found to reduce the incidence and grades of post-operative sore throat, cough and hoarseness of voice in the patients following extubation thereby, enhancing the overall satisfaction of the patients in the post-operative period.

Background: Haemorrhoids, or piles, are a common condition affecting many adults, characterized by swollen vascular structures in the anal canal, leading to discomfort and bleeding. Treatment options range from conservative management to surgical interventions, with haemorrhoidectomy being a definitive surgical option for advanced cases. This study compares two surgical techniques: conventional haemorrhoidectomy and stapled haemorrhoidectomy. Objective: The objective of this study is to conduct a prospective comparative analysis of conventional and stapled haemorrhoidectomy, focusing on their effectiveness, patient acceptance, postoperative outcomes, complications, and cost-benefit analysis. Methods: This prospective observational study was conducted over 18 months at Maharaja Agrasen Hospital, New Delhi, involving 60 patients with symptomatic Grade II/III haemorrhoids. Patients were randomly assigned to either stapled or conventional haemorrhoidectomy. Data were collected through clinical examinations, interviews, and standardized assessments, with postoperative outcomes evaluated using the Visual Analogue Scale (VAS) for pain and monitoring for complications. Result: The study found that stapled haemorrhoidectomy had significantly shorter operative times (22.27 vs. 25.00 minutes), less blood loss (30.47 vs. 78.30 mL), shorter hospital stays (1.53 vs. 2.77 days), and quicker return to work (5.2 vs. 15.4 days). Pain scores were significantly lower in the stapled group at all measured intervals. Late complications, such as delayed wound healing, were also less frequent in the stapled group. Conclusion: Stapled haemorrhoidectomy is shown to be a superior option for managing advanced haemorrhoids, offering benefits such as reduced operative time, lower blood loss, faster recovery, and fewer complications. While further long-term studies are needed to assess recurrence rates, the findings support the adoption of stapled haemorrhoidectomy in clinical practice for its efficiency and patient-centered outcomes.

Background: Chronic ulceration of lower leg including the foot is a frequent condition causing pain, social discomfort and generating considerable costs. The incidence of leg ulcers is widely recorded to range from 0.18% to 1%.The primary    etiologies of lower extremity ulcers include diabetes, venous insufficiency, arterial disease, and neuropathy. Chronic wounds are distinguished by a prolonged inflammatory phase that obstructs the process of regenerative wound healing. The objective of wound care for chronic leg ulcers is to promote healing and prevent lower limb amputations by implementing standardised protocols for wound management. Methods: The primary objective of this study was to assess the safety and effectiveness of autologous platelet-rich plasma (PRP) in the treatment of chronic skin ulcers, as compared to conventional skin dressings. Single centre, Prospective randomized controlled trial study with two parallel groups. Results: Wound Contraction: Cases showed significantly greater wound contraction compared to controls, highlighting the effectiveness of targeted interventions like PRP. Duration of Wound Contraction: The duration of wound contraction was significantly shorter in cases, indicating faster healing in the intervention group. Conclusion: The study highlights the need for integration of advanced wound care modalities, such as PRP, with standard diabetic foot care protocols to enhance healing rates, reduce treatment duration, and improve the quality of life for patients with diabetic foot ulcers(DFUs).

Introduction: Fingertip injuries are among the most common hand traumas and can significantly impact hand function and quality of life. Proper reconstruction is essential for preserving tactile sensation and aesthetics. Locoregional flaps are frequently employed in fingertip reconstruction due to their simplicity and effectiveness. Objective: To evaluate the functional and aesthetic outcomes of locoregional flaps in the management of fingertip injuries. Methods: This prospective observational study was conducted over a period of three years, from May 2022 to May 2025, at the Department of Plastic Surgery, Deccan College of Medical Sciences, Princess Esra Hospital. A total of 40 patients with fingertip injuries requiring flap coverage were included. Depending on the type and location of the injury, several locoregional flaps were utilised, including V-Y advancement flaps, thenar flaps, and cross-finger flaps. In order to evaluate flap viability, wound healing, function recovery, and cosmetic results, patients were monitored. Results: Most patients demonstrated good functional recovery with minimal complications. Flap survival rate was high, and the majority of patients reported satisfactory aesthetic results. Early intervention and appropriate flap selection were key factors contributing to successful outcomes. Conclusion: In order to effectively treat injuries to the fingertip, locoregional flaps are essential because they provide dependable covering with positive functional and aesthetic outcomes. In reconstructive hand surgery, this method is still useful and practical.

Background: Circumcision is one of the most frequently performed surgical procedures globally, commonly indicated for phimosis, balanitis, or cultural and religious reasons. Traditional conventional circumcision, involving scalpel dissection and suturing, is time-tested but often associated with longer operative times and increased postoperative discomfort. The introduction of stapler-assisted circumcision has offered a potentially faster and neater alternative, promising better cosmetic outcomes and reduced complications. Materials and Methods: This prospective comparative study was conducted over a period of 12 months at a tertiary care center. A total of 60 male patients aged 5–40 years undergoing elective circumcision were randomly divided into two groups: Group A (n=30) underwent conventional circumcision, and Group B (n=30) underwent stapler circumcision using a disposable circumcision stapler device. Parameters analyzed included operative time, intraoperative blood loss, postoperative pain (assessed using VAS score), complication rates (bleeding, infection, edema), and cosmetic outcome (graded by a 5-point Likert scale at 4 weeks). Results: The mean operative time in Group A was 32.5 ± 5.4 minutes, whereas in Group B it was significantly lower at 11.2 ± 3.1 minutes (p<0.001). Intraoperative blood loss was higher in the conventional group (mean 18.4 ± 4.2 mL) compared to the stapler group (mean 7.6 ± 2.1 mL, p<0.01). Postoperative pain on day 1 was significantly lower in Group B (VAS score: 3.2 ± 1.1) than in Group A (VAS score: 5.1 ± 1.3, p<0.05). Minor complications like edema and delayed wound healing were observed in 6 patients in Group A and 2 patients in Group B. Cosmetic outcomes were rated excellent in 76.7% of stapler cases versus 46.7% in conventional cases. Conclusion: Stapler circumcision demonstrates clear advantages over the conventional technique in terms of reduced operative time, minimal blood loss, lower postoperative pain, and superior cosmetic results. Although the cost of the stapler device is relatively higher, its benefits may justify its use, especially in high-volume surgical settings.

Introduction: Hypoalbuminemia has been found to be associated with increased morbidity and mortality in acute surgical patients. Any surgical procedure induces a stressful and catabolic state. Wound healing is also a catabolic process requiring adequate protein and energy reserves. Severely malnourished patients often demonstrate impaired wound healing and an increased predisposition to infection and other postoperative complications. Aims: To evaluate the role of preoperative serum albumin levels as a predictor of postoperative outcomes in patients undergoing emergency surgeries. Materials and Methods: This hospital-based prospective study was conducted in the Department of General Surgery, AGMC & GBP Hospital, from January 2021 to June 2022. A total of 64 patients undergoing emergency abdominal surgeries were included. Serum albumin levels were measured preoperatively. Postoperative outcomes, including surgical site infection, pulmonary complications, ventilatory support, sepsis, ileus, cardiac events, hospital stay duration, and mortality, were recorded and analyzed in relation to albumin levels. Results: Patients with hypoalbuminemia (<3.5 gm/dL) had a significantly higher incidence of postoperative complications, including surgical site infections (p < 0.001), sepsis (p < 0.001), prolonged hospitalization (p < 0.001), and mortality (p < 0.001), compared to those with normal albumin levels. Mean serum albumin levels were significantly lower in patients with complications than those without. Conclusion: Preoperative serum albumin level is a simple, cost-effective, and reliable biochemical marker that can predict postoperative morbidity and mortality in emergency surgical patients. Early identification and nutritional optimization may improve surgical outcomes.