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Volume 13 Issue 6 (June) 2024

Original Articles

Post operative delayed wound healing associated with discharge -A case series treated for EPTB
Dr. Parthasarathi Giri, Dr. Amita Majumdar Giri, Tapan Ghosh, Dr. Debjit Paul, Dr. Gautam Narayan Sarkar, Sujoy Roy

• To investigate the association between delayed wound healing and dischargeafter surgical procedure in patients treated for extrapulmonary tuberculosis (EPTB). • To start ATD therapy through the combined assessment by the Revised National Tuberculosis Programme(RNTCP)on the basis of clinical findings without much depending on the positive laboratory results. Material and Methods: A total of 22 individuals had surgical interventions in the Emergency Medicine (EM), Surgery, Gynaecology& Obstetrics (G&O), Orthopedic, and Medicine departments. Diagnosed with extra pulmonary tuberculosis (EPTB). This studypoints us cases of delayed wound healing following surgery, which were accompanied by the presence of discharge.The clinical evaluation and investigation followed a systematic protocol, which included a complete blood count (CBC), measuring erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, performing tuberculosis-specific assays such as the Mantoux test and GeneXpert MTB/RIF, and obtaining wound cultures to detect infectious agents. Imaging techniques such as X-rays, USG, MRI, or CT scans were used as needed depending on the clinical situation. These imaging investigations are used to create anatomical maps that help in surgery planning.The comprehensive medical history, Thorough physical examination, Evaluation of nutritional status, and Assessment of signs and symptoms of sepsis.Results:This included the distribution of different types of extra pulmonary tuberculosis (EPTB). The lymphatic type accounts for 6 cases, which is 27.27% of the total. The pleura type also has 6 cases, making up 27.27%. The skeletal and abdominal types each have 5 cases, representing 22.73% of the total.the distribution of operations based on their kind and timing. There were 10 emergency surgeries, accounting for 45.46% of the total, and 12 planned procedures, accounting for 54.54%. All patients were provided with sepsis control, nutritional support, anatomical mapping, and planning for future stages. The average recovery period is 45.65±5.34 days, with a range of 30 to 60 days. Every patient showed the progress and is now receiving ongoing ATD treatment in accordance with RNTCP recommendations.Conclusion: The implementation of ATD treatment had a crucial role in the establishment of many healthcare modifications aimed at improving the quality of life. The group of patients, consisting of 22 individuals with different characteristics, showed positive responses to ATD treatment within a timeframe of 3-6 months. Three patients required wound closure with cyanoacrylate glue application. A single patient had treatment with staples to close the gap. The discharge was halted upon the administration of ATD treatment.

 
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