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Introduction: Oophorectomy is the treatment of choice in ovarian torsion if after detorsion the ovary looks bluish black. Ovarian preservation is advocated by many studies in the pediatric age group quoting the ability of the ovary to recover despite the appearance after detorsion. Aims: This study aims to review the outcome of salvage surgery (detorsion) in the management of pediatric ovarian torsion. Materials and Methods: This is a retrospective study of girls under 18 years with ovarian torsion treated from January 2016 to June 2021. Data were collated from records and analyzed. Results: Ten girls with ovarian torsion were included (mean age of 11 years). Ultrasonography and Doppler confirmed ovarian torsion in all. Emergency laparoscopy with detorsion was done in all with the mean time lapse from onset to surgery being 35 h. All the ovaries were black initially and persisted to be bluish black after detorsion. All were conserved and fixed to the lateral abdominal wall. In one child with an associated ovarian cyst, the cyst excision was also done. All girls were asymptomatic on follow-up. Ultrasonography at 3-month follow-up showed a normal-sized ovary with good blood flow in 9 out of 10 girls (90% cases). Follicular changes were seen in five girls who had attained puberty. In one girl, the ovary was very small sized and flows were not well visualized. Conclusion: Detorsion and oophoropexy should be the procedure of choice in pediatric patients with ovarian torsion. The gross appearance of the ovary after detorsion should not be the sole determinant for oophorectomy.
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INTRODUCTION: Diabetic foot ulcers (DFUs) are a global burden on health care systems. Despite the availability of various treatment modalities, many DFUs do not heal. Nonhealing wounds can lead to various complications, which add to significant morbidity in terms of the degree of moisture retained in the dressing, pain, foul order, and restriction of daily activities. A different treatment modality that can promote the wound healing process earlier (and is cost-effective, easy to use, and readily available) may be necessary to consider. OBJECTIVE: The purpose of the current study was to demonstrate the efficacy of ultrathin skin grafting (UTSG) in the early healing of DFUs in terms of cost-effectiveness, reduced total number of hospital visits, and final wound outcome (ie, limb salvage rate). MATERIALS AND METHODS: A randomized controlled trial was conducted in which 52 patients were treated with either UTSG (test group) or conventional dressing (control group). Both groups were compared by time to healing, number of hospital visits, cost, and final outcome of the wound. RESULTS: By the end of the 12-week study period, 84.61% of wounds managed with UTSG healed completely, whereas only 53.84% of wounds managed with conventional methods achieved complete healing. The test group achieved a more than 50% wound size reduction within 6 weeks after grafting. There were fewer hospital visits for the test group, indicating this grafting technique was more cost-effective than the control group. CONCLUSIONS: As demonstrated in this study, UTSG appears to be beneficial in achieving faster healing of DFUs and improving the final outcome of the wound.