Introduction : Suprapubic hernia is the term to describe ventral hernias located less than 4 cm above the pubic arch in the midline. Hernias with an upper margin above the arcuate line encounter technical difficulties, and the differences in repair methods forced us to define them as large...

Objective: We aimed to present a 76-year-old female patient with cecal necrosis, which is a rare cause of acute abdomen in elderly women and a variant of ischemic colitis. Material and Methods:The patient was admitted to hospital with abdominal pain, anorexia and nausea. Physical examination, laboratory parameters and abdominal computed tomography revealed acute abdomen. We operated the patient with below umbilical midline incision. Although the pain localized to the right lower quadrant made us consider acute appendicitis as first diagnosis, other pathologies were also kept in mind for differential diagnosis. Results: Non-occlusive cecal necrosis was determined, and terminal ileum and cecum resection and Meckel's diverticulum excision were performed. Arterial pulsation was palpated, and no sign of thrombus was found. Conclusion: Isolated necrosis of the cecum may be due to multiple reasons. Especially in elderly female patients with predisposing factors like hypotension, sepsis, shock, drug use, vasculitis, and hypercoagulability, cecum necrosis should be kept in mind.

In this study, we aimed to evaluate the clinical efficacy and safety of negative-pressure wound therapy (NPWT) in the treatment of the patients with electrical burns. This study was retrospectively performed using a database placed prospectively in the burn center of our hospital. All consecutive patients with electrical burns treated using NPWT at our center between August 2008 and December 2012 were included. The treatment results in our study were grouped as successful or unsuccessful considering the treatment objectives in accordance with therapy indications. In total, 39 patients were included in our study; of them, 36 (92.3%) were men. The average age was 34.9±9.8 years (range, 17-63 years). The majority of the patients in our study (92.3%) had been exposed to high voltage electricity. The mean total burned body surface area (TBSA) was 19.3±9.8 (range, 4-44). Six patients (15.4%) had TBSAs ≥30%, 31 (79.5%) had third degree burns, and 8 (20.5%) had fourth degree burns. In our study, indications of NPWT included bone and/or tendon exposed deep wounds that are not suitable for early grafting or flap applications owing to the lack of supporting tissue in 27 (69.2%) patients, graft fixation in 8 (20.5%) patients, and secondary grafting following graft loss in 4 (10.3%) patients. The general success rate of NPWT was 90.7% according to indications and treatment objectives in our study. In the light of our results, NPWT may contribute to the present conventional treatments used in severe electrical burns.

OBJECTIVE: An inguinal hernia may transform to an incarcerated hernia, which would require emergency surgery with increased morbidity and mortality. This study aims to analyze whether it is possible to predict intestinal ischemia in incarcerated hernia using complete blood count parameters and serum C-reactive protein (CRP). METHODS: Medical records of 129 patients were used to analyze whether there is a correlation between intestinal ischemia and laboratory parameters. Receiver operating characteristics analysis and Youden index were used to determine cutoff values, sensitivity, and specificity. RESULTS: Female patients, those with a femoral type hernia, and patients with additional diseases were found to be more prone to bowel resection. CRP, lymphocyte to CRP ratio (LCR), and neutrophil to CRP ratio (NCR) parameters were significant (AUC=0.914, p<0.001; AUC=0.901, p<0.001; and AUC=0.908, p<0.001, respectively). A value 19 in CRP has a 90% sensitivity and 88.9% specificity. CONCLUSION: Decreased pre-operative NCR and LCR, and increased CRP levels can be used as a predictor for estimating intestinal ischemia.