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BACKGROUND፡ Surgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients.METHODS: We performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher’s exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes.RESULTS: Of 114 patients, median age was 46 months [range: 1day-13years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96,p=0.003). Age (p=0.004) and malnutrition (p1 hour before surgery and operative time >2 hours are independent predictors of SSI.

BACKGROUND : Pediatric surgical emergency condition is a broad spectrum of surgical pathologies/disorders occurring in pediatric age group requiring proper emergency surgical care as the only option of management to salvage life, avoid/minimize disability or palliation. The objective of this study is to analyze the pattern and outcome of pediatric surgical emergencies managed at Tikur Anbesa Hospital and the factors associated with outcome. METHODS : Retrospective analysis of medical records of patients was conducted to assess the pattern, outcome and factors associated with outcome of pediatric surgical emergencies admitted and managed at Tikur Anbesa Specialized Hospital, from January 1, 2015 to December 31, 2015. Data was checked for completeness and entered into SPSS version 20 for statistical analysis. RESULTS : A total of 454 patients’ medical records were analyzed. The presentation was after 5 days of illness in 182(40%), and >3 days in 243(53.4%), while only 89(19.6%) of them come within 24 hours of the illness. The etiologies were abdominal/gastrointestinal emergencies 210(46.3%), foreign body in aero digestive system in 133(29.3%), urogenital surgical emergencies in 27(5.9%). The other causes include superficial and deep tissue abscess collections in 22(4.8%), trauma /injury related cases in 24(5.3%) and others in 38(8.4%) respectively while congenital malformations were only 57(12.6%) of the cases. Finally, 439(96.7%) were discharged cured or improved without major disabilities documented, while 9(2%) died. CONCLUSIONS : Delayed presentation, unstable condition on arrival, younger age group and the nature of underlying pathology could have contributed for the death, but this needs further study. KEYWORDS : Pediatric surgery, Emergency Surgery, Ethiopia

BACKGROUND: Hypospadias repair is one of the problematic issues in pediatric surgery. As a result of the multiple complications following the procedure, a variety of techniques have been used and newer methods continue to emerge. There is still controversy regarding the best method of repair. We aimed to determine the outcome of surgery and factors contributing to unfavorable outcomes in children with hypospadias.MATERIALS AND METHODS: This is a retrospective review undertaken from September 2009 to August 2014. The research was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. All children who underwent hypospadias repair and had regular follow-up were included in the study.RESULTS: A total of 202 boys aged less than 13 years were assessed. Most surgeries (80.3%) were performed in children older than 18 months. Transverse incised plate urethroplasty (TIP) was frequently performed for distal hypospadias (71.2 %), while transverse ventral preputal flap (TVPF) was the most common procedure done for proximal hypospadias (62.8 %). Overall success rate for first surgery was 55.9 %. There was a high rate of major post-operative complications (44.1%) of which urethrocutaneous fistula (UCF) was the most common (31.2%) followed by meatal stenosis and glans breakdown (7.4 % each). These complications were found to be higher in those who were operated at a later age and those with proximal hypospadias (p=0.03 and p=0.01 respectively). There was also a significant difference among the type of procedures with TIP and TVPF having the least complications (p