Milind Rao

Publications (2)4.77 Total impact

• Article: A prospective randomised study comparing two treatment modalities for chronic pilonidal sinus with a 5-year follow-up.

  Milind M Rao, Wojtek Zawislak, Raymond Kennedy, Robert Gilliland
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  ABSTRACT: The optimal treatment of chronic pilonidal sinus is a matter of debate. Although excision and suture offers faster healing, it is associated with an increased incidence of wound infection. This study compared excision and primary closure of pilonidal sinus using incorporated gentamicin impregnated collagen with conventional laying open. Consecutive patients with pilonidal sinus were randomly assigned to one of two treatment groups: (1) open method-wound left open post-excision and (2) closed method-wound closed in two layers over gentamicin impregnated collagen. The main outcome measures were operating time, hospital stay, linear analogue pain scores (days 1, 2, 4, 7 and 14), healing rates, analgesic use and cost. Rate of recurrence at 5 years was further assessed by means of a telephone survey. Sixty patients were recruited from June 1999 to December 2000. Operating time was significantly longer in the closed method. Pain scores were significantly lower for the closed group. A significantly higher proportion of closed wounds healed at 4 weeks. The overall cost per patient was significantly lower for the closed group. Recurrence rate was similar at 5 years. Excision and primary closure over a gentamicin impregnated collagen is a cost-effective method of treating pilonidal sinuses, as it ensures faster healing, causes less pain and its long-term recurrence rates are similar to other techniques.
  International Journal of Colorectal Disease 10/2009; 25(3):395-400. · 2.38 Impact Factor
• Article: Role of cyclooxygenase-2 in the angiogenesis of colorectal cancer.

  Milind Rao, Wenxuan Yang, Alexander M Seifalian, Marc C Winslet
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  ABSTRACT: Cyclooxygenase (COX) is the rate-limiting enzyme in the synthesis of prostaglandins. It exists in two isoforms: COX-1 which is constitutively expressed and COX-2 which is an inducible form activated by a variety of cytokines during inflammation. Interest in this enzyme arose in the early 1990s when, following epidemiological studies, aspirin (which is a COX inhibitor) was found to reduce the risk of colorectal cancer. Since then various studies to decipher the mechanisms by which COX reduces the development of colorectal cancer have been undertaken. One of the mechanisms being studied is its role in the angiogenesis of colorectal cancer. Angiogenesis of its own has been well established as a key factor in the development of tumours. Agents that specifically inhibit COX-2 are now in clinical development and have been licensed to be used in patients with familial adenomatosis polyposis. What needs to be determined is whether the antiangiogenic effects of COX-2 inhibitors can be used in the prevention and/or treatment of colorectal cancer and its metastases.
  International Journal of Colorectal Disease 02/2004; 19(1):1-11. · 2.38 Impact Factor