Saphenous vein autograft for long term hemodialysis

The analogous saphenous vein was used as a blood access graft in t he upper arm, between the brachial artery and the axillary vein for lognterm hemodialysis in 18 patients, representing 155 of all patients referred to our outpatient clinic for A-V fistula, in the period from 1/96 to 3/97. This modality was used because 50% of those patients were obese, with deep superficial veins, 27.8% have small inadequate vessels and in 22.2% the superficial veins were thrombosed and exhausted. Patency rate was 83.3% for a follow up period ranging from 15-27 months with a Thrombosis occurred in 16.7%, infection in 5.6%, haematoma in 11.1%, aneurismal dilatation in 11.1% and arterial steal in 5.6% of the patients. Reassessment of 10 patients out of the 18 was done for another 12 months, during this period aneuismal dilation appeared in another 5 patients, arterial steal in one patient, and haematoma at the site of puncture in one patient. Saphenous vein autograft can be considered a good alternative modality for blood access when the primary form can't be used

Evaluation of the role of prophylactic antibiotics in the management of simple accidental wounds

Four hundred and forty seven patients were randomized into two groups. One group of patients were given prophylactic antibiotics in conjunction with wound closure and the other group were sutured without antibiotic, then the wounds were evaluated for occurrence of infection. Prophylactic antibiotics failed to produce any significant improvement concerning wound infection in any of the subgroups of those patients receiving antibiotics

Duodenogastric reflux before and after simple cholecystectomy in patients with gallstone disease

20 gallstone patients were investigated for the occurrence of duodenogastric reflux [DGR] before and after cholecystectomy and compared their results with 20 control subjects. DGR was found in 35% of the control group compared to 70% of the gallstone patients, and the mean bile acid [BA] concentration in the gastric juice of the control group was 1.86 mu mol/hour compared to 7.93 mu mol/hour for gallstone patients before operation and 26.49 mu mol/hour after cholecystectomy. None of the gallstone patients without DGR developed reflux after cholecystectomy. However, in those with DGR, the reflux increased significantly after cholecystectomy. This may be due to the presence of great amount of BA in the duodenum after cholecystectomy which leads to greater reflux through the previously incompetent pyloric sphincter