ABSTRACT
Eighteen injured peripheral nerves at the forearm level were repaired primarily either by immediate or by delayed primary repair according to the mechanism of injury, the presence of contamination and /or skin loss. Nine nerves were cut sharply and were immediately repaired of which four nerves achieved excellent results, three achieved good results and the results were poor in the remaining two nerves. In nine nerves, there were laceration, contamination and /or skin loss and they were repaired by delayed primary neuropathy after one week from the time of injury. Two nerves achieved excellent results, five nerves achieved good results and two nerves achieved poor results
Subject(s)
Humans , Male , Female , Wounds and Injuries , Forearm/surgery , Nervous System/surgeryABSTRACT
Analizamos las infecciones postoperatorias en 866 pacientes. El lavado de campo operatorio se efectuó con clorhexidina y se inyectó cloxacilina profiláctica. Hubo 1 infección de la herida operatoria (0,1 por ciento). El tiempo de seguimiento fluctuó entre 9 meses y 4 años. El método mostró ser eficaz, sin casos de sobreinfección, alergia ni toxicidad sistémica, pero al no haber un control, no permite concluir que se debe usar ATB profilácticos en todos los pacientes neuroquirúrgicos. La situación epidemiológica es diferente en cada hospital, siendo el diagnóstico local fundamental en la elaboración de programas de prevención. Es necesario definir las cirugías con mayor riesgo de infecciones postoperatorias y los gérmenes más probables y según esto establecer el esquema ATB profiláctico
Subject(s)
Humans , Asepsis , Surgical Wound Infection/prevention & control , Nervous System/surgery , Chlorhexidine/administration & dosage , Cloxacillin/administration & dosage , Drug Therapy, Combination/administration & dosage , Clinical Trial , Surgical Wound Infection/diagnosis , Surgical Wound Infection/epidemiology , Therapeutic IrrigationSubject(s)
Infant, Newborn , Infant , Humans , Anti-Bacterial Agents/therapeutic use , Central Nervous System Infections/drug therapy , Neurosurgery , Neurosurgery/adverse effects , Postoperative Period , Drug Therapy, Combination , Central Nervous System Infections/prevention & control , Nervous System/surgerySubject(s)
Humans , Male , Female , Adult , Middle Aged , Neoplasms/surgery , Nervous System/surgery , NeurosurgeryABSTRACT
Baseado em 733 cirurgias neurologicas realizadas em um periodo de 50 meses o autor expoe as providencias tomadas para conter o surto infeccioso.Alteracoes de tecnica de antissepsia e tatica cirurgica foram levadas a efeito durante os tres periodos de duracao do estudo. Nas duas primeiras etapas, de l7 meses cada uma, a incidencia de infeccao em cirurgias limpas foi de 10,3 e 6,7%. Na ultima etapa de 15 meses, quando se associou o uso de antibiotico topico (oxalina em po), este indice caiu para 0,6%.As taxas gerais de infeccao para os tres periodos, somando-se as cirurgias limpas, limpas com implantes, limpas contaminadas e contaminadas foi de 7,08%, 6,8 e 3,4%, respectivamente. Uma revisao sumaria dos dados de literatura referentes a antibioticoterapia profilatica sistemica e topica antecedem os comentarios sobre as bases da mudanca de tecnica efetuadas durante o estudo Tricotomia proxima a operacao, adocao de tecnica seca para a preparacao do retalho da pele e musculatura, uso exclusivo do coagulador bipolar, uso restrito de soro epidural, e uso de oxacilina em po antes do fechamento foram os itens principais das modificacoes realizadas