Intracavitary urokinase for enhancement of percutaneous abscess drainage: phase II trial.

OBJECTIVE: To evaluate the effectiveness of urokinase as an abscess-cavity irrigant during percutaneous abscess drainage. SUBJECTS AND METHODS: In a prospective study, approved by the Food and Drug Administration and the review board at our institution, urokinase and saline were used as abscess-cavity irrigants. In the study group of 42 patients, half the patients were randomly placed into the urokinase group and the other half were placed into the control saline group. Doses used varied with the size of the abscess. Data collected from patient charts were evaluated with standard statistical methods. RESULTS: The results indicate definite benefits of the urokinase treatment. The length of stay (p = 0.0025) and treatment costs (p = 0.0021) were significantly less for the urokinase group. Other clinical parameters, including the febrile course, elevated WBC, and days of drainage, trended in a favorable fashion. CONCLUSION: Urokinase injected intracavitarily is an effective technique for shortening the treatment time and improves the clinical course for patients treated with percutaneous drainage techniques.

The role of bone scans in the assessment of prognosis of scaphoid fractures.

Fifty patients with radiographic evidence of an acute scaphoid fracture were studied prospectively. Technetium bone scans were performed on all patients soon after injury in an attempt to detect fractures at risk of non-union or avascular necrosis. In three patients the scan showed a focal area of decreased radionuclide concentration in the region of the proximal pole of scaphoid implying avascularity, and each developed the radiographic signs of avascular necrosis. Two of these patients, each with a displaced fracture, developed non-union. Acute fractures of the scaphoid with evidence of avascularity on bone scan are at high risk of developing non-union.