[25-year experience with reusable heart catheters]. / 25 Jahre Erfahrung mit wiederaufbereiteten Herzkathetern.

For 25 years, cardiac catheters have been prepared for reuse in a hospital for heart and vessel diseases, in the beginning by the hospital itself, later on by a specialized company with a standardize, validated certified procedure. Experiences with almost 100,000 interventions with flow directed catheters, diagnostic left-heart- and angiography-catheters, balloon- and electrophysiology-catheters, which were performed with reused material in more than half of these cases, are reported. All patients were informed that disposable catheters were reused. Neither the duration of the intervention, the x-ray load for the patient, the consumption of contrast media and the change rate of catheters, nor the catheter dependent complication rates were increased for reused catheters in comparison to single use. Therefore the reuse of cardiac catheters does not affect patients' safety, but is a cost-saving strategy.

"Die sanfte Sektio"--Eine Variante der Cohen-Methode im Vergleich zum klassischen Pfannenstielschnitt.

This paper was intended to settle the question whether the so-called gentle sectio caesarea with a high skin incision as described by Cohen in 1972 [2] could be applied in combination with a sectio on the level of the classic Pfannenstiel's incision which would be more satisfying cosmetically. Furthermore a comparison was to be drawn between the postoperative condition of those patients on whom this surgical method had been performed and the condition following a classic Pfannenstiel's incision. Between January 1997 and July 1997 we compared the classic method of Pfannenstiel's incision with the variant of Cohen's method as described above in a prospective randomised study. On applying this surgical technique, the abdomen was opened according to Cohen's method using a surgical knife but for the skin, and the tissue layers underneath were opened blunt with two fingers. Following the extraction of the child only three sutures were made: Uterus, fascia and skin. Redon drainages were not inserted. We were able to show that this method of applying mainly blunt "incision" to sectio caesarea the tissue is at least equal to the sharp opening of the abdominal cavity. In some respects, such as the early postoperative mobilisation, it is, in fact, superior, because the blunt opening causes less bleeding and the reduction to three sutures only, deliberately leaving the two peritoneal membranes open, as well as leaving away the redon drainages, considerably increases the patients' postoperative well-being. It is for these reasons that we call for this method to become part of the routine procedures in caesarean sectio.