[Preoperative reduction of intestinal bacteria through orthograde lavage of the large intestine]. / Die präoperative Darmkeimverminderung durch orthograde Dickdarmspülung

The orthograde colon lavage, suggested by Crapp, is a new method for the preoperative preparation of the colon. On the day prior to surgery, the sitting patient receives for 4 h through a stomach probe, 101 of physiological saline solution warmed up to 37 degrees C. The result is a complete evacuation of the bowel. If a bactericidal antibiotic with a broad spectrum of activity (neomycin) is added, the suppression of the microflora amounts to 92%. The regeneration of the intestinal flora could be observed after a few days. A complete evacuation of the colon is guaranteed by this procedure, so that all operations can be performed under optimal conditions. From the clinical as well as from the microbiological point of view this method is without any risk. -- The orthograde colon lavage is indicated in every case of colon, rectum and anal surgery, but it is contraindicated in patients with highly stenosing tumors.

[Supracondylar fracture of the humerus in childhood. Complications, possibilities of treatment and late results (author's transl)]. / Die suprakondyläre Humerusfraktur im Kindesalter. Komplikationen, Behandlungsmöglichkeiten und Spätergebnisse

At the Chirurgische Universitätsklinik Köln-Lindenthal, 103 children were treated for supracondylar fracture of the humerus from 1955 to 1975. The method of choice for treatment was Baumann's vertical suspension. Lesions of the brachial nerve were found to be the primary complication in 7% of the children and circulatory disorders in 10%. While the nerve injuries were treated conservatively, except for one case, 9 children had to be operated on because of ischemia of the forearm. The circulatory disorders could be rectified by thrombectomy and reconstruction of the brachial artery. In one child in whom the indication for operative revision in good time was missed, an ischemic muscle contracture developed.

[Results of the treatment of diaphragmatic lesions (author's transl)]. / Spätergebnisse der Behandlung von Verletzungen des Zwerchfells

During the period of 1959 to 1975 34 patients were operated at the Chirurgische Universitatsklinik Koln-Lindenthal because of lesions of the diaphragm. From the survivors 20 patients were examined again 2 to 15 years after operation. 15 patients (75%) stated subjective complaints. On these patients cicatrizations in the sinus phrenicocostalis, higher position of the diaphragm, axial hernia of the hiatus, restricted flexibility of the diaphragm, flattened diaphragm and paralysis of the diaphragm were found. More than 50% of the patients showed a significantly restricted total and vital capacity. Most important was the fact that in 25% of the reexamined patients there existed an axial hernia of the hiatus caused by the trauma.

[Appendicitis in infants]. / Die Appendizitis im Säuglings- und Kleinkindesalter

Results from cases of appendicitis occurring during the first three years of life are compared with those found in the literature. In the Departments of Surgery and Paediatrics in the University of Köln-Lindenthal 26 cases of appendicitis occurred in this age group between 1960 and 1975. The majority of cases were of the advanced forms of the disease in which the appendix was already perforated. Successful operations were performed in 25 children, but in a 12-day old infant the disease was diagnosed only at autopsy. An early diagnosis is imperative, and can only be deduced from a thorough diagnosis and compilation of symptoms.

[Treatment of fractures of the proximal femur]. / Zur Behandlung von Frakturen am proximalen Oberschenkel

For early revasculation of the head of the femur and in order to avoid delayed healing, today the surgical treatment of lateral fractures of the neck of the femur as well as of fractues of the trochanter is unquestioned. In a group of 25 injured persons the method of osteosynthesis of the neck of the femur was applied, and its favourable results led to the development of a new method for the treatment of lateral fractures ofthe neck of the femur and fractures of the trochanter.

Metabolic and structural recovery of left ventricular canine myocardium from regional complete ischemia.

The capacity for recovery of the normothermic left ventricular myocardium from a regional complete ischemia (RCI) was investigated using changes in the myocardial metabolic status (ATP, ADP, AMP, creatine phosphate (CrP), free creatine, glycogen, glucose, lactate) and alterations of the morphology as parameters. In dogs, an area of the anterior wall of the left ventricular myocardium was temporarily deprived completely of its blood supply by 5--7 overlapping ligatures extending into the heart cavity. The metabolites of the adenylic acid-CrP system returned to normal tissue levels after 30 and 60 min of RCI within 14 and 35 days of recovery, respectively; restoration averaged 82% after 100 min, 74% after 140 min, and 38% after 180 min of RCI after 5 weeks of recovery. At the same time glycogen amounted to 163% after 100 min, 114% min, and 65% after 180 min of RCI. The biochemical data correlated well with the structural changes in the affected myocardium, especially with the amount of de- and regenerating heart muscle cells. These obviously were functionally defect and were not comparable with normal structured and functioning heart muscle cells.