ABSTRACT
Sixty general surgical cases in a district hospital had skin closure accomplished with an adhesive membrance device (Op-site, Smith and Nephew). The technique of application is described. Thirteen cases had minor wound complications. It was found that the device was not applicable to all skin wounds, had some limitations in vertical wound closure, was comparable in price with skin sutures, usually gave good cosmetic results especially in transverse wounds, and as it could be removed by the patient, avoided problems of suture removal after discharge from hospital.
Subject(s)
Bandages , Biological Dressings , Dermatologic Surgical Procedures , Tissue Adhesives , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Postoperative Complications , Surgical Wound Infection/etiology , Wounds and Injuries/surgeryABSTRACT
Three patients presenting with shotgun injuries at Middlemore Hospital during 1979 are described. The important features of such wounds are described and management is discussed emphasising that thorough debridement and removal of foreign bodies are essential in close-range wounds, that many wounds can be closed primarily or within the first three or four days, and that medium to long-range injuries of the thorax and abdomen can be treated expectantly.
Subject(s)
Abdominal Injuries/surgery , Thoracic Injuries/surgery , Wounds, Gunshot/surgery , Adolescent , Adult , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
A double blind, randomized, controlled trial was carried out at two hospitals to try the effect of metronidazole, which is effective against most anaerobes, and cefazolin, which is effective against many aerobic organisms, singly and in combination, on the incidence of wound sepsis following appendicectomy. Patients were placed at random into one of four groups; to receive metronidazole and placebo, cefazolin and placebo, metronidazole and cefazolin, or double placebo. Patients with generalized peritonitis were excluded for ethical reasons. Treatment was started before operation and continued eight-hourly for twenty-four hours. All patients in the trial were followed up at about two weeks after discharge from hospital and their wounds inspected. Two hundred and seventy-one patients were assessed. Sepsis rates at the two hospitals were similar. On the untreated controls, 30% discharged pus from their wounds, and in the groups receiving one drug only, about 20%. In those receiving both drugs the infection rate was 3%, a highly significant difference from that in the other three groups.
Subject(s)
Appendectomy/adverse effects , Cefazolin/therapeutic use , Metronidazole/therapeutic use , Surgical Wound Infection/prevention & control , Adolescent , Adult , Cefazolin/administration & dosage , Clinical Trials as Topic , Double-Blind Method , Drug Therapy, Combination , Humans , Metronidazole/administration & dosage , PlacebosABSTRACT
Twenty-five cases of abdominal tuberculosis treated in Kathmandu, Nepal are presented. The clinical features, diagnostic investigations, surgical treatment and pathology are discussed and the literature on abdominal tuberculosis, with special reference to developing countries, is reviewed.
Subject(s)
Abdomen , Tuberculosis/diagnosis , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Nepal , Peritonitis, Tuberculous/diagnosis , Tuberculosis/epidemiology , Tuberculosis/therapy , Tuberculosis, Gastrointestinal/diagnosis , Tuberculosis, Lymph Node/diagnosisABSTRACT
The frequency of non-clostridial anaerobic infection was studied in 95 patients who had undergone acute appendicectomy: 49 received prophylactic metronidazole and 46 received placebo. Anaerobic infection did not develop in any of the metronidazole-treated patients, but infections did develop in nine (19%) of the 46 controls. Metronidazole is conveniently administered by suppository to patients who cannot take oral drugs. Five patients with intra-abdominal infections caused by non-clostridial anaerobes were successfully treated with metronidazole.
