Early repair of inguinal hernia in premature babies.

Inguinal hernia (IH) is relatively common in premature newborn infants, and the timing of surgical correction is controversial. We studied 40 premature infants who developed an IH and who were initially treated in a neonatal intensive care unit. Birth weight (BW) ranged from 492 to 2,401 g; 21 infants had a BW less than 1,000 g. The weight of the infants at operation ranged from 1,000 to 4,400 g. Twenty-one patients underwent herniotomy within 2 weeks after the diagnosis (short waiting group), in which 1 case of incarceration occurred; 19 waited longer than 2 weeks between diagnosis and surgery (long waiting group). Two cases of strangulation occurred in this latter group, and in 1 of those testicular necrosis occurred. Operation time was analysed in boys with bilateral herniotomy (n = 25): the short waiting group (n = 12) showed a significantly reduced operation time compared to the long waiting group (n = 13). Patients weighing less than 1,000 g at birth (n = 21) had a longer average waiting period for surgery. In the group of male patients with bilateral herniotomy, average operation time was longer in the group weighing less than 1,000 g at birth (n = 13) than in the group over 1,000 g (n = 12). Body weight at surgery did not affect operation time. It is concluded that early hernia repair should be considered in premature infants to avoid operative difficulties and gonadal ischaemia caused by incarceration.

Changing patterns of Pseudomonas aeruginosa antibiotic sensitivity.

Using a sample of 71 Pseudomonas aeruginosa infected burns patients admitted to the Burns Injury Unit of the Royal Brisbane Hospital within an 11-year period the pattern of sensitivity of the organism to 18 antibiotics was studied longitudinally looking at first and last cultures (either pus, blood or sputum) separately. Only 5 antibiotics reflected a significant change (towards resistance) in sensitivity patterns (chloramphenicol, gentamycin, kanamycin, tetracycline, achromycin). Six of the other 13 antibiotics showed a trend towards increasing resistance but the changes were not statistically significant (polymyxin B, carbenicillin, sulphanomides, cotrimoxazole, streptomycin, teramycin). The other 7 antibiotics showed no change, all but one (colistin) being resistant throughout.