New technique in anastomotic surgery--experimental and preliminary clinical experience.

With the purpose to minimize the complications in anastomotic surgery, we have developed a new soluble device, the SBS-TUBE. This paper presents our first results in experimental and clinical surgery with this device. In experimental surgery the SBS-TUBE was applied in ten pigs (+ two controls) with transection of the sigmoid colon. The cut ends of the colon were assembled and sutured with continuous one layer monofil nylon over the SBS-TUBE. The post-operative course was uncomplicated. Post-mortem examination of the pigs in the experimental surgery showed a reduction of the diastasis in the tunica muscularis of the gut to one fourth in the pigs operated with application of the SBS-TUBE, compared to the tunica muscularis in pigs with anastomoses performed without use of the SBS-TUBE. So far four patients with malignant diseases of the colon have been operated with resection of colon tumor and application of intestinal anastomosis using the SBS-TUBE. The postoperative course was without complications. The preliminary results encourage to use the SBS-TUBE in anastomotic surgery.

Surgical wound dressing in outpatient paediatric surgery. A randomised study.

A comparison of two different wound dressings was carried out in a series of 88 paediatric patients. The patients were randomised to either Steristrip plus Cutiplast, a conventional absorbent wound dressing, or to DuoDERM, an occlusive adhesive dressing. The study, set up to show which was the most convenient dressing for minor outpatient surgery, focused on the psychological aspects of operative treatment of infants and children. The results showed that the DuoDERM group had fewer bandage changes than the Steristrip & Cutiplast group, although this was not significant. Significantly less pain was experienced on removal of the wound dressing in the DuoDERM group. When dressed with DuoDERM, children could be bathed in the immediate postoperative period without complication. In conclusion, an occlusive wound dressing (DuoDERM) seems to minimize the physical and psychological trauma to the infant or child and reduce the disruption to the child's and the parents' daily routines.

Emergency presentation of inguinal hernia in childhood--treatment strategy. A follow-up study.

This article presents a retrospective study of 95 cases of irreducible inguinal hernia in 93 children (median age 0.5 years; range 0-13 years) admitted with this diagnosis. In 38 cases operations were performed without delay, in 51 from 12 to 48 hours after admission, and in 6 cases at a later stage. Thus, a total of 57 patients (60%) could be treated with conservative measures at the time of admission. Three instances of minor wound haematoma which did not require treatment and two instances of pneumonia caused by aspiration were recorded. Eighty-three patients could be traced, 70 of whom responded to our questionnaire. The number of infections was 2 (2.8%) and the number of recurrences was 9 (12.3%). In order to reduce the recurrence and infection rates in emergency cases of irreducible inguinal hernia in childhood, the following treatment strategy is suggested: primarily gentle taxis, combined with sedation, if necessary. If reduction is impossible, surgery should be performed without delay. If reduction is achieved, the child can be discharged after 24 hours of observation and readmitted after one week for elective out-patient herniotomy.

[Preoperative ultrasonic diagnosis of maldescended testis]. / Praeoperativ ultralydundersøgelse af den maldescenderede testis.

In 30 boys with a total of 35 maldescended testicles, the present authors found that ultrasonic examination was a useful aid in the diagnosis of maldescended testicles, including intraabdominal testicles. Ultrasonic examination is recommended preoperatively in boys with non-palpable testicles in order to provide optimal surgical intervention.