Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
-
The incidence of postoperative nausea and vomiting (PONV) of in- and outpatient surgical patients is about 30% (range 2-45%). ⋯ There is a need for surgeons to pay more attention to patient-related symptoms.
-
The most frequent complications in diverticular disease are local abscess, perforation with peritoneal sepsis, fistula and ileus. Extraabdominal manifestation is an actual rarity. ⋯ Our case presents a patient with brain abscess caused by asymptomatic, retroperitoneal perforated colonic diverticulosis. We discuss diagnostic steps both in diverticular disease and brain abscess and different surgical options in the treatment of colonic complicated diverticular disease.
-
Injuries of the anal sphincter and the pelvic floor are rare and have a large range of variations. This report is based upon 28 patients with perineal injuries treated in a 17-year period. Mortality depends on accompanying injuries. ⋯ In extraperitoneal rectal injuries diversion, presacral drainage and distal rectal washout is recommended. Loss of continence is the most severe complication of injuries of the anal sphincter. The best results are obtained by primary repair.
-
Case Reports
[Pyoderma gangrenosum after TAPP hernioplasty. A rare differential necrotizing wound infection diagnosis].
Pyoderma gangrenosum is an aseptic skin disease that occasionally complicates operative incisions and mimics postoperative necrotising wound infection. So far there are only a few case reports about bacterial necrotising infections following laparoscopy; no report exists about postoperative pyoderma gangrenosum after minimally invasive surgery. ⋯ Here we present the case of a patient who developed pyoderma gangrenosum after laparoscopic hernioplasty. Pathophysiological, clinical and therapeutic aspects of the disease are discussed.
-
The increasing amount of clinical data, intensified interest of patients in medical information, medical quality management and the recent cost explosion in health care systems have forced medical institutions to improve their strategy in handling medical data. In the orthopedic department (3,600 surgeries, 75 beds, 14,000 consultations) software application for comprehensive patient data management has been developed. ⋯ Evaluation of the saving on working hours showed that such a system can amortize within a year. The latest improvements in hardware and software technology made the electronic medical record with integrated quality-control practicable without massive expenditure. The system supplies an extensive platform of information for patient treatment and an instrument to evaluate the efficiency of therapy strategies independent of the clinical field.