Magyar sebészet
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Median sternotomy is still the most commonly used approach in cardiac surgery. Closure of the sternal halves is usually performed with stainless wires. ⋯ On the other hand in a small number of patients this simple method is not efficient to resist the great spreading forces on the sternal halves leading to sternal instability and other serious complications. We describe successful application of a newly introduced device, the Ley-prosthesis, which may be a very useful treatment for postoperative sternal dehiscence even in complicated cases.
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Procalcitonin test (PCT) has been proposed to check severity of generalized infections or sepsis. The authors measured the PCT values with PCT-Q quick test (BRAHMS DIAGNOSTICA GmbH, Berlin) at 14 surgical patients treated in their intensive care unit (7 sepsis, 4 peritonitis, 2 localized pancreatic abscess, 1 postoperative fever). At 3 septic patients (2 pancreatitis, 1 intestinal necrosis) they measured the PCT levels repeatedly during treatment. ⋯ In 2 septic patients with pancreatitis elevated PCT levels indicated the need for surgery. In most patients PCT was a good indicator of generalized infections. PCT levels measured repeatedly in sepsis were lower than in patients with peritonitis.