American journal of surgery
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Review Comparative Study
A comparison of monobactam antibiotics in surgical infections.
The introduction of gentamicin almost 20 years ago provided an effective option for the treatment of gram-negative bacillary infections. During the past few years, the availability of aztreonam (a monobactam), imipenem (a carbapenem), and newer cephalosporins within vitro activities comparable with aminoglycosides against many gram-negative bacilli, has stimulated a reassessment of the role of aminoglycosides in treating these infections. When determining the role of new antimicrobials as potential replacements for more established agents, the clinical focus should be on three factors: comparative efficacy, safety, and cost. ⋯ The only member of this class currently in clinical use is aztreonam. A comparison with aminoglycosides is particularly relevant because aztreonam is active against aerobic gram-negative bacilli. This review will discuss the acknowledged concerns with aminoglycoside use and compare the characteristics of aztreonam and currently marketed aminoglycosides.
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The ability to predict whether burn wounds will heal spontaneously or will require skin grafting is important because of increasing utilization of primary excision and grafting. This study prospectively evaluated the ability of heated laser Doppler flow measurements obtained in the first 48 hours after burn injury to predict whether burn wounds would heal within 3 weeks. ⋯ There was also a significant correlation between initial flow measurements and severity of scarring at 3 months. We conclude that heated laser Doppler flow measurements performed early after burn injury are useful in predicting whether healing is likely to occur, as well as the quality of late scar formation; therefore, the method is useful in selecting patients for primary excision and grafting of burn wounds.