The British journal of surgery
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Randomized Controlled Trial Clinical Trial
The effect of topical povidone-iodine on the incidence of infection in surgical wounds.
A randomized stratified clinical trial of topical povidone-iodine in 627 patients undergoing abdominal procedures demonstrated a reduction in postoperative wound sepsis in female patients, in patients receiving subcutaneous low dose heparin and during the first quarter of the trial when the infection rate in control subjects was high. Overall, there was no significant reduction in wound sepsis after administration of povidone-iodine due mainly to a high infection rate in povidone-iodine treated male appendix operations where, by chance, there was an increased incidence of contamination with Bacteroides fragilis. Postoperative stay in those developing wound infection was significantly reduced in the povidone-iodine group. This is considered as indirect evidence for a decrease in severity of wound infection.
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Two cases are reported of gallstone ileus complicating terminal ileal Crohn's disease. Both patients had a prolonged history of Crohn's disease without the need for surgical intervention. They were admitted with small bowel obstruction which failed to resolve on conservative management as is usually the case. The features of these two cases that may lead to the development of this complication and the pointers in diagnosis are discussed.