The British journal of surgery
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It has been shown previously that, at least in dogs, a vascularized pancreatic allograft with ligation of the pancreatic duct can maintain normal beta-cell function for at least 5 years. In this study common organ preservation techniques, as used in human cadaveric kidney transplantation, were applied to canine pancreatic allografts to determine the influence of 24-hour preservation on beta-cell function, graft survival and histological appearances. ⋯ It appeared that both preservation methods were equally effective and that preservation did not alter either the graft's function or its histological appearance. No significant differences after transplantation were observed in the endocrine function tests of the three groups when compared with the preoperative values; neither was there a significant difference in the mean graft survival time between the groups.
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Randomized Controlled Trial Clinical Trial
A prospective trial of prophylactic antibiotics in hand lacerations.
A series of 368 patients with hand lacerations which required suturing were randomly allocated to one of three treatment groups. The incidence of infected and of imperfectly healed wounds was noted 7 days after suturing. As well as the influence of antibiotics on healing, sixteen other factors which it was considered might affect healing were analysed. ⋯ The imperfect healing rate (which includes the infected cases) was 24-6 per cent. There was a lower rate (P less than 0-05) of imperfect healing in the Triplopen group (15 per cent) than in either the flucloxacillin group (29-5 per cent) or the group who received no antibiotics (29-0 per cent). Other factors associated with imperfect healing found to be significant at the 1 per cent level, were wound contamination, pain and the presence of a wet or changed dressing at the second examination.
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A case of anaphylactic shock after percutaneous liver biopsy is described. This was due to rupture of a large echinococcal cyst localized in the liver. Diagnosis and treatment with a review of the literature are discussed with emphasis on the complete removal of both the cyst and the surrounding capsule of fibrous liver tissue.
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After gastro-intestinal operations wound infection is usually caused by the inoculation of bacteria present within the intestinal tract into the incision during the surgical procedure. In theory, wound sepsis may be minimized by the following methods: (a) avoiding intestinal contamination of the incision; (b) altering the normal flora of the intestinal tract by adding oral antimicrobials to bowel preparation; (c) using topical or systemic prophylactic antibiotic administration for certain high-risk patients. The relative importance of these methods of prophylaxis is described.
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Forty-two patients with idiopathic megacolon who were seen at St Mark's Hospital over an 18-year period are reviewed with regard to presentation, investigation and management. The differential diagnosis is discussed with particular reference to Hirschsprung's disease. ⋯ The indications for surgical intervention in 14 patients are reviewed. The results following subtotal colectomy were better than following a localized sigmoid resection.