The British journal of surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of plastic skin and wound drapes on the density of bacteria in operation wounds.
Operation wounds were sampled quantitatively by the velvet pad rinse technique to determine the effect of impervious plastic skin and wound drapes on the density of bacteria. A controlled trial (clean operations) revealed no significant difference between the bacterial density of herniotomy wounds for which the skin had been covered with adhesive plastic drapes, and the bacterial density of wounds in which skin drapes had not been used. The bacterial density in the wounds did not differ significantly from that on the adjacent skin; both densities were slightly higher at the end of operation than at the beginning. ⋯ The reduction in the density of intestinal species was close to 100 per cent and did not differ significantly from that of alpha-haemolytic streptococci, the density of this species being significantly more reduced than that of staphylococci, diphteroids and bacilli. It is concluded that plastic skin drapes were without influence on the species and density of bacteria in operation wounds. Plastic wound drapes, on the other hand, considerably reduced not only exogenous but in particular endogenous bacteria, which otherwise would have remained in the operation wounds.
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This is a retrospective study of 80 patients with 94 severely ischaemic lower limbs treated over a period of 6 years. Arterial reconstruction was possible in 47 patients (54 limbs) and 76 per cent of these limbs were salvaged. ⋯ The fate of the patients who underwent major amputation is described. The selection of patients for direct arterial surgery is discussed, together with some of the technical problems involved.
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Two cases of blunt liver trauma managed by hepatic artery ligation are reported. Lobar dearterialization is a simple and effective method of achieving haemostasis in exsanguinating wounds of the liver. The postoperative management and scope of this procedure are discussed.
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The indications for transplantation, complications, management and results in 127 consecutive patients who had received renal transplants between October 1960 and December 1974 are presented. In 2 cases the donor was an identical twin, in 22 a living relative other than a twin, in 2 an unrelated individual in whom nephrectomy was performed for therapeutic reasons and in 101 a cadaver. ⋯ Thirty-four patients were employed or doing routine housework or receiving full-time education. One patient fathered a child 4 years after transplantation; another gave birth to a healthy infant 3 years after transplantation.