J Trauma
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Randomized Controlled Trial Comparative Study Clinical Trial
Tube thoracostomy and trauma--antibiotics or not?
Controversy persists regarding the use of antibiotics in association with t tube thoracostomy for trauma patients. We conducted a prospective randomized study of patients requiring tube thoracostomy for pneumo- and/or hemothorax complicating blunt or penetrating thoracic trauma in an attempt to assess the efficacy of prophylactic antibiotic therapy. Fifty-eight patients were included in the study. ⋯ Cultures demonstrated significant conversion from negative to positive both within each group and between groups. The organism most commonly recovered was S. aureus. Our findings strongly suggest that patients requiring tube thoracostomy for trauma, whether blunt or penetrating, should receive the benefit of systemic prophylactic antibiotic therapy.
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To describe the epidemiology of hospitalized, work-related burns among Massachusetts residents aged 16 years or older, 825 Massachusetts residents who were burned between 1 July 1978 and 30 June 1979, and who were treated as hospital inpatients in any of 240 New England hospitals, were studied. Two hundred forty (29%) of the 825 identified burns were known to be work-related. ⋯ Young workers and black workers experienced the highest rates of burning, with rates two and four times higher than their older and white counterparts, respectively. Scalds were the most common type of work-related burn injury for individuals in each age category, accounting for 45% of the burns overall.
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Fifty-two tibial shaft fractures in 50 patients were treated with flexible medullary nails (Ender type). In 32 cases the fracture was closed and in the remaining 28 cases the fracture was open. Forty-eight of the 52 fractures united in an average time of 16.8 weeks and there were no cases of deep infection or osteomyelitis. ⋯ Dynamic controlled motion at the fracture site leads to early callus formation which is biomechanically and biologically favorable. The procedure is relatively easy to perform, short in duration, and requires little specialized equipment. Flexible medullary nailing is an alternative treatment modality for selected open and closed displaced tibial shaft fractures.