Chirurgia Bucharest
-
A quantitative method for measuring trauma severity has many potential applications: patient triage, a common terminology about injuries severity, prognosis assessment, trauma care audit and epidemiological. ⋯ Despite their imperfections, trauma scores are very important tools in trauma patients management and research. Using large national databases allow a better research, validation and development of scoring systems.
-
Chirurgia Bucharest · Mar 2012
[Perforation of hollow organs in the abdominal contusion: diagnostic features and prognostic factors of death].
Blunt hollow viscus perforations (HVP) due to abdominal contusions (AC), although rare, are difficult to diagnose early and are associated with a high mortality. ⋯ Hollow viscus perforations due to abdominal contusions have a high mortality, early diagnosis is difficult, repeated abdominal CT and the selective use of diagnostic laparoscopy for haemodynamic stable patients with ambiguous clinical examination and diagnostic imaging are salutary. Prognostic factors for death were the ISS value and associated craniocerebral trauma.
-
Chirurgia Bucharest · Jan 2012
Case ReportsPyoderma gangrenosum--a postoperative "pseudo-infection".
Pyoderma gangrenosum is a skin ulcerative necrosis, due to dermal neutrophilic infiltration, through a non-infectious exacerbation of cell -mediated immunity. Being characterized by pathergy, the disease may be triggered by surgery; in this case, it is easily mistaken for a postoperative infection. We report a case of pyoderma gangrenosum after coronary artery bypass surgery. ⋯ Treatment for wound sepsis was ineffective. After pyoderma gangrenosum was recognized, corticosteroids (Prednisone 80 mg/d) led, in two days time, to a spectacular improvement, and in 7 weeks, to complete epithelization of the lesions. If after debridement of a supposedly infected wound (with pustules, bullae or ulcerations), there is no improvement, but a centrifugal extension of the lesions, with a "sepsis-like" syndrome and persistent negative cultures, one should think at pyoderma gangrenosum; in that case, not the antibiotics, but corticosteroids (or other immunosuppressants) are the treatment.
-
Chirurgia Bucharest · Jan 2012
Comparative Study[Role of procalcitonin in monitoring the antibiotic therapy in septic surgical patients].
Based on the need for rigorous monitoring of antibiotic and a proper assessment of patients with sepsis, procalcitonina as biological marker appears to have significant value, being proposed for both detection and for evaluation of bacterial infection and antibiotic management. ⋯ In conclusion, dynamic measurement of PCT may be a predictor for life-threatening infections with antibiotics that can monitor and direct the time and efficiency. The value of PCT as a guide of antibacterial therapy which can reduce mortality and morbidity in surgical septic patients remains to be fully evaluated by future studies, but we can say that the determination of this biomarker could be introduced in the dynamically protocol of tracking the clinical course of septic patients.