S Afr J Surg
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The incidence and nature of and the outcome following adverse events were studied prospectively in a surgical intensive care unit over a period of 1 year. From a total of 657 patients, 229 (34.8%) suffered 369 adverse events. The number of adverse events per patient ranged from 1 (58.1%) to a maximum of 4 (6.1%). ⋯ There was no significant difference in mortality between patients with single or multiple events. Twenty-two patients died as a direct result of the event, the commonest reason being loss of airway control. Adverse events contribute significantly to mortality in critically ill patients.
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A postmenopausal woman with suppurative actinomycotic uterine infection complicated by an enterocutaneous fistula is reported. It occurred against a background of prolonged use of an intra-uterine contraceptive device.
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Much confusion about the management of the burn wound still exists in many a clinician's mind. This is an attempt to clarify the problem and create a better understanding of the importance of assessing the various depths of penetration of the thermal agent. ⋯ A 'critical depth' of penetration at the deep dermal level, which spares the acini of the sweat glands, is suggested as the factor initiating later development of hypertrophic scarring. This can be prevented by early excision and skin grafting.
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Case Reports
Barium contrast study converts partial small-bowel obstruction into a complete one. Report of 2 cases.
The use of barium contrast study is considered accurate and safe in suspected intestinal obstruction. However, the use of barium in 2 patients with small-bowel obstruction converted their partial obstruction into a complete one. This complication has been previously mentioned but not documented. The use of water-soluble agents may be safer.