Surgery, gynecology & obstetrics
-
Surg Gynecol Obstet · Jul 1991
Randomized Controlled Trial Comparative Study Clinical TrialA prospective trial comparing Biobrane, Duoderm and xeroform for skin graft donor sites.
Many new dressings have been introduced for use on split-thickness skin graft donor sites in an effort to reduce pain at the donor site and decrease healing time, while maintaining a low infection rate and cost. To assess these factors in two such dressings, Biobrane (temporary wound dressing) (Winthrop) and Duoderm (hydrocolloid dressing) (Convatec), we compared them with a conventional fine mesh gauze dressing, xeroform, in a prospective, randomized study of 30 donor sites in the same number of patients. Wounds were considered healed when they were 100 per cent re-epithelialized and required no further dressings. ⋯ The results of our study confirm the usefulness of xeroform as a donor site dressing as it promotes relatively rapid healing, is easy to use and is inexpensive. We found Duoderm to be ideal for smaller donor sites when pain could be significantly reduced with minimal increase in cost. Biobrane is too costly and the infection rate too high for it to be used routinely as a skin graft donor site dressing.
-
Surg Gynecol Obstet · Jul 1991
Intrathecal phenol rhizotomy for management of pain in recurrent unresectable carcinoma of the rectum.
The medical records of 11 patients with recurrent unresectable adenocarcinoma of the rectum who had intrathecal phenol block for the management of intractable pain were reviewed. There were seven patients with pelvic and four with combined pelvic and perineal recurrences. Five patients had sacral involvement by tumor. ⋯ Patients with good results had relief for a median of three months. The over-all survival rate after phenol injection was three months. Phenol rhizotomy is indicated for the relief of intractable pain secondary to recurrent unresectable carcinoma of the rectum in carefully selected patients.
-
Packed erythrocytes are frequently reconstituted with crystalloid during rapid infusion. Dilution of whole blood with calcium containing solutions, such as Ringer's lactate has been cautioned against, citing possible clot formation because of chelation of the citrate anticoagulant. We studied the compatibility of Ringer's lactate solution and citrate phosphate dextrose (CPD)-preserved packed erythrocytes to evaluate the safety of using Ringer's lactate solution as a diluent in the emergency setting. ⋯ Flow rates of packed erythrocytes diluted with Ringer's lactate and normal saline solutions were compared. There was no difference in flow rates between packed erythrocytes diluted with Ringer's lactate compared with normal saline solutions. Ringer's lactate solution can be safely used as a packed erythrocyte diluent in patients requiring rapid blood transfusions.