Surgery, gynecology & obstetrics
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Wounds closed by adhesive tapes have less inflammatory reaction, a lower rate of wound infection, greater tensile strength and better cosmetic results than sutured or stapled wounds. Special backing tapes, such as Steri-Strip, have been reported to have satisfactory results in closing laparotomy wounds. ⋯ The wounds closed with paper tape healed well and had satisfactory cosmetic results. Paper tape is a nonexpensive and convenient alternative to close abdominal wounds.
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Surg Gynecol Obstet · Jul 1990
Risk of postoperative septic complications after abdominal surgical treatment in relation to perioperative blood transfusion.
A group of 548 patients was analyzed retrospectively to determine risk factors, particularly the perioperative administration of blood, for postoperative septic complications after intra-abdominal operations. Of the entire group, 198 (36.1 per cent) had at least one complication. The postoperative mortality rate was 0.9 per cent. ⋯ Blood transfusion per se was not significant (p = 0.07). In patients who received more than 3 units of blood, the postoperative septic complication rate was significantly elevated (p = 0.003). We conclude that the perioperative administration of blood may negatively influence the risk of developing postoperative septic complications after intra-abdominal operations.
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Surg Gynecol Obstet · Feb 1990
Review Case ReportsObstruction of the neonatal airway from teratomas.
Most neonates with cervical or oral-pharyngeal teratomas have airway obstruction and an obvious mass. In previous reports, obstruction of the airway had caused 49 deaths in 164 newborns with cervical teratomas and five deaths in 24 newborns with oral-pharyngeal teratomas. ⋯ Three infants with cervical teratomas, one infant with an oral-pharyngeal teratoma and one with a combined cervical and oral-pharyngeal teratoma were born in Phoenix over a one year period of time, and all had airway obstruction. These five patients demonstrated the value of prenatal planning and prompt postnatal surgical care by an ultrasonographer, a perinatologist, a neonatologist, maternal and pediatric anesthesiologists and a pediatric surgeon.
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Surg Gynecol Obstet · Feb 1990
Review Historical ArticlePrinciples of management of shotgun wounds.
As an instrument of close range combat, the shotgun has no parallel. At short distances, its destructive capacity parallels that seen from high velocity missile injury. In this study, the history of the shotgun, wound ballistics, principles of initial therapy and special management problems related to shotgun wounds of specific sites are reviewed. ⋯ A subset of patients who do not require abdominal exploration exists. Specific problems encountered in defining this subset are enumerated. Three algorithms are presented that summarize our current management approach to shotgun wounds of the torso and extremities.
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Surg Gynecol Obstet · Feb 1990
The thumb and index finger as principal surgical instruments to secure the inferior vena cava between the liver and the diaphragm in routine operations of the liver.
Presented herein is a simple and safe technique to secure the IVC in its segments above the liver and below the diaphragm through a simple incision in the abdomen. After complete division of the hepatic ligaments, the index finger is passed through the upper recessus of the lesser sac, behind the vein, and just above the caudate lobe, meeting the right thumb on the right side of the vein. A tissue string is then passed, and the IVC is secured. The experience of the authors with more than 100 consecutive hepatectomies has shown this technique to be a reliable approach to secure the IVC during routine hepatic operations.