Surgery, gynecology & obstetrics
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Controlling seroma formation by the use of closed suction drainage and flap attachment to the chest wall lowered the incidence of seroma formation after mastectomy and axillary dissection below that in other reports. The presumed advantage would be fewer seroma-associated complications, such as infection, impaired shoulder motion and lymphedema.
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Surg Gynecol Obstet · Apr 1984
Comparative StudyA clinical evaluation of chlorhexidine gluconate spray as compared with iodophor scrub for preoperative skin preparation.
In a prospective, randomized study, 737 patients who were evaluated had the operative site prepared preoperatively by either a 0.5 per cent chlorhexidine gluconate spray or povidone-iodine scrub. The wound infection rate in these two comparable groups was not statistically different, although slightly favoring the spray technique (6.0 versus 8.1 per cent). The spray technique challenges the conventional preoperative scrub and offers further advantages of increased effectiveness while also offering savings of time and expense.
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Surg Gynecol Obstet · Mar 1984
Randomized Controlled Trial Comparative Study Clinical TrialCrystalloid versus colloid in fluid resuscitation of patients with severe pulmonary insufficiency.
Forty-six patients with severe pulmonary insufficiency were prospectively studied to compare the effects of resuscitation with either crystalloid or colloid. By random number, 26 patients received RL and 20 patients received 5 per cent ALB to maintain hemodynamic stability. Groups were comparable with respect to the cause of pulmonary insufficiency, age and sex. ⋯ The Qs/Qt in the ALB group was significantly lower than the RL group at the termination of the study, but this did not affect outcome. The RL group required more fluid than the ALB group, but the difference was not statistically significant. No clinical advantage was found for either solution in this study.
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Deaths from hemorrhage associated with legal induced abortion should not occur. Yet hemorrhage was the third most frequent cause of death from legal abortion in the United States between 1972 and 1979. This study was undertaken to document the scope of the problem, to identify risk factors for fatal hemorrhage and to recommend ways of preventing these deaths. ⋯ Documented uterine perforation or rupture was far more frequent among women who died from hemorrhage than those who died from other causes (71 versus 8 per cent; p less than 0.001). Women who sustained uterine perforation or rupture were over 1,000 times more likely to die from hemorrhage than those who did not. Deaths from hemorrhage can be eliminated by preventing uterine trauma during abortion and by rapidly diagnosing and treating hemorrhage if it occurs.