Surgery, gynecology & obstetrics
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Surg Gynecol Obstet · Nov 1983
Randomized Controlled Trial Comparative Study Clinical TrialPovidone-iodine wound irrigation and wound sepsis.
In this prospective, randomized study of 187 patients undergoing a variety of general surgical procedures, no significant difference could be demonstrated between those patients whose wounds were irrigated with normal saline solution and those whose wounds were irrigated with povidone-iodine. The potential of an alpha or a beta error is discussed.
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Only one instance of Dubin-Johnson syndrome associated with cholelithiasis has been reported. We present one additional patient, a 30 year old man with Dubin-Johnson syndrome in whom pancreatitis and cholecystitis, secondary to cholesterol gallstones, developed. A possible cause for the lithogenicity of the bile in the Dubin-Johnson syndrome is considered.
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Surg Gynecol Obstet · Oct 1983
The effect of incisional infiltration of bupivacaine hydrochloride upon pulmonary functions, atelectasis and narcotic need following elective cholecystectomy.
Forty randomly selected patients admitted for elective cholecystectomy were entered into the study after they have given informed consent. Arterial blood gas analysis, FVC and FEV1 were measured preoperatively and on the second postoperative day. Preoperatively and on the third postoperative day, roentgenograms of the chest were obtained. ⋯ The hospital stay was 6.6 days for those in the saline solution group and 5.9 days for those in the bupivacaine hydrochloride group (p value, not significant). No complications occurred. Intraoperative infiltration of bupivacaine hydrochloride into the wound improves pulmonary function, reduces the incidence of atelectases and lessens the use of narcotics following cholecystectomy.
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The burns which result from contact of human skin with hot tar may be quite serious in proportion to the body surface area involved. Although tending toward partial thickness burns, patchy areas of full thickness skin loss are commonly observed. ⋯ Tar burns involving greater than 10 per cent of the body surface area are likely to be the most serious and require intravenous fluid resuscitation. Many tar burns appear to be preventable.
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In patients having missile wounds, the most bizarre trajectories and lodgment sites have been reported. Entry of the missile into the blood stream and subsequent embolization is quite an uncommon event. Isolated reports published in the literature date back to the beginning of the century. ⋯ In such instances, a thoracotomy is recommended. The alternative treatment in the instances reported herein, conceived and successfully performed by us, was embolectomy through percutaneous cardiovascular catheterization. As a novel procedure, the method has proved effective and liable to minimal risk.