Zentralblatt für Chirurgie
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Comparative Study
["Fast-Track" for laparoscopic-assisted rectum resection--what can be achieved? First results of a feasibility study].
"Fast-track" multimodal rehabilitation is increasingly entering the perioperative management strategies in colon surgery aiming at minimized perioperative morbidity and accelerated recovery. So far little is known about the complementary effects of minimally invasive surgery along with "fast-track" rehabilitation in the treatment of rectal cancer. The aim of this pilot study was to investigate the influence of "fast-track" perioperative management on morbidity, recovery and length of hospital stay in laparoscopically-assisted rectum resections and to compare those data to earlier results. ⋯ "Fast-track" rehabilitation is feasible in rectum surgery and seems to complement the beneficial effects of minimally invasive surgery without increasing the complication rate.
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Randomized Controlled Trial Comparative Study
[Value of laparoscopic surgery in elective colorectal surgery with "fast-track"-rehabilitation].
Laparoscopic (LAP) versus open (CON) colonic resection with traditional perioperative care has some short term benefits postoperatively regarding functional recovery. Whether these benefits may also occur when all patients are treated with multimodal "fast-track"-rehabilitation programs is questionable. ⋯ Even with perioperative "fast-track"-rehabilitation programs short term advantages were found in laparoscopic compared with open colonic surgery in a non randomised population. The clinical relevance should be examined in controlled randomised trials.
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Randomized Controlled Trial Comparative Study
[Efficacy of treatment with Repithel and Jelonet in comparison to treatment with Jelonet alone - a randomized clinical trial in patients receiving meshed skin grafts].
Moist wound treatment is a well recognized method for the treatment of aseptic acute and chronic wounds. While the moist environment is beneficial to the woundhealing process, it also increases the risk of bacterial superinfection. We here report on the results of a clinical phase-III-study in which we tested the effect of a new PVP-iodine liposomal hydrogel (Repithel) on split-thickness skin grafts. This formulation optimizes moist wound treatment by improving the cell proliferation rate while preventing wound infection. ⋯ Repithel supports healing of meshgraft transplants and reduces the risk of graft loss. Patients who heal poorly benefit particularly from the Repithel treatment.
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Case Reports
[Fracture of the distal lower limb: two-stage surgical treatment with external fixator and locked-screw plate].
From January 1999 until October 2004 we treated 42 patients with closed fractures of the distal calf by a two-stage treatment plan: first the fracture was stabilized with an external fixator bridging the ankle joint. Second, after an average period of 8.3 days, an open reduction and internal fixation with a locked-screw implant followed. ⋯ Radiologically we saw in 31 fractures of the pilon-tibiale in 19 cases no or only few arthrosis of the ankle joint, in 9 cases intermediate and in 3 cases advanced arthrosis. With a two-stage surgical treatment with external fixator and locked-screw implant we achieved a good functional result with only few complications.