Zentralblatt für Chirurgie
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After twenty years of clean-air operating rooms, no uniform opinion about the efficiency in preventing infections has been achieved. The reason is that with an infection rate around 1% only very large series of homologous material are statistically significant. Vertical flow is more efficient than horizontal flow. Clean-air technique is only one of the many facets of antisepsis and asepsis; it should be used especially in implantation and transplantation surgery in spite of the fact that its efficiency is not yet clearly proven.
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Yersinia enterocolitica is a pathogenic organism, hitherto being of minor clinical interest only. In all unclear abdominal complaints especially in the right middle or lower part of the abdomen a Yersinia enterocolitica infection should also be taken into consideration.--Specific diagnostic measures have to be taken and in a suspected case antibiotics should be administered.--In every case an appendectomy has to be performed and a lymphnode should be extirpated and sent for histologic and microbiological examination.
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Case Reports Historical Article
[History of gastrotomy for the removal of foreign bodies].
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In the reconstruction of lacerated flexor tendons excellent and good results could be achieved in 51%.--The best results were obtained in zone 1, 3, 4 and 7 according to Verdan's classification. Depending on the operative technique of reconstruction the best results were obtained in reinsertion and primary suture of the tendons. In free tendon grafting the two-staged procedure gave better results than the modified Paneva-Holewich-technique and this was better than the classical tendon grafting in one operation.--Dissected flexor tendons are recommended to be reconstructed primarily according to Kleinert's principles. Some special operative techniques, suture materials, and new instruments are discussed.
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The diagnosis of life threatening situations due to blunt chest trauma, the priority of treatment, and therapeutical consequences are discussed. Rib fractures, pulmonary contusions could be treated conservatively. ⋯ Rupture or perforation of the oesophagus, traumatic aneurysms of the thoracic aorta, large diaphragmatic herniations, and penetrating thoraco-abdominal wounds demand an early thoracotomy. Indications for late thoracotomy are: clotted haemothorax and diaphragmatic herniations primarily not diagnosed.