Langenbecks Archiv für Chirurgie
-
Carcinomas, mainly of the squamous cell type, may occur in burn scars from 3 months to 75 years after the burn injury, and they have a poor prognosis. Therefore, unstable scars, chronic ulcers and tumors must be subjected to histological examination as soon as possible. If a malignant tumor is present, the therapy of choice is wide local excision, though in the event of progressive tumor development an ablative procedure may be necessary. ⋯ Unstable scars should be investigated to allow prophylactic surgery to be performed if appropriate [4]. Early mobilization of the (mostly elderly) patients is important. Three case reports of patients with burn scar carcinoma are presented.
-
Langenbecks Arch Chir · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[A concept for decreasing postoperative pain after inguinal hernia operation].
In Germany approximately 150,000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. ⋯ An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.
-
Langenbecks Arch Chir · Jan 1994
Review Case ReportsPerforation of the cecum by a toothpick. Case report and review of the literature.
Perforation of the colon can have any number of causes. Most often, it is the result of carcinoma or diverticulitis; specific inflammatory disease of the large intestine is a less common cause. Other possibilities are iatrogenic perforation, perforation as a result of blunt or penetrating abdominal trauma, and ingestion of a foreign body. A case of perforation of the cecum by a toothpick 3 weeks after consumption of a beef olive is reported; possible diagnostic problems, other conditions that need to be considered in the differential diagnosis and treatment are discussed.
-
Langenbecks Arch Chir · Jan 1994
Comparative Study[Pressure-volume analysis of wound suction drainage containers and suction capacity of drainage tubes].
Four low-vacuum systems and eight high-vacuum systems were examined with special reference to the pressure-volume relations. The maximum filling volume for adequate transport of wound secretion was determined for each type. The use of a synthetic wound fluid instead of water resulted in a smaller aspiration volume. ⋯ The suction maximum of normal tubes and silicon tubes was located at the proximal holes of the perforated tubes. The "Ulm drain," with perforation diameter increasing continuously to the distal end of the tube, was found to exert suction even at the more distal part of the tube. It is estimated that this tube allows locally more balanced vacuum in the wound.