摘要:

AbstractThe management of diverticular disease has altered radically with the widespread use of high fibre diet (HFD) over the past decade. However, whether this regimen has improved the prognosis in patients admitted with acute complications is still debatable.In this study the outcome of 100 such patients admitted to hospital with acute episodes of diverticular disease has been reviewed. Seventy‐five per cent were treated conservatively with HFD and review after 5–7 years showed that over 90 per cent remained symptom‐free, suggesting that HFD may afford protection by preventing further complica

ISSN:0007-1323    

DOI:10.1002/bjs.1800670202

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA technique is described which permits intraoperative application of antegrade bowel irrigation to clear the obstructed or loaded colon of faeces with minimal risk of cantamination. The procedure extends the indications for safe primary anastomosis in surgery of the left colon.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670203

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe effects of a minor degree of hypovolaemia on colonic blood flow and on systemic haemodynamics have been studied in nine greyhound dogs.A loss in blood volume of 10 per cent over 20 min produced no change in blood pressure and only a 7 per cent rise in heart rate. Cardiac output, however, fell by 26 per cent and central venous pressure also fell significantly. Colonic blood flow fell by 28 per cent and oxygen availability by 29 per cent. All these changes were statistically highly significant. Retransfusion of shed blood resulted in a slow and incomplete return to pre‐bleed status.Since colonic blood flow and oxygen availability during and after surgery may be important for colonic healing, it is suggested that even the slightest degree of hypovolaemia should be avoided in cases involving colonic anastomosis. Systemic blood pressure may be an inadequate index of the need for transfusion in these case

ISSN:0007-1323    

DOI:10.1002/bjs.1800670204

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractIn an attempt to improve the management of the perineal wound after abdominoperineal excision of the rectum we have assessed the value of foam elastomer, a catalysed silicone polymer dressing. This substance has already been used successfully in the treatment of open, granulating wounds at other sites (1).On the fourteenth postoperative day 50 patients with open perineal wounds were randomized to receive either conventional gauze packing or treatment with a foam elastomer dressing. Patients were received weekly until healing occurred. When no cavity remained, a dry dressing alone was used. Initial wound volume was calculated in all patients by forming a foam dressing the volume of which was measured by displacement of water.Healing times were shorter in patients who received foam elastomer, but not signficantly so. However, less analgesia (P<0·01) and fewer district nurse visits (P<0·001) were required by patients in the foam elastomer group.This study suggests that foam elastomer dressing is a more comfortable alternative to a gauze pack in the management of the perineal wound and substantially reduces the amount of nursing supervision which is required. We recommend its routine use in the management of the open perineal wound particularly in the young and cooperative patien

ISSN:0007-1323    

DOI:10.1002/bjs.1800670205

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractCotrimoxazole and metronidazole were given prophylactically to patients undergoing colorectal surgery as a single peroperative dose or in multiple doses for 5 days. A total of 60 operations randomly divided into two groups showed that the rate of wound infection was low in both groups and there was no statistical difference between them. There were no cases of anastomotic dehiscence in those patients where the anastomosis was carried out from within the abdomen, but 7 out of 9 patients with transsphincteric colo‐anal anastomoses developed a suture line dehiscence. A greater degree of post‐catheterization urinary tract infection was seen in the single dose group (which lacks statistical significance). There were no toxic effe

ISSN:0007-1323    

DOI:10.1002/bjs.1800670206

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA retrospective survey of 15 019 patients treated with clindamycin for a soft tissue infection was carried out to determine whether the incidence of serious side effects was sufficient to preclude the continuing use of this antibiotic. Thirteen patients were found to have had severe diarrhoea and 2 of these required inpatient treatment for pseudomembranous colitis. Certain limitations of the use of clindamycin are suggested but, in view of the recently improved understanding of the nature of pseudomembranous colitis and more effective methods of treatment of this complication, it is concluded that this antibiotic still has a useful role to play in the treatment of acute soft tissue infection.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670207

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractSeventy‐nine patients about to undergo cardiac operations were randomly allocated to two treatment groups in an attempt to reduce postoperative chest infections. The group receiving a short peroperative course of cefamandole, an antibiotic effective against both the pneumococcus and Haemophilus influenzae, had a significantly lower postoperative chest infection rate than the group receiving a 3‐day course of cephradine, an antibiotic previously chosen to prevent intracardiac infection during the operation. By selecting an appropriate antibiotic it is possible, using a short peroperative course, to reduce the post‐operative chest infection rate in patients undergoing cardiac opera

ISSN:0007-1323    

DOI:10.1002/bjs.1800670208

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractThrombocytopenia and haemolysis in intraoperative autotransfusion result mainly from extravascular tissue contact and therefore are not correctable by mechanical improvements in the autotransfusion apparatus. Instead, attention must be directed towards prevention of blood ‘recognition’ of extravascular tissue or stabilization of blood components against this damage. Methylprednisolone is shown to be effective in alleviating red cell and platelet damage induced by intraoperative autotransfusion in the canine mo

ISSN:0007-1323    

DOI:10.1002/bjs.1800670209

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractSixity‐five cases of carcinoma of the tongue treated by surgery were reviewed. The types of operation included hemiglossectomy, subtotal and total glossectomy with or without hemimandibulectomy and laryngectomy. Simultaneous neck dissection was usually performed except for patients who had radiotherapy and did not have clinical lymph node involvement. The hospital mortality and five‐year survival rates were analysed for individual subgroups of patients classified according to clinical and pathological features.The overall hospital mortality rate was 21·5 per cent. The size of the tumour and the presence of extension posteriorly, to the opposite side and to the floor of the mouth increased the mortality. Lesions situated on the dorsum fared worse than those at the edge or undersurface. Clinically and pathologically involved lymph nodes adversely affected the mortality. The more extensive the resection, the higher the mortality. Old age and previous failed radiotherapy also increased mortality. The overall five‐year survival rate was 46 per cent. Long term survival was not so much affected by the size of the primary tumour and degree of local extension as was the hospital mortality. Clinical as well as pathological staging of regional lymph nodes were more important in influencing long term survival. Recurrence after radiotherapy had a worse prognosis than previously untreated t

ISSN:0007-1323    

DOI:10.1002/bjs.1800670210

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractSolitary abscess of the spleen is a potentially lethal condition. It is difficult to diagnose but relatively easy to treat, resulting in cure of the majority of the patients. A case is described to illustrate the important factors in aetiology, presentation, diagnosis and treatment. All cases reported since 1960 are reviewed: the mortality of untreated patients is shown to be 100 per cent. If this condition is sucessfully diagnosed and treated, without rupture, no patient should die from it.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670211

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY