摘要:

AbstractAlthough most patients are essentially well enough to be able to resist or to adapt to unfavourable ambient conditions, this may not be so with an ill patient or one who is having or has had a serious operation. The climatic conditions necessary in the operating room to give an optimal environment are discussed. These are second in importance only to control of infectivity. Airconditioning in operating suites should be obligatory; there is even official acceptance of this. Earlier recommendations that the operating room should be heated to up to 80 °F(27·9 °C) are obsolete. The temperature most favoured by surgeons is 18·5–21 °C; some prefer a range of 21–22 °C. The critical ambient temperature desirable is 21 °C. For infants and children this may be increased up to 24 °C. It is difficult or impossible to achieve climatic conditions in the operating room that are acceptable to all. The needs of the patient are of special importance and are largely neglected; he alone is unable to speak for himself. The disposition of air inlets in the operating room is fully discussed.Climatic conditions in the intensive care unit are of great importance and are discussed. The need for full air‐conditioning is absolute although this is often ignored. The delivery of conditioned air within the intensive care unit is also fully presented, especially the need to avoid direct chilling of the patient. The advantages of horizontal laminar air flow

ISSN:0007-1323    

DOI:10.1002/bjs.1800620402

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractObservations are presented which suggest that peripheral venous pressure can be measured indirectly by a noninvasive technique at the bedside, using a portable Doppler ultrasound flowmeter.The pressure at which the audio signals are heard over veins on release of the occluding cuff seems to be a measure of peripheral venous pressure. This is supported by showing a correlation between the method and conditions in which raised venous pressure in the lower limb are known to exist. The results of a few direct venous pressure measurements are reported which appear to give added support.It is suggested that this simple non‐invasive technique may be of value in detecting certain cases of deep vein thrombosis of the lower extremitie

ISSN:0007-1323    

DOI:10.1002/bjs.1800620403

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA family in which several members have medullary carcinoma and phaeochromocytoma is described. Four of the 5 patients in this family who had a phaeochromocytoma have died; in one of these the medullary carcinoma may have contributed to death but in general the thyroid cancers were slow growing. In our experience successful diagnosis and treatment of the phaeochromocytomas have presented the greatest challenge. The welfare of future generations with this syndrome would seem to depend upon regular clinical and biochemical surveillance of the individuals and expeditious diagnosis and treatment of their tumours, particularly the phaeochromocytomas.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620404

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractTwo cases of adenocarcinoma arising in sequestrated duplications of the bowel in adults are reported. The literature is reviewed and a tendency for duplications to present in early childhood is noted. Although relatively few of these anomalies persist into adult life 8 cases of neoplastic change have now been reported. The histological features of many of the duplications undergoing malignant degeneration suggest the presence of underlying epithelial instability in this condition. It is postulated that duplications of the large bowel have malignant potential.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620405

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThis trial has investigated the value of gentamicin therapy in patients requiring biliary surgery. One hundred consecutive patients were randomly allocated to receive either gentamicin or no antibiotic. Postoperative infection was assessed by an independent observer. Cultures and gentamicin assays were performed on bile and blood sampled during and after operation. The minimum inhibitory concentrations of gentamicin were measured with isolated bacteria.In 80 per cent of patients biliary organisms were inhibited by 2μ g/ml of gentamicin. Twice this concentration was found in the serum at operation in 88 per cent, but in the bile in only 18 per cent. Nevertheless, gentamicin lowered the incidence of bacteria in the bile from 42 to 25 per cent. There was a reduction in wound sepsis from 21 to 6 per cent (P<0·05). Bacteriaemia was demonstrated in only 1 patient receiving gentamicin compared with 5 controls and 1 death occurred from endotoxaemia in the control group.These data suggest that gentamicin will reduce the morbidity of biliary surgery, particularly in patients in whom the bile is infected at operatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800620406

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA review has been undertaken of the 47 patients who have had open pancreatic biopsy performed at the Royal Free Hospital between 1967 and 1972. It is concluded that not only is the procedure safe when using the technique described but also it is a valuable and accurate diagnostic procedure.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620407

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractLarge bowel cancer is not common but is showing increased frequency in the northern part of the Sudan. It is relatively uncommon among southerners, which may be due to the socio‐economic factors prevailing in the Sudan.The disease affected our population at a younger age than has been generally reported in the literature, and the lesions in nearly 30 per cent were of the mucoid and undifferentiated types.The incidence in young adults is difficult to explain in the absence of precancerous lesions, and there is not enough evidence to incriminate parasitic infestatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800620408

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThree methods of perineal wound closure were studied in a randomized prospective clinical trial in 106 patients undergoing excision of the rectum for inflammatory or malignant disease. In method 1 the perineal wound was managed by open drainage. In both methods 2 and 3 the perineal wound was closed by primary suture, suprapubic suction drains being left down to the presacral space, but in method 2 the pelvic peritoneal floor was reconstituted, whilst in method 3 it was left unsutured. Topical and systemic antibiotics were administered to all patients submitted to primary closure of the perineal wound but not routinely to those whose perineal wound was left open.The overall operative mortality was 8·5 per cent but no deaths could be definitely attributed to perineal wound complications. The incidence of primary wound healing after methods 2 and 3 was 45·2 and 4·9 per cent respectively. Operative contamination of the perineal wound had an adverse effect on perineal wound healing. The incidence of persistent wound sinuses and unhealed wounds at 3 and 6 months after primary wound closure was rather less than that encountered after open drainage.It was concluded that primary closure of the perineal wound is the treatment of choice following excision of the rectum, except in cases in which contamination of the perineal wound has occurred during operation or the final state of haemostasis in the pelvis with diathermy and suture at the conclusion of the dissection was deemed to be unsatisfacto

ISSN:0007-1323    

DOI:10.1002/bjs.1800620409

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractOne hundred and ninety‐two operation wounds in a general surgical practice were randomly allocated to receive either topical cephaloridine or a povidoneiodine spray, and the rate of wound sepsis was studied. In all types of operation cephaloridine proved superior to povidone‐iodine as a prophylactic, the difference reaching a significant level in potentially contaminated wou

ISSN:0007-1323    

DOI:10.1002/bjs.1800620410

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractCulture of flower vase water from wards in the David Lewis Northern Hospital, Liverpool, revealed large numbers of potentially pathogenic bacteria. The types of organisms isolated may reflect the particular ecology of this hospital as they differed in some ways from those reported from other centres. The incidence of wound infections during the period of study was low (5·2 per cent) despite the regular overgrowth of bacteria in flower vases, and there did not appear to be any definite correlation between the types of bacteria isolated from flower vase water and those responsible for wound infections.The addition of hydrogen peroxide to flower vases proved a very effective antiseptic and is recommended for general use as a precautionary measure

ISSN:0007-1323    

DOI:10.1002/bjs.1800620411

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY