ISSN:0007-1323    

DOI:10.1002/bjs.1800740202

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740203

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740204

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740205

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe clinical presentation and management of 28 popliteal artery injuries following penetrating and blunt trauma during a 6 year period is reviewed. Clinical and Doppler evaluation identified an arterial injury in 24 (85 per cent) patients. In eight (29 per cent) patients with arteriovenous fistulae or false aneurysms, pedal pulses were palpable during initial assessment. Three (10·7 per cent) patients had limb amputation attributable to delayed vascular repair, crush injury and sepsis. End‐to‐end arterial repair following blunt trauma resulted in early failure with thrombosis in two patients. Autogenous vein grafting was used in 12 patients and is advocated in all blunt popliteal arterial injuries. Routine repair of associated venous injuries and liberal criteria for early fasciotomy were used. Exoskeletal fixation or skeletal traction for compound and comminuted fractures is recommended for simplicity of application and wound management. The significant functional orthopaedic disability following blunt arterial trauma at the knee is emphas

ISSN:0007-1323    

DOI:10.1002/bjs.1800740206

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe significance of staphylococcal infection has been studied prospectively in 250 wounds healing by open granulation. In a series of 50 axillary skin excisions, 17 became infected with Staphylococcus aureus with consequent pain and delay in healing. The infections responded well to Fucidin ointment. Nasal carriers of the organism may be especially liable to this complication. In contrast, although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied. The susceptibility of superficial wounds to the infection is ascribed to friction from dressings. Deep granulating wounds are occasionally affected similarly when the cavity has filled.

ISSN:0007-1323    

DOI:10.1002/bjs.1800740207

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe results are presented of vascular surgical audits in Oxford over the 10 years 1975–85. Changes observed include the decreasing use of endarterectomy (other than carotid), the introduction of transluminal angioplasty, and fewer lumbar sympathectomies. The number of major amputations has increased relative to arterial reconstructions. Our audit methods over the 10 years included the use of punch cards, two different computer programs, and a simple weekly audit of cases. The relative merits of these methods are compared. Numbers of procedures performed in Oxford were compared with expected figures calculated from the Hospital In‐patient Enquiry, the Lothian audit, and the Vascular Surgical Society survey. In general the calculated and actual numbers are similar. Difficulties in finding comparable operation categories and the totally inadequate classification of nationally collected data highlight the need for improved audit in vascular surg

ISSN:0007-1323    

DOI:10.1002/bjs.1800740208

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractOne hundred patients with duodenal or pyloric/prepyloric ulcer disease were operated with parietal cell vagotomy (PCV) and followed for a minimum of 10 years. At 6 weeks, 1,5 and 10 years postoperatively gastric secretory tests, haematological work‐up and clinical examination or telephone interview were performed. There was no operative mortality and the frequency of postoperative sequelae was minimal. The cumulative ulcer recurrence rate was 18 per cent and another 14 per cent had slight to moderate symptoms of epigastric pain without any signs of ulcer. Upper gastrointestinal endoscopy was used to reveal recurrences but was performed only if the patient had symptoms of recurrence. A rise in basal acid secretion and in pentagastrin‐stimulated secretion was observed the first year postoperatively, whereas insulin‐stimulated peak acid output increased during the first 5 years. We conclude that PCV has a low rate of per‐ and postoperative complications and an acceptable recurrence rate. Therefore, it seems that PCV is the method of choice in chronic duodenal ulcer

ISSN:0007-1323    

DOI:10.1002/bjs.1800740209

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractA prospective controlled study in 60 patients undergoing simple closure of perforated duodenal ulcer demonstrated a significant (P>0·05) benefit following postoperative cimetidine treatment, in terms of avoiding subsequent dyspeptic symptoms and complications of peptic ulcer disease. Thus cimetidine is recommended in the follow‐up management of perforated duodenal ulce

ISSN:0007-1323    

DOI:10.1002/bjs.1800740210

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractMaximal gastric secretion was studied in 41 unoperated patients with gastric ulcer, 201 patients with duodenal ulcer, and 122 control subjects. The patients with a gastric ulcer were divided into high, body and prepyloric, according to the site of the ulcer. Both high and body gastric ulcers secreted significantly less than the controls, and the duodenal ulcer patients secreted significantly more. However, the patients with gastric ulcer were older and lighter than the controls and, since these factors are known to influence maximal gastric secretion, the controls and patients with duodenal ulcer were standardized to the mean weight (and age, for the controls) of the gastric ulcer group. After this standardization, there was no significant difference in secretion between the patients with body ulcers and normal controls. Pyloric loss was a similar percentage of maximal gastric secretion in all groups, but duodenogastric reflux was higher in the gastric ulcer group compared to the controls. The mean volume of duodenogastric reflux was greatest in the patients with a prepyloric gastric ulcer. It is commonly accepted that hyposecretion in patients with a gastric ulcer is due to gastritis consequent upon increased duodenogastric reflux. However, in this study, no gastric hyposecretion was evident in the body and prepyloric gastric ulcer groups, both of whom had greater than normal levels of duodenogastric reflux.

ISSN:0007-1323    

DOI:10.1002/bjs.1800740211

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY