ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

In a reproducible infected rat burn model, subeschar infusion of antibiotics failed to protect the animals from death via burn wound invasion excepting those animals receiving carbenicillin. Subcutaneous injection of maximal doses of carbenicillin at a distance from the burn wound protected these animals equally well. Some advantage was defined for the subeschar route of administration with suboptimal doses of carbenicillin.More important is the fact that prospective selection of an effective antibiotic could not be made on the basis of in vitro antibiotic sensitivity tests.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The effect of Hydron burn wound dressing was evaluated using a standard Walker burned rat model (N= 156) and a rabbit ear wound model (N= 34). In both studies Hydron was administered only once in one group and changed twice weekly in another. Animals were predesignated as controls and for pathologic examination. Gross observations, including photographic documentation, and the pathologic analyses revealed no gross purulence or sepsis. No deaths occurred in the rabbit study. Of the 156 animals in the rat study only two died; a culture of the wounds revealed no sepsis. Statistical analyses revealed that in the rat study the once only application was significantly better at 7 days postburn than the twice weekly treatment and control groups. No significant differences among the treatment and control groups used in the rabbit study were revealed. The application of Hydron burn wound dressing did not adversely affect the wound healing.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Forty fractures and fracture-dislocations of the neck of the talus are reviewed. Undisplaced fractures are associated with a high proportion of good results. Type n fractures, where there has been subluxation of the subtalar joint, require accurate reduction to avoid subtalar joint incongruity, and have a 20% incidence of avascular necrosis. Type III fractures, with dislocation of the body of the talus, have a poor prognosis and have a 100% incidence of avascular necrosis. Hawkins' sign of subcortical radiolucency is helpful in ascertaining the presence or absence of avascular necrosis. Accurate open reduction and rigid internal fixation with early range of motion of the involved joints is recommended where a closed reduction has failed to provide anatomic reduction.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A retrospective study of 46 femoral shaft fractures treated with A.O. compression plating by eight surgeons of varying expertise in A.O. techniques at two large trauma hospitals was undertaken. Information was gained from hospital and office records, X-rays, operative summaries, and personal interview and examination. Average followup was 3 years. There was a 24% complication rate including failure of plates and screws, refracture after plate removal, fracture near the end of the plates, nonunion, and infection. Average time to union was 7 months. Despite less than optimal surgical technique, excellent or good results were obtained in 88% of all patients and 100% of those patients who did not have complications.Conclusions1) This is an acceptable method of treating femoral shaft fractures which are not amenable to I.M. nailing providing: the A.O. techniques are strictly adhered to; bone grafts are used when there is loss of bone, less than anatomic reduction and rigid internal fixation, and or devascularized bone; the patient is followed with partial weight bearing and cast brace if necessary until healed; plate is left in situ 1 year following union; and 2) all surgeons using the A.O. technique should be aware of the necessity of anatomic reduction and rigid internal fixation, and trained in its use.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The results of operative treatment of 83 pathologic fractures and 17 impending pathologic fractures of the long bones are reported. The results of a group of 53 patients who underwent an osteosynthesis only are compared with those of a group of 43 patients who were subsequently treated 47 times with an osteosynthesis in combination with bone cement. With regard to the degree of mobilization there is a statistically significant difference in favor of the group treated with bone cement. The incidence of complications is low. Immediate use of the involved extremity in these patients minimizes complications associated with prolonged immobilization and enhances the quality of the remainder of their lives.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Tumbling pentobarbital-anesthetized rats (25 mg/kg) in a Noble-Collip drum for 600 revolutions resulted in a severe form of circulatory shock, and all traumatized rats died within 5 hours. However, rats subjected to sublethal tumbling (i.e., conditioning) for 4 days before lethal tumbling developed tolerance to this usually lethal dose of trauma. After the tumbling, untreated nonconditioned rats showed a marked production of the cardiotoxic peptide, myocardial depressant factor (MDF), and depression of reticuloendothelial system (RES) function. Conditioned rats subjected to trauma did not show these changes. Nonconditioned tumbled rats developed severe twisting of the small intestine resulting in a vascular strangulation of the intestine: conditioned rats did not exhibit strangulation after tumbling. To eliminate mesenteric strangulation during tumbling, two methods were employed: 1) a four-baffle drum to prevent torsional twisting of rats in the drum; and 2) emptying the intestinal contents before tumbling in the ordinary two-baffle drum. Both of these procedures eliminated mesenteric strangulation in rats during tumbling, and all rats subjected to either of these procedures survived 5 hours post-trauma. Thus mesenteric strangulation may be a critical factor contributing to lethality in Noble-Collip drum trauma. Post-traumatic splanchnic lysosomal labilization, depression of RES function, and pancreatic MDF formation and its accumulation in the plasma may be direct consequences of the splanchnic ischemia leading to lethal shock. Since conditioned rats did not develop mesenteric ischemia during tumbling, no subsequent detrimental event occurred, and these rats did not develop lethal circulatory shock.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Although hemostatic defects have been reported with large-volume autotransfusion, the effect on platelet function has not been well defined. Twenty adult mongrel dogs underwent controlled intraperitoneal hemorrhage with collection and reinfusion using the Sorenson System. Each animal was autotransfused twice its E.B.V. over a 4-hour period. A.C.D., delivered at the sucker tip, served as the only anticoagulant. Mean arterial pressure and cardiac output remained stable during the study period with the additional volume support of 50 cc/kg Ringer's lactate. A moderate consumptive coagulopathy ensued. The P.T., P.T.T., and T.C.T. were all significantly prolonged, with a decrease in fibrinogen at 4 hours compared to baseline. Platelet counts fell significantly to 71% of baseline. In addition, platelet aggregation response to A.D.P. and collagen was markedly depressed, with corresponding prolongation in bleeding times at 4 hours. Twenty-four hours following autotransfusion the P.T., P.T.T., T.C.T., and fibrinogen levels returned toward normal. In contrast, the platelet counts continued to fall and the aggregation response remained markedly impaired. Methylprednisolone (30 mg/kg), administered to 10 animals, had no statistically significant effect on the coagulation parameters.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Donor source stimulation for a regional skin bank is discussed, emphasizing the importance of coordination with other organ donor programs, centralization of a public information and donor identifying communication system, exploitation of regional legislative precedents which facilitate organ donation, and finally, identification of health professional and related groups with a common interest in matters associated with rational planning for the time of death. The specific problem associated with skin donation, namely, a sensitive description of the technical details of skin harvest, is also considered.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Several therapeutic modalities in the management of low-velocity gunshot wounds to extremities were investigated. Local excision of wound margins, irrigation, and primary or delayed primary closure without the use of the operating room or prophylactic antibiotics produced results which were comparable to those obtained with a more aggressive surgical protocol.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID