Purulent Wounds Research Articles

Ceftriaxone is more effective than gentamicin/metronidazole prophylaxis in reducing wound and urinary tract infections after bowel operations

A controlled, randomized trial with blind assessment of end points is described comparing ceftriaxone (1 g) given at induction of anesthesia with gentamicin (2 mg/kg) and metronidazole (500 mg) (GM), three times, every eight hours starting at induction, in preventing wound, chest, and urinary tract infections following bowel operations. Patients with inflammatory bowel disease received prophylaxis for five days. Two hundred sixty patients were randomized, and 196 were studied after exclusions. Ninety-four were given ceftriaxone, and 102 were given GM. Chest infection was defined as pyrexia plus clinical or radiologic signs of consolidation or the production of purulent sputum. Wound infection was diagnosed on the basis of purulent wound discharge or pyrexia plus swelling, redness, and pain around the wound, and urinary tract infection was diagnosed from microbiologic results. There was a significant reduction in wound infection (17 percent to 6 percent; P < 0.05) and in urinary tract infection (8 percent to 1 percent; P < 0.05) in the ceftriaxone group compared with the GM group. Chest infection occurred in 16 percent of the ceftriaxone group compared with 25 percent of the GM group, but this difference was not statistically significant. Infected patients were in the hospital more than four days longer than uninfected patients, a statistically significant difference (P < 0.01). It is concluded that ceftriaxone is superior to GM in reducing postoperative sepsis and that this effect is likely to be due to the sustained bactericidal blood levels achieved by ceftriaxone.

Treating purulent wounds of the anterior abdominal wall after obstetric and gynecological operations by using low-intensity laser irradiation

Treating purulent wounds of the anterior abdominal wall after obstetric and gynecological operations by using low-intensity laser irradiation

Hospital‐associated infections in obstetrics and gynecology

To determine whether continuous surveillance of hospital-associated infections with regular feed-back to the staff reduces the infection rate in obstetrics and gynecology. Two infection control nurses surveyed all patients over a 2-year period for infections and potential risk factors. After an initial 9-month period (period A), quarterly information to all doctors and nurses was introduced for the rest of the study (period B). A department of obstetrics and gynecology at a Swedish university hospital. All patients undergoing surgery, excluding vacuum aspiration abortions and dilatation and curettage. 2,334 patients were surveyed. In period A, 14.2% of all operations were followed by an infection, compared with 9.5% in period B (p less than 0.001). For purulent wound infections and for endometritis, a significantly reduced rate was noted from period A to B. Several risk factors for infection were significantly more common in period B than in period A. Cesarean sections and hysterectomies were the most common operations also having among the highest infection rates. For both of these operations, infection rates were significantly reduced from period A to period B (from 15.1% to 9.0% and from 15.7% to 10.7%, respectively). The average length of hospitalization was 6 days longer for an infected than for an uninfected patient. Surveillance of hospital-associated infections including regular feed-back to the staff was accompanied by a significant reduction in infection rates. A quality surveillance program for departments of obstetrics and gynecology therefore seems to benefit from including such surveillance. Surveillance could possibly be limited to only a few common operations with high infection rates.

Immediate Muscle Flap Coverage for Repair of Cardiac Rupture Associated with Mediastinitis

Sternal wound infection with mediastinitis is a dreaded complication of cardiac surgery. Even more devastating is perforation of the heart or great vessels secondary to advanced mediastinitis. The exsanguinating hemorrhage and presence of extensive infection usually lead to a poor salvage rate in these patients. Citations in the English literature of successful management of cardiac rupture associated with mediastinitis are, as expected, scare. Recently, the capability for immediate muscle flap coverage in the repair of associated rupture of the heart secondary to active mediastinal infection has been discussed in two reports. This article presents another report, in which bilateral pectoralis major muscle flaps were used successfully in salvage of a patient who sustained rupture of the right ventricle after debridement of an extensively purulent sternal wound and mediastinum.

A randomized prospective study to compare ceftizoxime with cephradine as single dose prophylaxis in elective cholecystectomy

This study compares the efficacy of ceftizoxime with that of cephradine as single agent prophylaxis in elective cholecystectomy. The incidence of purulent wound infection was low in both groups (ceftizoxime 1 99 ; cephradine 2 92 ). No adverse reactions to the trial antibiotics occurred in either group. Ceftizoxime is a safe, effective, convenient and well-tolerated antibiotic for use as single agent prophylaxis in elective cholecystectomy. However, because it has no demonstrable advantage over cephradine and is three times as expensive, its routine use is not justified.

The Use of Mupirocin Before Skin Surgery

Presumed skin cancers were excised from 46 consecutive outpatients without antibiotic cover. A purulent wound developed in ten patients. Similar, but contaminated lesions were excised from 40 patients, but mupirocin ointment was used before surgery. Not one purulent wound developed out of 45 excisions.

Septic Complications of 100 Abdominal Deliveries in the Rural Tropics

This paper examines the nature of abdominal deliveries in 100 women who presented at the Holy Family Hospital in Ghana, suffering from delivery complications. The main indicator disease for surgery was cephalic- pelvic distortion, previous cesarian section, ruptured uterus, and placenta previa with hemorrhage. The most common septic complication of abdominal deliveries is purulent wound infections. 4 deaths occurred, within 48 hours of surgery, and none of the survivors developed pelvic abscess. Sepsis is the most important factor in maternal morbidity and mortality; risk factors associated with delivery of C-section include inadequate antenatal care, anemia, poor socioeconomic status, prolonged labor with ruptured membranes. However this information must be weighed in the context of the existing environment. Most of the cases present to the hospital in severe distress, having been in labor for many hours. Therefore, it is important to provide comprehensive education through primary health care to traditional birth attendants on issues surrounding pregnancies. For the purpose of prevention of sepsis, prophylactic antibiotics should be used on mothers showing evidence of complications, and more importantly, they should be aggressively administered to those women having ruptured membranes.

On the treatment of purulent wounds

In 1985-1987, we treated 142 patients (77 male and 65 female) aged 1 to 85 years old with purulent wounds and purulent-necrotic lesions of soft tissues at the surgical department of the Central Regional Hospital. Pathogenic microflora isolated from wounds was found to be sensitive to kanamycin, ampicillin, streptomycin, monomycin, carbenicillin.

Treatment of purulent wounds in diabetic patients with low-frequency ultrasound combined with helium-neon laser

Acute surgical infection in diabetes mellitus is still one of the difficult problems of practical medicine and requires more in-depth research.&#x0D; The aim of this work was to determine the effectiveness of treatment of acute pyo-inflammatory diseases of soft tissues in diabetic patients with ultrasound treatment of wounds with low-frequency ultrasound and subsequent stimulation of reparative processes in them by radiation of low-intensity helium-neon-based laser.

Compression cranioplasty for surgical treatment of purulent wounds

The presence of powerful antibacterial agents and the positive outcomes of using a blind suture after surgical treatment of purulent wounds of the skull and brain gave us the basis in an experiment on 36 dogs to find out the possibility of primary closure of skull defects using the compression method of cranioplasty developed at the Department.

Debrisan in the treatment of purulent wounds. (Russian)

Debrisan in the treatment of purulent wounds. (Russian)

The use of a CO&lt;sub&gt;2&lt;/sub&gt; laser in purulent surgery

In recent years, the use of laser technology in surgery has found more and more widespread use. Low invasiveness, good hemostasis, antiseptic properties, non-contact, analgesic effect of the laser beam give it a significant advantage over traditional surgical instruments, including the electric knife. In 1981-1982. in the 1st surgical department of the hospital st. Kazan performed 91 opening of purulent cavities and treatment of purulent wounds with a laser beam in 80 patients who had various purulent-inflammatory and other diseases: abscesses, phlegmon (22), purulent wounds (13), osteomyelitis, gangrene of the fingers (11), carbuncles, boils (10), epithelial-coccygeal cysts (8), trophic ulcers (6), mastitis (5), burns (3), benign tumors (2). There were 46 men, 34 women, the patients' age was from 24 to 81 years.

Treatment of purulent wounds

The experience of treating 994 patients with purulent wounds after opening a purulent-inflammatory focus is generalized. Comparison of various methods of treatment It was found that when opening and tamponing purulent wounds with gauze napkins, the terms of treatment are significantly increased, and plastic surgery is possible only in 64.8% of patients. As a result of primary surgical treatment of purulent wounds with the imposition of primary or primary delayed sutures, subject to drainage of wounds and lavage, the healing time is reduced, and plastic surgery is feasible in 87.3% of patients.

Treatment of purulent wounds and fistulae with an adhesive wound irrigation device

Treatment of purulent wounds and fistulae with an adhesive wound irrigation device

Effect of (white) birch buds tincture on purulent wounds. (Russian)

Effect of (white) birch buds tincture on purulent wounds. (Russian)

Effect of local hyperbaric oxygenation on infected wounds

As a result of exposure to oxygen under increased pressure on the flora of purulent wounds of soft tissues in all 167 patients treated with this method, the antibiotic resistance of the microflora decreased. After 5-7 sessions, the wound cultures became sterile. The control group patients (79 people) showed an increase in the antibiotic resistance of the microflora.

Change in oxygen tension in the capillary blood of tissues of infected wounds during local hyperbaric oxygenation

84 patients with purulent wounds were treated with local application of oxygen under pressure using mobile portable pressure chambers. The study of the dynamics of pO2 in a purulent wound confirms the positive effect of this method of hyperbaric oxygenation on the local hypoxia of a purulent wound and on its healing.

Infections associated with genital Mycoplasma

Eleven case reports are presented in order to illustrate the part that genital Mycoplasma (M.) may play in human disease. Three cases were of pelvic inflammatory disease and T strain M. was isolated from the exudate in one and M. hominis in 2 cases. In four cases Mycoplasma was isolated from purulent postoperative wounds. Four cases developed sepsis after delivery or missed abortion; in one case the blood culture yielded T strain M., in the others M. hominis.

On the effectiveness of the combined use of antibiotics and pentoxyl in the treatment of purulent wound infection

Research data of our department show that purulent staphylococcal processes, difficult to treat because of their complication with Proteus, under the influence of treatment with a combination of penicillin and synthomycin (or levomycetin) proceed more easily and end earlier than those treated with penicillin alone (Melnikov, Gubaidullina, Kutdusova). However, even with the combination of penicillin and synthomycin complete recovery of animals comes not earlier than 4-5 weeks. Such duration of the healing process, we must think, to some extent associated with inhibition of immunological reactions by antibiotics, which contributes to the preservation of proteus in the wound and delays the process of tissue regeneration.In this regard, the question of reasonable forms and methods of adding any stimulating drugs to antibiotic therapy, providing greater efficiency in the fight against infection, is of interest. In search of such a method we stopped on pentoxyl.

NONDRAINAGE AND EARLY AMBULATION IN CASES OF PERFORATIVE APPENDICITIS

THIS paper is a study of 15 cases of perforative appendicitis with peritonitis or abscess formation in which the appendix was removed, sulfathiazole was employed intraperitoneally, the incision was closed without drainage and spinal anesthesia and early ambulation were used. There were no deaths; a secondary intraperitoneal abscess requiring drainage occurred in 1 case. There were no other complications and no purulent wound infections. Penicillin was administered in the last 7 cases. From this small series of cases the following conclusions have been deduced: Nondrainage in cases of perforative appendicitis with peritonitis is preferable to drainage. It is safe, and is desirable because it eliminates prolonged drainage and wound infection and minimizes the hazard of such postoperative sequelae as adhesions, hernia, fistula and obstruction. It shortens the stay in the hospital, saves dressings and bandages, lessens expense to the patient and lowers mortality. It is, moreover, impossible to drain the