Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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The dorsal approach for reposition and stabilisation of dorsal and lumbal spine fractures is widely accepted. It is much easier for the surgeon and with lower risk for the patient. For placement of the pedicle screws 3 steps with X-ray fluoroscopy in transversal and anteroposterior direction are necessary: K-wire placement in the pedicle, drill for opening the pedicle and finally screw placement. With the use of two fluoroscopes and a central cannulated drill which is placed over the K-wire the operation gets much shorter, easier and the fluoroscopy time can be reduced significantly.
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In a retrospective study of surgical patients during a period of 9 years 296 cases of pulmonary embolism were recorded by analysing autopsy findings and perfusion pulmonary scans. The frequency of pulmonary embolism among patients who underwent a surgical procedure was 0.55%, the frequency of lethal pulmonary embolism was 0.15%. ⋯ With regard on the preceding operation a high frequency of pulmonary embolism after septic abdominal surgery (1.5%) and vascular surgery (0.9%) became obvious, especially after operations on the abdominal or thoracic aorta (2.1 resp. 4.8%). In 198 cases venous thrombosis were found. 104 (52%) of these were located in the cranial venous system and in 46 patients there was a connection to the site of central venous lines.
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Randomized Controlled Trial Clinical Trial
[Treatment of pilonidal sinus with excision and primary suture using a local, resorbable antibiotic carrier. Results of a prospective randomized study].
The excision of a pilonidal sinus with wound healing by second intention, often results in a long duration of treatment. On the other hand, primary suture after excision has a high rate of abscess formation. In a randomized study we treated 40 patients with excision of pilonidal sinus, insertion of a collagen sponge containing Gentamicin and primary suture (group 1) to prevent this abscess formation. ⋯ In group 1 only 7.5% of the patients had a postoperative abscess formation, in contrast to group 2, with an abscess rate of 52.5% and consecutive surgery (p less than 0.001). One year after the operation the recurrence rate was 0 in both groups. Considering the results mentioned, surgical excision of the pilonidal sinus in combination with insertion of a resorbable antibiotic sponge we recommend this therapy.