American journal of surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of synthetic adhesive moisture vapor permeable and fine mesh gauze dressings for split-thickness skin graft donor sites.
SAM and fine mesh gauze dressings were compared on 60 consecutive skin graft donor sites. SAM dressings are significantly better than fine mesh gauze dressings for healing of split-thickness skin graft donor sites; healing occurs much more rapidly with much less pain. In patients known to be colonized with Pseudomonas, care should be taken when using SAM dressings, although it is not an absolute contraindication. There were no clinically significant differences between Tegaderm and Op-Site.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cholecystectomy with and without drainage. A randomized, prospective study of 300 patients.
A randomized, prospective study of 300 cholecystectomies was undertaken to evaluate the merits of drainage through a standard Penrose or Chaffin-Pratt sump tube matched against no drainage at all. There was no difference in mortality or length of hospital stay. ⋯ Neither drain fulfilled its objective of providing outflow for a subhepatic collection, thus avoiding bile peritonitis. This study suggests that surgical drainage after every uncomplicated cholecystectomy is unnecessary and unwise.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative intermittent positive pressure breathing versus physiotherapy.
Seventeen patients admitted to the hospital to undergo elective upper abdominal surgery were randomly assigned to one of the two treatment groups: intermittent positive pressure breathing or physiotherapy. Postoperative pulmonary care in the two groups differed only with regard to administration of intermittent positive pressure breathing and chest physical therapy. Prospective evaluation included clinical examination, whole body plethysmography and determination of arterial blood gases preoperatively and on the 3rd postoperative day. ⋯ Although not statistically significant, the postoperative decrease in paitial arterial oxygen pressure was more pronounced in the physiotherapy group. Neither of the two therapeutic modalities is more effective than the other in preventing postoperative pulmonary complications. Considering the potential hazards, chest physical therapy is clearly the preferred treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of effect of narcotic and epidural analgesia on postoperative respiratory function.
A prospective, randomized comparison was made of the value of meperidine versus epidural analgesia when used for the relief of pain after cholecystectomy in twenty patients without cardiopulmonary disease. Respiratory function was assessed the day before surgery and at 3 to 4 hours and 24 hours after operation by the bedside measurement of expiratory peak flow, vital capacity, and arterial blood gases. The two groups of patients were comparable as to age, height, weight, smoking habits, preoperative peak flow, vital capacity, and duration of operation. ⋯ However, at 3 to 4 hours postoperatively, vital capacity was significantly greater in the epidural anesthesia group. This might account for the differences in arterial blood gases the following day. These findings suggest that epidural analgesia is valuable in the early postoperative period after upper abdominal surgery.