The British journal of surgery
-
Whether or not the soleus muscle should be excised during below-knee amputation is a point of contention. The anatomical basis for the blood supply to the skin of the posterior calf has been examined by dissection and selective arterial injection of cadavers. ⋯ There is no contribution by blood vessels that pass through the soleus muscle. When a posterior flap for below-knee amputation is constructed the soleus muscle should be completely excised.
-
A prospective study of 111 patients with low velocity gunshot wounds of the abdomen was conducted to determine whether a policy of selective conservative management based on repeated physical examination is a safe form of treatment. Laparotomy was undertaken in 89 patients (80 per cent), seven of which were negative. Of the patients 22 (20 per cent), eight of whom were considered to have peritoneal penetration, underwent conservative management. ⋯ Eight patients (7 per cent) died, all deaths occurring in the positive laparotomy group. The incidence of significant intra-abdominal injury if the peritoneal cavity had been penetrated was 89 per cent. Selective conservative management may be applied safely to a limited group of patients with gunshot wounds of the abdomen.