The British journal of surgery
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Randomized Controlled Trial Clinical Trial
The effect of topical povidone-iodine on the incidence of infection in surgical wounds.
A randomized stratified clinical trial of topical povidone-iodine in 627 patients undergoing abdominal procedures demonstrated a reduction in postoperative wound sepsis in female patients, in patients receiving subcutaneous low dose heparin and during the first quarter of the trial when the infection rate in control subjects was high. Overall, there was no significant reduction in wound sepsis after administration of povidone-iodine due mainly to a high infection rate in povidone-iodine treated male appendix operations where, by chance, there was an increased incidence of contamination with Bacteroides fragilis. Postoperative stay in those developing wound infection was significantly reduced in the povidone-iodine group. This is considered as indirect evidence for a decrease in severity of wound infection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus.
Gastrostomy feeding has been a well established form of nutritional support for patients presenting with total dysphagia for carcinoma of the oesophagus. More recently, total parenteral nutrition has proved to be efficient and safe, offering an alternative to gastrostomy feeding. ⋯ However, gastrostomy feeding is still preferred as it is cheap, simple and safe, and allows patients to be active, mobile and self dependent. Total parenteral nutrition is reserved for those patients in whom an earlier operation is advisable.
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Randomized Controlled Trial Comparative Study Clinical Trial
The bacteriology of primary wound sepsis in potentially contaminated abdominal operations: the effect of irrigation, povidone-iodine and cephaloridine on the sepsis rate assessed in a clinical trial.
Two hundred and nine potentially contaminated abdominal operations were randomly allocated to prophylaxis with a single dose of 1 g cephaloridine intraincisionally, irrigation of the wound at the end of the operation with saline or spraying of the wound with povidone-iodine. In high risk operations (ileocolorectal or those in obese patients) the rate of major wound sepsis in those protected by cephaloridine was 3.8% compared with 13.2% in the irrigation and 16.7% in the povidone-iodine groups. ⋯ Bacteriological studies of incised organs, subcutaneous fat and pus showed that the majority of wound infections arose from endogenous sources. The outstanding problem remains that of prevention of contamination of the abdominal wall during surgery.
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Randomized Controlled Trial Clinical Trial
A prospective trial of prophylactic antibiotics in hand lacerations.
A series of 368 patients with hand lacerations which required suturing were randomly allocated to one of three treatment groups. The incidence of infected and of imperfectly healed wounds was noted 7 days after suturing. As well as the influence of antibiotics on healing, sixteen other factors which it was considered might affect healing were analysed. ⋯ The imperfect healing rate (which includes the infected cases) was 24-6 per cent. There was a lower rate (P less than 0-05) of imperfect healing in the Triplopen group (15 per cent) than in either the flucloxacillin group (29-5 per cent) or the group who received no antibiotics (29-0 per cent). Other factors associated with imperfect healing found to be significant at the 1 per cent level, were wound contamination, pain and the presence of a wet or changed dressing at the second examination.
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Randomized Controlled Trial Clinical Trial
Proceedings: A randomized controlled trial of preoperative intravenous nutrition in patients with stomach cancer.