Langenbecks Archiv für Chirurgie
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Langenbecks Arch Chir · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Effect of orthograde intestinal irrigation with Prepacol and polyethyleneglycol solution on duration of postoperative ileus after colorectal resections].
In a prospective randomized study in 100 patients undergoing conventional (n = 66) or laparoscopic (n = 34) colorectal resection, mechanical lavage with 2 l of a polyethylene glycol (PEG) solution (group A, n = 50) combined with a laxative was compared with lavage with 4 l of PEG alone (group B, n = 50). The influence of bowel preparation on postoperative ileus was investigated. The efficacy of bowel preparation was determined intraoperatively by a surgeon blind to the type of preparation. ⋯ The first bowel movement occurred 3.2 +/- 1.1 days after conventional surgery and 4.3 +/- 1.2 days (P < 0.001) after laparoscopic surgery. The type of preoperative bowel preparation had no influence on the duration of postoperative ileus. The postoperative interval before the first bowel movement was shorter after laparoscopic surgery.
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Langenbecks Arch Chir · Jan 1995
Randomized Controlled Trial Clinical TrialEffects of ozone on how well split-thickness skin grafts according to Thiersch take in war wounds. Results of prospective study.
In a prospective study on 35 wounded persons we examined the effects of ozone on how well split-thickness skin grafts took in war wounds. Each of the 35 wounded persons hat at least two similar gunshot wounds, one on the lower leg or forearm and the other on the upper leg or upper arm. During the first 10 days all wounds were treated with 10% NaCl water solution dressings until the moment when healthy granulations were observed. ⋯ More than 74.3% of the split-thickness skin grafts treated with ozone had a take of more than 75% of the covered surface as apposed to only 40% of the grafts treated with the conventional method. The results in these two groups were compared with a chi square matched pair test. Difference in take of the skin grafts in these two groups was statistically significant at P < 0.01.
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Langenbecks Arch Chir · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial[A concept for decreasing postoperative pain after inguinal hernia operation].
In Germany approximately 150,000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. ⋯ An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.
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Langenbecks Arch Chir · Jan 1981
Randomized Controlled Trial Comparative Study Clinical Trial[Parenteral antibiotic prophylaxis or oral antimicrobial bowel preparation for colorectal surgery (author's transl)].
A prospective randomized trial was designed to establish whether parenteral antibiotic prophylaxis was as effective as oral antimicrobial bowel preparation in preventing sepsis after colorectal surgery. Patients scheduled for elective resection of colorectal cancer received metronidazole and kanamycin either orally in the preoperative phase or parenterally as a short-term perioperative prophylaxis. The former regimen resulted in reduction of the microbial concentrations in the bowel contents in the absence of therapeutic serum concentrations at the time of operation, whereas the latter achieved therapeutic intraoperative serum levels without altering the colonic microflora. 72 patients were studied. ⋯ This difference was most probably due to an overgrowth of kanamycin-resistant coliforms during the period of oral antibiotic preparation. The presence of resistant organisms did not, however, result in failure of systemic prophylaxis. The authors conclude that short-term parenteral application is the safer method of antibiotic prophylaxis in colorectal surgery and is to be preferred to oral antimicrobial bowel preparation.
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Langenbecks Arch Chir · Jan 1967
Randomized Controlled Trial Clinical Trial[Postoperative nitrogen balance in parenteral feeding with synthetic amino acid solutions and fat emulsions].