Langenbecks Archiv für Chirurgie
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Langenbecks Arch Chir · Jan 1996
[Risk factors, preoperative delay and mortality in surgical gerontologic interventions].
A total of 1026 patients over 65 years of age underwent abdominal surgery during the period from 22 September 1987 to 12 February 1992 at the Surgical Department of Aachen Technical University. The data of these patients were analysed with respect to pre-operative risk factors, pre-operative rest period, their history and mortality. ⋯ Mortality after emergency intervention (16.54%) was about three times as high as after elective surgery (5.54%). The anamnesis was 2-10 months for 30% of the patients whereas 8.2% of the patients reported a history of complaints of less than 24 h.
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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 1997
[Systemic release of prostanoids after surgically-induced injury of lung tissue].
In a prospective study, the systemic inflammatory consequences of surgery-induced lung tissue injury were evaluated using biochemical markers. The aim was to examine whether this type of injury produces a specific pattern of prostanoid plasma levels (prostacyclin, thromboxane, PGE2, PGF2 alpha, and PGM). We, therefore, compared 18 patients (group 1) who underwent thoracotomy without injury to the lung with 26 patients (group 2) that had a resection of pulmonary tissue due to benign diseases. ⋯ Therefore, it can be suggested to be specific for that type of injury. Thus, the release of prostanoids following surgery-induced lung tissue damage may indicate the importance of these mediators, particularly in thoracic injuries associated with lung damage since those may lead to post-traumatic pulmonary dysfunction. These substances may also be useful in evaluating both the severity and the extent of lung tissue damage following major trauma.
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Langenbecks Arch Chir · Jan 1997
Comparative Study[Biomechanics of femoral interlocking nails at the bone-implant transition].
Today there is a variety of different interlocking intramedullary nail designs available for the femur-each designed with a different approach to achieve stability for fracture fixation. We compared different nail types in the bone-implant complex (BIC) of four unreamed solid nails and a slotted, reamed nail to see if there are major differences in stiffness for axial load, bending and torsion. We simulated comminuted mid-shaft fractures by a 2 cm defect osteotomy in paired human cadaver femora. ⋯ This study shows that stiffness of the BIC in interlocking femoral nails is more dependent on nail profile than on the press-fit of nails in the medullary canal. For torque stiffness the absence of a slot is of special importance. According to our study, all of the unslotted nails tested give adequate stability for fracture fixation.
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Langenbecks Arch Chir · Jan 1997
[O2 utilization during hyperthermic extremity perfusion with rhTNF alpha and melphalan].
During isolated limb perfusion (ILP) severe metabolic impairment with a subsequent alteration in oxygen consumption can be observed. The mechanisms responsible for this may be extracorporeal circulation, hyperthermia, and application of cytostatic drugs and cytokines. Thirty-three patients underwent ILP with rhTNF alpha and melphalan for melanoma or soft-tissue sarcoma. ⋯ Elevation of lactate values after reperfusion and the increase in oxygen utilization might be due to oxygen depletion in the perfused limb. This could contribute to the development of lactacidosis or rhabdomyolysis. Therefore, to minimize toxicity it seems to be mandatory to measure adequate tissue oxygen supply during ILP.