Biomedical subjects
Publications and source records attributed to A I Davidson.
Late infection of a total hip arthroplasty recently presented as an ischiorectal abscess. A likely pathogenesis is suggested and the literature on late infection in prosthetic joints is reviewed.
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Hospital admissions for symptomatic diverticular disease of the colon were studied during two periods, 1958-61 and 1968-71, in a relatively closed community in north-east Scotland. There was a significant increase in the numbers admitted, from 206 to 366. In the earlier 4-year period among patients aged 70 years and over there was a preponderance of females, but in the later study period the risk of developing symptomatic disease was almost as great among elderly males. Most of the elderly female patients were widowed city dwellers. The proportion of patients requiring operation for or dying from diverticular disease declined, but perforation remained as a frequent complication carrying a high mortality.
A 61-year-old, bronchitic male developed respiratory failure due to a pneumoperitoneum following gastroscopy. The management of this case and the possible complications following gastroscopy are described and discussed.
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The incidence of postoperative wound infection in a general surgical unit is reported both before and after transfer from a "Nightingale" type multibed ward to a new "race-track" type of surgical ward with controlled ventilation and with 40% of its beds in single rooms. Following transfer postoperative wound infection was reduced by about 55%.With the use of certain types of staphylococcal infection as an index of cross-infection it was shown that transfer was followed by a 72% reduction in cross-infection of wounds.A case is made for control of hospital cross-infection in surgical wards. The principal change in ward architecture resulting from the transfer was the extensive division of ward space into separate compartments (40% of single-bed rooms), which make controlled ventilation easier.
A detailed investigation has been carried out into the behaviour of wounds after 1,000 general surgical operations, about equal numbers of patients having been studied in two different ward and operating theatre environments. The wound sepsis rate was reduced after transfer to the new type of ward. It is concluded that features of the new ward environment were responsible for the observed fall in the incidence of cross-infection.
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