Biomedical subjects

D H Murray

Publications and source records attributed to D H Murray.

10 recordsLinked to original sources

PubMed1990

Improved trauma care in a rural hospital after establishing a level II trauma center.

A study of motor vehicle accident deaths occurring in Napa County, California, from 1979 through 1983 showed that there was a preventable death rate of 42% for deaths that were not related to central nervous system injuries. After developing a Level II trauma center at our hospital, the preventable death rate decreased to 14%. This was statistically significant (total chi-square, 0.01 less than p less than 0.025). There was a significant increase in the average Injury Severity Score (34 versus 45, p less than 0.005) as well as significant improvements in the surgeon's response time (32 minutes versus 11 minutes, p less than 0.005) and in the time from hospital arrival to the start of surgery (3.6 hours versus 1.9 hours, 0.01 less than p less than 0.025). We conclude that these changes are indicative of improved trauma care and reflect favorably upon the effectiveness of a rural trauma center that meets Level II trauma center guidelines established by the American College of Surgeons Committee on Trauma.

Accidents, Traffic↗

PubMed1984

Peripheral arterial emboli.

One hundred eleven patients with 130 emboli treated in nonteaching private hospitals have been evaluated with respect to cause, mortality rate, and amputation rate. For surgically treated patients with balloon embolectomy, the mortality rate was 13.7 percent overall, with a limb salvage rate of 94.5 percent. The operative mortality was 8.3 percent. The mortality for late embolectomy was 3 percent with a limb salvage rate of 100 percent. The most critical factor in predicting mortality was age of the patient, with a significantly higher mortality in patients of advanced years. In this series, a prolonged duration of embolus before embolectomy did not have an adverse effect on the mortality rate.

Aged↗

PubMed1978

Use of synthetic absorbable sutures for abdominal and chest wound closure. Experience with 650 consecutive cases.

The advent of synthetic collagen suture (polyglycolic acid and polyglacin 910) has provided a new dimension in surgical suturing. However, surgeons in general have not yet taken full advantage of the potential that this new material offers. Associated evisceration and wound dehiscence rates as well as the incidence rate of wound infection were assessed since these represent standards by which the suture material can be evaluated. In an entire series of 650 cases, there has been one case of wound dehiscence with evisceration. The incidence of infection has been less than 1%, which is comparable to previous experience with interrupted, nonabsorbable sutures. The time required for closure using the new material has been approximately one third of that associated with the use of conventional interrupted closure sutures. This implies a substantial cost reduction for the patient. As a result of this experience, the synthetic absorbable sutures seem to represent the material of choice for routine abdominal or chest wound closure.

Abdominal Injuries↗

PubMed1978

Tourniquet control of liver bleeding.

Many methods have been described for control of bleeding from the liver. We have found that the technique of simply securing a 2 1/2 cm (1-in) Penrose drain as a tourniquet around the left or right lobe of the liver is a rapid and effective method of obtaining hemostasis. The tourniquet can be used to temporaily control bleeding so individual points can be secured, or tied down onto the liver and removed later. This method has been used without complications in five patients with severe liver trauma. Serial liver function studies obtained on all patients found no significant alterations in any.

Adolescent↗

PubMed1970