Septicemia is a persistent problem during total parenteral nutrition (TPN). The skin around the catheter insertion site is one possible source of this infection. In previous studies we showed mechanical cleansing of the skin was more important than the ointment applied; however, alternate day dressing changes did not completely eradicate all skin organisms. The present study was designated to examine the effects of daily dressing changes on the skin flora beneath the subclavian dressing. Fifteen patients receiving TPN were studied for a minimum of 11 days each. The dressing was changed daily and the catheter site cultured immediately. The area was then scrubbed with polyvinylpovidine-iodine, an antibiotic ointment was placed on the catheter insertion site, and a new dressing applied. There were no positive skin or blood cultures in this group during a total study period of 242 patient-days. The control group consisted of 23 patients receiving identical subclavian catheter care but on an alternative rather than daily basis. In the control group there was a 3.5% incidence of positive skin cultures in 530 patient-days. Daily dressing changes eliminated all skin organisms beneath the subclavian dressing during TPN and would be useful in patients who are at high risk for septic complications.

Adolescent↗

PubMedDate not supplied

A study of the percutaneous absorption from topically applied zinc oxide ointment.

The systemic absorption from topical applications of 40% zinc oxide ointment was investigated in a series of healthy subjects (phase one) and in patients receiving total parenteral nutrition (phase two). In the first phase, six subjects completed a controlled, cross-over trial involving 3 hourly serum sample determinations for zinc concentration following a massive application of 40% zinc oxide ointment and plain petrolatum ointment. There was a mean increase in serum zinc from 107.3 +/- 5.32 to 116.1 +/- 5.02 micrograms/dL 1 hr after application of 40% zinc oxide ointment (p greater than 0.05). Three patients receiving total parenteral nutrition completed phase two of the protocol in which 40% zinc oxide ointment was applied daily to a specified area of the thigh. Analysis of these patients' serum revealed that the zinc concentrations remained relatively constant over the 10-day study period. These findings suggest that topical applications of 40% zinc oxide ointment do not result in significant absorption. This study serves as a starting point for further investigations.

Administration, Topical↗

PubMedDate not supplied

Rate of weight loss after vertical banded gastroplasty in morbid obesity: relationship to serum lipids and uric acid.

The relationship between postoperative weight loss after vertical banded gastroplasty in morbidly obese patients and preoperative serum triglycerides, cholesterol, HDL-cholesterol, uric acid and fasting plasma glucose was evaluated. The rate of weight loss, calculated as a percentage of original weight, was determined at three and six months after surgery. There was a significant correlation between rate of weight loss at three months and preoperative serum uric acid (r = -0.60, p less than 0.01). and also with the total cholesterol: HDL-cholesterol ratio (r = 0.61, P less than 0.01). At six months, the rate of weight loss correlated with preoperative serum triglycerides (r = -0.54, p less than 0.02) and total cholesterol: HDL cholesterol ratio (r = 0.44, p less than 0.05). The reasons for the predictive value of these biochemical parameters is unknown and deserves further study.

Adult↗