Biomedical subjects
Publications and source records attributed to M D Middleton.
When tripping and falling patients with rheumatoid arthritis may adopt the 'fetal tuck' position to protect their painful deformed hands. There is then a risk of splenic injury by the left elbow, which may not be immediately apparent.
Local recurrence after abdomino-perineal excision of the rectum for Dukes C carcinoma is common. The influence of postoperative radiotherapy in reducing this is currently under investigation, and one of the potential complications is radiation damage to the small bowel. This paper describes a simple and quick method of excluding the small bowel from the pelvis which, combined with more sophisticated radiation field planning, could dramatically reduce the incidence of enteric effects.
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The EEA circular stapling instrument has been used to create an end to side anastomosis in 50 consecutive routine and emergency right colonic resections. This has proved to be an effective, rapid method of creating the anastomosis with low anastomotic complication rate (4%).
Subcutaneous injection of bupivacaine around the wound was used to provide postoperative analgesia in patients who had undergone herniorrhaphy. This proved to be an effective means of providing postoperative pain relief with no unwanted general or local effects.
Two hundred and ninety major lower-limb amputations were performed on 286 patients during the period 1969-79. The early mortality rate was 6.9%. The mean age of the amputees was 70.2 (range 35-91) years. The commonest site for amputation was above the knee (77.2%). Failure to obtain immediate satisfactory healing of the stump occurred in 18.4% and reamputation was required in 5.6%. The hospital mortality rate was 25.5%. Routine prophylactic penicillin was not given. One patient developed gas gangrene.
Clinical, operative, and conventional radiological criteria may provide insufficient indications for exploration of the common bile duct. The technique of contact cholangiography improves the radiographic definition, especially in the obese, and has resulted in more positive choledochotomies and in fewer negative explorations.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.