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Biomedical subjects

M Evans

Publications and source records attributed to M Evans.

At least 415 records · Page 23Linked to original sources
PubMed1978

The bacteriology of primary wound sepsis in potentially contaminated abdominal operations: the effect of irrigation, povidone-iodine and cephaloridine on the sepsis rate assessed in a clinical trial.

Two hundred and nine potentially contaminated abdominal operations were randomly allocated to prophylaxis with a single dose of 1 g cephaloridine intraincisionally, irrigation of the wound at the end of the operation with saline or spraying of the wound with povidone-iodine. In high risk operations (ileocolorectal or those in obese patients) the rate of major wound sepsis in those protected by cephaloridine was 3.8% compared with 13.2% in the irrigation and 16.7% in the povidone-iodine groups. In low risk operations no significant differences in sepsis rates were found. Bacteriological studies of incised organs, subcutaneous fat and pus showed that the majority of wound infections arose from endogenous sources. The outstanding problem remains that of prevention of contamination of the abdominal wall during surgery.

Abdomen↗
PubMed1978

Should you drain a perforated appendix?

One hundred and three consecutive patients undergoing appendicectomy for perforated appendicitis were randomly allocated either to have an intraperitoneal drain inserted or not. The results of this trial lend no support to the advocates of drainage.

Adolescent↗
PubMed1978

The role of antibacterial preparation of the intestine in the reduction of primary wound sepsis after operations on the colon and rectum.

A consecutive series of 320 patients undergoing operations on the colon and rectum, under the care of one surgeon, was studied to determine the influence of oral antibacterial preparation of the intestine on the incidence of postoperative wound sepsis. Thirty patients were excluded from the analysis, and the rates of major wound sepsis in the remaining 290 patients were 21.7 per cent when no antibacterial preparation was used; 18.6 per cent when the intestine was prepared with phthalylsulfathiazole and neomycin, and 1.6 per cent when the intestine was prepared with phthalysulfathiazole, neomycin and tetracycline. Other important determinants of the rate of wound sepsis were obesity and the use of cephaloridine prophylaxis. Results of bacteriologic studies showed the effectiveness of triple antimicrobial preparation of intestine against gram-negative aerobes and Bacteriodes species.

Anti-Bacterial Agents↗
PubMed1977

Wound sepsis after cholecystectomy: effect of incidental appendicectomy.

The records of a consecutive series of 224 patients were analysed to discover the effect of incidental appendicectomy on the wound sepsis rate after cholecystectomy. One hundred and five patients had had a cholecystectomy alone and 119 cholecystectomy with incidental appendicectomy. The incidence of wound sepsis in patients not given adequate antibiotic prophylaxis was significantly lower (16-1%) when cholecystectomy alone was carried out than when the appendix was removed as well (41-1%).

Adult↗
PubMed1977

Single dose intra-incisional antibiotic prophylaxis of surgical wound sepsis: a controlled trial of cephaloridine and ampicillin.

In a series of 410 consecutive potentially contaminated operations, we have compared the relative efficacy of intra-incisional cephaloridine and ampicillin in single doses of 1 g in 2 ml of water. In high risk operations (ileocolorectal surgery, perforated appendicitis, or when the patient has 2-5 cm or more of subcutaneous fat at the site of the incision) cephaloridine prophylaxis resulted in a primary sepsis rate of 14 per cent compared with 36 per cent for ampicillin. In all other patients the two antibiotics were equally effective. Secondary sepsis, following discharge from the wound of a substance other than pus, was equally common in the two groups.

Ampicillin↗
PubMed1977

Abdominal wound closure: a trial of nylon, polyglycolic acid and steel sutures.

Failures after abdominal wound closure (early dehiscences and late incisional hernias) are due to breakage of sutures, slippage of knots or tearing out of sutures from the tissues. The suture-holding capacity of the entire thickness of muscle and aponeurosis is nearly twice that of the anterior rectus sheath, and deep bites (1-0 cm from the cut edges) are nearly twice as secure as bites of 0-5 cm. In a random controlled clinical trial of 357 major laparotomies, closure with either layered monofilament nylon or mass polyglycolic acid or steel resulted in 2 burst abdomens (0-56%), 10 incisional hernias due to suture failure (3-4%) and 8 incisional hernias caused by deep sepsis (2-7%). There were no statistically significant differences among the treatment groups, but 1 patient in the nylon and 3 in the steel groups had persistent sinuses until their sutures were removed.

Abdomen↗
PubMed1977

The acute effects of ethanol on liver and brain tryptophan metabolism.

1. The effects of acute ethanol administration of liver and brain tryptophan metabolism are reviewed. 2. Ethanol enhances the activity of rat liver tryptophan pyrrolase by increasing the availability of circulating free tryptophan to the liver by catecholamine-mediated lipolysis followed by displacement of protein-bound serum tryptophan. 3. The response of the mouse liver enzyme to ethanol is strain-dependent. Ethanol activates the enzyme in CBA/CA but not in C57/BL mice. 4. Ethanol exerts a biphasic effect on the concentrations of rat brain tryptophan, 5-hydroxytryptamine and 5-hydroxyindol-3-ylacetic acid. 5. Both aspects of this biphasic effect are associated with an altered availability of circulating free tryptophan. 6. The initial enhancement by ethanol of brain tryptophan metabolism may be due to the above-mentioned lipolytic mechanism, whereas the subsequent decrease in brain indoles may be caused by the enhanced tryptophan pyrrolase activity. 7. Brain tryptophan metabolism is decreased by ethanol in CBA/CA whereas no change is observed in that in C57/BL mice. 8. These results are discussed in relation to previous work on the acute effects of ethanol on rat and mouse brain 5-hydroxytryptamine metabolism.

Animals↗