Low-dose heparin: an aid to therapy.
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Biomedical subjects
Publications and source records attributed to T H Covey.
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Three hundred thirty-nine of 400 chronic cutaneous ulcers in 264 patients (including some with multiple or bilateral ulcers of both) were healed with silver-zinc-allantoinate creamed (AZAC 1%). Some of the patients treated had failed to respond to medicated wrappings, saline dressings, and various other therapeutic agents, including antibiotics. In one week of treatment with AZAC 1%, bacterial counts were reduced on the average from approximately 2 X 10(7) to 2 X 10(5) (99%). Silver-zinc-allantoinate cream also demonstrated a wide spectrum of antimicrobial activity. It did not give rise to resistance by the infecting organisms, was nonallergenic, debrided necrotic tissue, and stimulated healthy granulation. Treatment was well tolerated, side effects being limited to a burning sensation in three patients. Most patients cared for themselves at home with minimal interference in their usual daily activities.
We describe our experimental studies of a powder formulated to treat serious burn wounds on-the-scene. The wound powder comprises two parts silver-citro-allantoinate, two parts zinc allantoinate and 96 parts pure allantoin. The back skin of 62 rats was shaved and exposed to actively boiling water for ten seconds, resulting in third degree burns of 20% of the total body surface. Immediately, 1 ml of a culture containing 2 X 10(8) Pseudomonas aeruginosa was applied to the burn. The animals were isolated. Of the 30 control rats, six were powdered with allantoin only. Thirty-two rats were dusted with the silver-zinc-allantoin powder within 15 minutes of burning. Cultures were taken at 48 hour intervals. Eighty-seven percent of the control animals died an average of six days postburn. In the treated animals, the mortality was 15%. A mean of 27% of the applied silver (0.35 gm) became incorporated in the eschar. In all control rats, sepsis was detected under the eschar. In treated animals, bacterial concentration fell from an initial average of 5 X 10(4) at 4 hours postburn to 6 X 10(2) at 96 hours.
One hundred five patients over age 40 undergoing various major operations were randomly divided into control and treated groups; all were treated by subcutaneous injection containing either 5,000 international units aqueous heparin sodium or a placebo one hour prior to operation and every 12 hours thereafter for eight days. Deep vein thrombosis (DVT) was detected by daily -125I-fibrinogen injection and leg scanning, and confirmed by ascending phlebography. Both groups were comparably distributed by age, sex, variety of operation, incidence of previous thromboembolism, and myocardial and cerebrovascular disease. Blood loss was not increased in the treated group. Incidence of DVT was 8.6 percent for the total group, 7.5 percent in the heparin-tested group (four of 53), and 9.6 percent in the control group (five of 52), including one control patient with a normal scan (who later had a pulmonary embolus.
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