Biomedical subjects

W P Schecter

Publications and source records attributed to W P Schecter.

42 records · Page 3Linked to original sources

PubMed1987

Temporary colostomy for trauma. A new method to simplify colostomy closure.

A technique for construction of a functional loop colostomy is described for the management of colonic injuries in which complete fecal diversion is not required. The colostomy and mucous fistula are converted into a functional loop colostomy at the initial procedure and exteriorized through a single stoma. Subsequent colostomy closure is simplified. Intraperitoneal colostomy closure can usually be performed by mobilizing the colon at the stoma site without resorting to formal laparotomy.

Colon↗

PubMed1986

Critical care complications in the trauma patient.

Critical care therapy of the multiply injured patient results in multiple potential complications. Nosocomial infections, gastrointestinal complications, and pulmonary complications are reviewed. Complications that are anticipated can often be avoided by prophylactic therapy. Early intervention, once complications have occurred, may result in decreased morbidity and mortality.

Catheters, Indwelling↗

PubMed1985

Can general surgery improve the outcome of the head-injury victim in rural America? A review of the experience in American Samoa.

We analyzed the records of 50 head-injury patients managed by general surgeons from 1974 to 1981 in American Samoa. Patients were divided into three groups. Group 1 was awake and alert (n = 24). Group 2 was obtunded by talking (n = 7). Group 3 was comatose (n = 20). All patients were managed with diagnostic burr-hole procedures. Eighteen of the 20 unconscious patients had an intracranial hematoma. Five of the seven obtunded patients had an intracranial hematoma. Three of the nine deaths were directly attributable to a delay in diagnosis of an intracranial hematoma. We conclude that a burr-hole procedure in unconscious head-injury patients in rural hospitals is a safe and effective method of diagnosing and treating extradural and subdural hematomas. General surgery residents should receive training in operative head-injury management, to improve the care of the head-injury victim in rural America.

Adolescent↗

PubMed1982

Peripartum pseudomalignant myositis ossificans of the finger.

Two cases of pseudomalignant peripartum myositis ossificans of the finger are reported. The benign diagnosis is confirmed by the histologically characteristic zone phenomenon, consisting of a transition from an inner zone of proliferating spindle cells to a middle zone of well-oriented osteoid and finally to an outer zone of mature bone. In Case No. 1, because of the question of malignancy, a ray amputation was performed. In Case No. 2, the patient was observed during the peripartum period to show diminution in the size of the tumor. The lesion was eventually treated by local excision.

Adult↗

PubMed1981

Management of upper airway obstruction in the intensive care unit.

Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of the cricothyroidotomy. The literature of acute upper airway obstruction is reviewed and recommendations made for rapid assessment and management of these patients. The importance of rapid cricothyroidotomy through a small incision in patients unresponsive to less invasive measures is emphasized. The use of a small pediatric endotracheal tube placed through the cricothyroidotomy incision is suggested as a method to increase the speed and safety of the procedure and avoid the potential long-term complication of laryngeal stricture.

Airway Obstruction↗

PubMed1977

Transmetatarsal amputation.

We have reviewed the records of 25 patients who underwent a transmetatarsal amputation at San Francisco General Hospital. The average patient age was 63 years old. Twelve of the patients were diabetic, while transmetatarsal amputations were performed in eleven with simple arteriosclerosis. Two patients underwent amputations for either trauma or nonhealing ulcer. Thirteen of the patients healed their amputation, and twelve of these became ambulatory. Eleven required higher amputation, because of nonhealing due to infection in seven and progressive ischemia in four. One patient died on the first postoperative day of pneumonia. The failure group was younger, contained more diabetics, and had a higher incidence of infection. The operative procedure of transmetatarsal amputation is described. We believe that patients with distal gangrene without spreading infection should be considered for transmetatarsal amputation, reserving initial below-knee amputation for those with greater involvement of the foot.

Adult↗