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At least 217 records · Page 12Linked to original sources
PubMed1981

Antimicrobial prophylaxis in surgery: Part 1.

The use of antimicrobial agents for prophylaxis in gastrointestinal, obstetric-gynecologic, cardiovascular-thoracic, orthopedic, and head-and-neck surgery is reviewed. English-language reports of studies on antimicrobial prophylaxis in surgery are reviewed. The methodology of each study was evaluated using predetermined criteria, and "evaluable" regimens are included in this review. For each type of surgical procedure, the discussion covers normal infection rates, probable bacterial contaminants, evaluable studies, and specific treatment recommendations. Regimens found to be evaluable numbered 76, with 72 of these showing a decreased infection rate with antibiotics versus placebo. Statistically significant decreases were found in 57 regimens. When properly used, antimicrobial agents have experimental justification for use in some surgical procedures. Factors that should be considered in the risk-benefit equation include: potential for and significance of surgical infection; cost, adverse effects, and ease of administration of antimicrobial agents; development of resistant microorganisms and of superinfection; and improper reliance on antimicrobial agents with resulting disregard for aseptic technique.

Anti-Bacterial Agents↗
PubMed1995

[Clinical evaluation of patients with cardiopulmonary bypass by plasma granulocyte elastase].

To evaluate the role of granulocyte elastase (GEL) at cardiopulmonary bypass (CPB), the plasma GEL level was measured in 24 patients who underwent elective cardiac surgery and 47 patients who underwent elective gastroenterological surgery. The cardiac surgical patients were divided into two groups: 5 patients with CPB less than 120 minutes (HL group), and 19 patients with CPB more than 120 minutes (HH group). The patients with gastro-enterological surgery were also divided into two groups: 15 patients with postoperative complications (GC group), and 32 patients without postoperative complications (GU group). All the patients of GU, HL and HH groups were alive. Two patients of GC group died because of multiple organ failure (MOF). The serum levels of GEL in both the HH group and the GC group remained higher than in the GU group at 6 postoperative day (POD). The high serum level of IL-8 gave rise to high serum level of GEL in the HH group, even after cardiac surgery. We assumed that anti-cytokine therapy and aggressive administration of Ulinastatin are useful against postoperative complications and that careful management is need after long CPB.

Cardiac Surgical Procedures↗
PubMed1995

General surgery considerations in the diabetic patient.

Early studies implicated diabetes as a risk factor for serious postoperative complications, but many of these conclusions have not withstood the scrutiny of analyses correcting for comorbid conditions. Asymptomatic gallstones in the diabetic patient are not an indication for preemptive surgery. Biliary tract surgery can be undertaken in the diabetic with little or no increased risk compared with the nondiabetic with similar physical status. Attempts at laparoscopic cholecystectomy, however, are more likely to require conversion to an open procedure. Whether or not rates of wound infection are increased by diabetes, when they do occur they are likely to be more severe than in the nondiabetic patient. Regardless of whether diabetes is a primary risk factor for complications following surgery or merely a marker for the existence of comorbid conditions that increase risk, the presence of diabetes in a patient requires careful assessment for and correction of conditions that occur frequently in diabetics and may contribute to surgical morbidity.

Biliary Tract Surgical Procedures↗