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Biomedical subjects

D Raahave

Publications and source records attributed to D Raahave.

At least 55 records · Page 3Linked to original sources
PubMed1980

Cimetidine for severe gastroduodenal haemorrhage: a randomized controlled trial.

During a period of 12 months, 88 patients with severe haemorrhage from gastric or duodenal ulcers or from erosive gastritis completed a double-blind trial of either cimetidine or placebo. Only patients needing immediate blood transfusion were admitted to the trial. It was found that in patients with severe bleeding from gastric or duodenal ulcers neither the severity of bleeding nor the incidence of emergency surgery was reduced by cimetidine. Furthermore, the treatment did not improve the mortality rate. It is concluded that patients with severe bleeding from gastric or duodenal ulcers will not benefit from immediate treatment with intravenous cimetidine.

Adult↗
PubMed1980

Situs inversus of the descending colon and sigmoid.

A case is described where the descending colon and the sigmoid were sited totally in the right side of the abdomen, verified radiologically and in connection with an operation for perforated tumour of the colon.

Aged↗
PubMed1976

Effect of plastic skin and wound drapes on the density of bacteria in operation wounds.

Operation wounds were sampled quantitatively by the velvet pad rinse technique to determine the effect of impervious plastic skin and wound drapes on the density of bacteria. A controlled trial (clean operations) revealed no significant difference between the bacterial density of herniotomy wounds for which the skin had been covered with adhesive plastic drapes, and the bacterial density of wounds in which skin drapes had not been used. The bacterial density in the wounds did not differ significantly from that on the adjacent skin; both densities were slightly higher at the end of operation than at the beginning. Within the operation wound, sites of low bacterial density were close to sites with a high density. Staphylococcus epidermidis predominated, while Staphylococcus aureus occurred only once; intestinal species were not isolated. In another controlled trial (potentially contaminated operations) plastic wound drapes gave an equally high reduction in bacterial density before closure of laparotomy wounds after either truncal vagotomy and pyloroplasty or gastric and colorectal operations. The reduction in the density of intestinal species was close to 100 per cent and did not differ significantly from that of alpha-haemolytic streptococci, the density of this species being significantly more reduced than that of staphylococci, diphteroids and bacilli. It is concluded that plastic skin drapes were without influence on the species and density of bacteria in operation wounds. Plastic wound drapes, on the other hand, considerably reduced not only exogenous but in particular endogenous bacteria, which otherwise would have remained in the operation wounds.

Adhesiveness↗
PubMed1976

Postoperative wound infection after implant and removal of osteosynthetic material.

Osteosynthetic material was implanted and removal in 972 consecutive operations in the upper and lower extremity. Early post-operative wound infection developed significantly more often after osteosynthesis than after removal of the implant; neither sex nor age influenced significantly the frequency of wound infection. The latter was higher when insertion or removal of material was performed in the lower extremity than in the upper extremity. The hip and ankle regions were involved most often. Staph. aureus and Staph. albus predominated among the Gram-positive infections; gram-negative infections, however, occurred remarkably frequently, E. coli being the most common organism isolated. To decimate exogenous and endogenous contamination of the wounds during operation, aseptic and antiseptic measures should be reinforced. In operation in a region proven to carry a higher post-operative infectious risk, i.e. the hip and ankle, it is suggested that antibiotics should be administered at the time of osteosynthesis.

Adolescent↗
PubMed1976

Penetration of penicillin into laparotomy wounds to reduce bacterial contamination during intestinal operations.

Serum and tissue specimens from the surgical wound were taken simultaneously during colo-rectal operations (i) at the start, (ii) when entering the peritoneal cavity, (iii) during bowel procedures and (iv) before closure of the wound. A dose of 5 megaunits penicillin intravenously after incision gave a median serum concentration of 140.0 IU/ml and a tissue concentration of 33.8 IU/mg at the time the peritoneum was incised. During operation the concentration in serum fell significantly, being 18.5 IU/ml after more than 3 h of operation, while that in wound tissue decreased to 7.2 IU/mg. After concentration was 16.0 IU/ml in serum and 1.9 IU/mg in wound tissue at the time of incision and when entering the peritoneal cavity; thereafter the concentrations decreased with operation time. The concentrations in serum exceeded markedly those in wound tissue, being linearly correlated throughout operation. Only the intravenous bolus produced concentrations of penicillin antibacterial to a variety of aerobic organisms.

Adult↗
PubMed1976

Bacterial density in laparotomy wounds during gastro-instestinal operations.

Operation wounds were sampled quantitatively for aerobic bacteria in 56 patients by the velvet pad rinse technique in a prospective, randomised study of abdominal operations (1) truncal vagotomy and pyloroplasty, (2) gastric or (3) colo-rectal operations, and (4) exploratory laparotomy. On entering the peritoneal cavity and prior to incision of the gastro-intestinal tract the bacterial density in the wounds did not differ significantly between these four types of operations, the median being 5.4X10(-1) viable counts/cm2 (range 0.7-135.8). In all series of operations the median bacterial density was increased prior to closure of the wounds, significantly so after colo-retal operations, being 21.3X10(-1) viable counts/cm2 (range 1.1-144.4), caused by a rise in density of aerobic intestinal species, especially Escherichia coli. Regardless of type of operation, all wounds were contaminated during operation by aerobic commensals of the skin and mucous membranes of the upper respiratory tract, in particular by Staphylococcus epidermidis, this species not differing significiantly in density from the beginning to the end of operation. This same study revealed that within the operation wound, sites of low or even zero bacterial density were close to sites with a high density. It is suggested that postoperative wound infection is closely related to the density of the different species of bacteria present in the operation wound at closure.

Adult↗
PubMed1975

Experimental evaluation of the velvet pad rinse technique as a microbiological sampling method.

The use of velvet pads glued to aluminium foil has been evaluated as a microbiological sampling method in quantitative bacterial recovery experiments, and the efficiency and precision have been determined. The velvet pads uptake of Staphylococcus epidermidis was 0.93 (or 93 per cent) after sampling from a test surface on blood agar, while the release by subsequent imprinting on blood agar was 0.02, the median effective transfer being 0.02. A mechanical rinse and shake procedure of the velvet pad in 0.9 per cent saline followed by centrifugation and surface plating significantly increased the median release to 0.66, the median effective transfer being 0.61. There was no difference in uptake, release and effective transfer between a pure culture of S. epidermidis and a mixed culture of S. epiderimidis and Escherichia coli. Storage of the velvet pad in 0.9 per cent saline for 2 h at room temperature did not influence bacterial recovery significantly, in contrast to a significant decrease after storage in saline for 24 h or storage in a dry Petri dish for 2 h. The high and fairly constant efficiency of bacterial recovery of the velvet pad rinse technique suggests that it could be employed clinically.

Bacteriological Techniques↗
PubMed1975

New technique for quantitative bacteriological sampling of wounds by velvet pads: clinical sampling trial.

A new surface sampling method, the velvet pad rinse technique, was compared with the velvet pad imprint method, in a randomized bacteriological sampling trial, using surgical wounds to evaluate quantitative results. The efficiency of bacterial recovery was increased 20-fold by the new technique, and the improvement was ascribed in particular to the introduction of a procedure of rinsing the velvet pad after sampling.

Bacteria↗
PubMed1975

Anaerobic and aerobic skin bacteria before and after skin-disinfection with chlorhexidine: an experimental study in volunteers.

The amount, composition, and localization of anaerobic and aerobic bacteria in the normal skin before and after disinfection were the subject of a volunteer study. The superficial bacterial flora were sampled by velvet pad imprints, and the deep flora were determined from whole skin biopsies. Only one anaerobic species, Propionebacterium acnes, was encountered even though other and more strict anaerobic bacteria could have been grown with the anaerobic technique employed. Staphylococcus albus dominated among the aerobic superficial bacteria, while diphtheroids, Micrococcus spp., and lactobacilli occurred sporadically. The deep aerobic bacteria were present in a significantly greater amount than the anaerobic. A two-step cleansing/disinfection procedure was evaluated in vivo in volunteers as well as in surgical patients, and aqueous cetrimide/chlorhexidine (Savlon) followed by chlorhexidine in alcohol (Hibitane) almost eradicated both the superficial and deep anaerobic and aerobic skin flora.

Adolescent↗
PubMed1975

Penicillin concentrations in abdominal operation wounds after intravenous administration.

The concentration of benzylpenicillin has been studied in serum and in homogenates of the subcutaneous tissue from abdominal operation wounds in 13 patients who underwent surgery of the colon and/or rectum. An intravenous bolus of 5 megaunits benzylpenicillin gave rise to a serum median concentration of 128.0 i.u./ml and a corresponding tissue median concentration of 29.6 i.u./ml in the operation wound. The serum concentration never fell below the tissue level in sequential periods, and a significant correlation between the concentrations in serum and tissue supports a hypothesis of penetration of penicillin into the wound tissue by diffusion. The results indicate that administration of benzylpenicillin initiated at the time of colo-rectal surgery ensures concentrations in the operation wound inhibitory to a variety of contaminating bacteria, thus being an adjunct to the tissue defences in combating the development of postoperative wound infection.

Adult↗