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J Hahn-Pedersen

Publications and source records attributed to J Hahn-Pedersen.

7 recordsLinked to original sources

[Factors determining the development of wound infection after appendectomy].

In order to illustrate which factors are of significance for the development of wound infection after appendectomy, an extensive prospective material of 2,097 patients submitted to appendectomy was analysed. Regression analyses demonstrated that age alone, employment of preoperative antibiotics (cefoxitin) and patient delay (time from onset of symptoms till admission) were of significance. The present authors conclude, on the basis of this material, that all patients over 25 years of age should be given preoperative antibiotic prophylaxis which covers aerobic and also anaerobic microorganisms. If a gangrenous or perforated appendix is found, antibiotics should be administered intraoperatively if prophylactic treatment has not been administered. In cases of perforation, antibiotics should be administered postoperatively for 72 hours.

Adolescent

Functional closure of the femoral canal revealed by computed tomographic scanning.

The lacuna vasorum contains, as well as the external iliac vessels, a space called the femoral canal which allows pulsation and other changes in the diameter of the two vessels. The canal is closed by a connective tissue septum which is too weak to prevent a herniation alongside the vessels. The functional closure of the canal was investigated by artificial augmentation of the intraluminal pressure of the vein in five specimens and by computed tomographic (CT) scanning during a Valsalva manoeuvre in ten normal persons. In the abdomen the intraluminal and extraluminal pressures are raised in parallel, with no consequence for the diameter of the vessels. In the area of the lacuna vasorum the intravenous pressure is conveyed down to the first competent valve which is located 0.5 cm distal to the inguinal ligament, while the extraluminal pressure is reduced to normal. At each rise of the intra-abdominal pressure the vein will therefore bulge and exactly fill the empty space of the femoral canal thus preventing herniations by an on-demand mechanism. By CT scanning it was found that the vein in the femoral canal increased its diameter 2.5-3.0 times during the Valsalva manoeuvre.

Abdomen

Antibiotic prophylaxis in acute nonperforated appendicitis. The Danish Multicenter Study Group III.

In a prospective, block-randomized, multicenter study, the safety and efficacy of cefoxitin in preoperative prophylaxis were studied. 1735 patients undergoing appendectomy were evaluable, and half of these patients received 2 g of cefoxitin before undergoing operation. The patients were divided into three groups: patients with a normal appendix, patients with an acutely inflamed appendix, and patients with a gangrenous appendix. The study showed for each group a significant reduction of the incidence of wound infection in patients receiving prophylaxis. However, intra-abdominal abscess formation was not influenced by preoperative antibiotic prophylaxis. Consequently, routine preoperative prophylaxis is recommended before appendectomy.

Abdomen

Improvement in quality of life following jejunoileal bypass surgery for obesity.

Psychological and physical adaptation to jejunoileal bypass surgery for obesity was evaluated in 55 patients observed 15 months to 6 1/2 years postoperatively after a weight loss of about 50 Kg. The response to weight loss, as assessed by a comprehensive, structured questionnaire was an improvement in working capacity, interpersonal relationship, leisure time activity and adjustment to daily life. Sexual activity improved, particularly in men, and irregular menstruation normalized. Body image improved. Major postoperative psychiatric complications were not seen, which may be due to meticulous selection of the proper patients.

Adaptation, Physiological