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Biomedical subjects

K G Harding

Publications and source records attributed to K G Harding.

17 recordsLinked to original sources
PubMed1991

Leg ulcers.

Explore the source record for details and available documents.

Humans↗
PubMed1990

Continuing education for general practice and the role of the pharmaceutical industry.

A survey of the involvement in and attitudes towards continuing medical education of 101 general practitioners achieved a 95% response rate. Ninety per cent of the 96 doctors worked in practices which held meetings the content of which was organized by representatives of pharmaceutical companies but only 46% worked in practices which organized their own educational meetings. Seventy six per cent attended meetings away from their practice which were organized by drug companies and 75% had attended at some time continuing medical education activities organized by a local postgraduate centre. The promotional aspects of the drug company organized meetings were disliked by a majority of respondents (58%); more of the trainers (62%) and more of those who had entered general practice within the last seven years (71%) disliked this aspect. Nonetheless the educational content of both meetings held in the practice and those held elsewhere was the aspect most liked by over half of the respondents (59% and 53% respectively). Only 16% of all respondents thought that visits by representatives from pharmaceutical companies were educationally valuable and 37% thought that educational events organized by these companies were of value. Surprisingly 60% of those who worked in practices which held meetings organized by drug company representatives thought them to be of little or no educational value. There is clearly a need for practice based continuing medical education but the current level of dependence on drug companies for organizing these meetings must be questioned. Alternative strategies for the provision of independent non-sponsored educational activities should be sought.

Drug Industry↗
PubMed1990

Using modern dressings to effect debridement.

Before sloughy or necrotic wounds can begin to heal, they must be debrided. Some of the modern wound dressings are not only extremely effective in this, but they do not damage surrounding tissue.

Bandages, Hydrocolloid↗
PubMed1989

General practitioners' continuing medical education within and outside their practice.

To study continuing medical education 96 out of 101 general practitioners chosen at random from the list held by a family practitioner committee were interviewed. The results provided little evidence of regular attendance at local postgraduate centre meetings, though practice based educational meetings were common. Thirty one of the general practitioners worked in practices that held one or more practice based educational meetings each month at which the doctors provided the main educational content. Performance review was undertaken in the practices of 51 of the general practitioners, and 80 of the doctors recognised its value. The general practitioners considered that the most valuable educational activities occurred within the practice, the most valued being contact with partners. They asked for increased contact with hospital doctors. The development of general practitioners' continuing medical education should be based on the content of the individual general practitioner's day to day work and entail contact with his or her professional colleagues.

Clinical Competence↗
PubMed1987

Staphylococcal infection of open granulating wounds.

The significance of staphylococcal infection has been studied prospectively in 250 wounds healing by open granulation. In a series of 50 axillary skin excisions, 17 became infected with Staphylococcus aureus with consequent pain and delay in healing. The infections responded well to Fucidin ointment. Nasal carriers of the organism may be especially liable to this complication. In contrast, although S. aureus was not infrequently found in deep granulating wounds, there was no clear evidence of harm resulting in the 50 laparotomy wounds and 150 pilonidal sinus excisions studied. The susceptibility of superficial wounds to the infection is ascribed to friction from dressings. Deep granulating wounds are occasionally affected similarly when the cavity has filled.

Axilla↗
PubMed1985

Pilonidal sinus excision--healing by open granulation.

A prospective study is reported of 100 pilonidal sinus excisions healing by open granulation. Delays in healing appeared to be due to infection, particularly by anaerobic bacteria. Comparisons are made between three groups studied consecutively - 30 wounds not treated with antibiotics, 20 given a fixed two-week course of metronidazole and 50 managed flexibly. In this last group, wound management was determined by clinical appearance; 24 wounds were clinically healthy throughout and received no antibiotic while 26 looked unhealthy initially or after an interval and were treated with metronidazole, supplemented in some cases with erythromycin. The best results were obtained in the group managed flexibly. It is considered that the problems of delayed healing are due to excisions which leave a wound of a shape ill-designed to maintain good drainage. Unhealthy wounds should be re-shaped if possible and treated early with a combination of metronidazole and erythromycin.

Bacteria, Anaerobic↗
PubMed1985

The disinfection of silicone-foam dressings.

The efficiency of four commonly used antiseptics, chlorhexidine, povidone-iodine, cetrimide and sodium hypochlorite was compared in the disinfection of silicone-foam dressing used in the management of open granulating wounds. An in vitro model was first used to determine the minimum effective concentration of each antiseptic in killing a standard culture of Pseudomonas. The appropriate concentrations were then compared in comparative studies of clinical wounds. Chlorhexidine proved to be the most effective antiseptic, povidone-iodine and cetrimide were moderately successful, but sodium hypochlorite gave poor results. A subsidiary study looked at the problem of wound irritation by carry-over of the antiseptic. A rinse of the dressing after disinfection prevented irritation by chlorhexidine without compromising its antibacterial effect, but this procedure sometimes failed to prevent irritation when using the other antiseptic agents. It is concluded that chlorhexidine is the preferred cleansing agent in the management of silicone-foam dressings on both grounds of bacteriological efficiency and lack of wound irritation. It should be noted that Hibitane concentrate used in this work contains non-ionic detergent and a stabilizing agent. Pure preparations of chlorhexidine may not behave similarly.

Anti-Infective Agents, Local↗
PubMed1983

A comparison of skin grafting and healing by granulation, following axillary excision for hidradenitis suppurativa.

The treatment of established hidradenitis suppurativa demands complete excision of the apocrine glands in the affected area. Ten patients undergoing bilateral excision of the axillary skin, had one axilla grafted and the other allowed to heal by granulation utilising Silastic foam dressing, in order to compare the two methods. Split skin grafting resulted in more rapid healing of the excised area than healing by secondary intention. However, Silastic foam dressing resulted in certain healing with a good cosmetic result and avoided the need for immobilisation and a painful donor site. Most patients in this series preferred Silastic foam dressing to skin grafting.

Axilla↗