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Biomedical subjects

L Bröte

Publications and source records attributed to L Bröte.

24 records · Page 2Linked to original sources
PubMed1976

Wound infections in general surgery. Wound contamination, rates of infection and some consequences.

Rates of wound infection have been studied in a clinic performing to an equal degree both clean surgery and potentially contaminated surgery. Included in the study were 2827 patients with 213 (7.5%) postoperative wound infections. The postoperative mortality was 2.1%. Primary illness and cardiovascular complications were the main causes of postoperative death, while infectious complications (pneumonia, peritonitis and wound infection) were associated with or caused 1/3 of all postoperative deaths. Positive cultures from the wound before closure and from the wound dressings, immediately after operation, were followed by an increased risk of wound infection compared to negative cultures. Rates of wound infection were significantly higher in potentially contaminated operations compared to clean operations. Gram negative bacteria dominated in isolates from infected wounds after the former type of surgery, while S. aureus was the most common bacteria in wound infections after clean surgery. The time interval between operation and the discovery of wound infection was in the mean 10 days for staphylococci, and 9 days for Gram negative bacteria. The average time of hospitalization for patients contracting postoperative wound infections was 9 days longer than that for non-infected patients, which means that 3.4% of all nursing days were lost owing to excess hospitalization of infected patients.

Aged↗
PubMed1976

Wound infections in clean and potentially contaminated surgery. Importance of bacterial and non-bacterial factors.

Postoperative wound infections in clean--and potentially contaminated surgery were studied with regard to demonstrable wound contamination and the occurrence of non-bacterial wound infection promoting factors. The incidence of demonstrable wound contamination in clean surgery was low, and observed rates of wound infection could not be related to differences in wound contamination, but to the occurrence of non-bacterial wound infection potentiating factors, e.g. implantation of foreign materials (osteosynthesis), cicatrical tissues or a compromized host. Corresponding studies in potentially contaminated surgery revealed a significantly higher incidence of wound contamination compared to clean surgery and a significant correlation between Gram negative wound contamination and rates of postoperative wound infections in certain types of gastrointestinal surgery. Patient factors, such as age or malignancy, did not influence the wound infection frequency when the incidence of wound contamination was taken into consideration.

Adolescent↗
PubMed1976

Prophylactic cephalothin in gastrointestinal surgery.

A prospective study was carried out to evaluate the effect of a strictly standardized, short-term prophylactic treatment with cephalothin (Keflin) on the incidence of postoperative wound infections in gastrointestinal surgery. Achieved levels of cephalothin activity in serum and interstitial water were studied, and the sensitivity of isolated bacteria at the end of operation and from septic wounds was defined. Patients were divided at random into treatment and control groups. The treatment group received 2 g cephalothin at the induction of anesthesia and another 2 g, 5 and 10 hours after the primary infusion. The control group remained untreated. The rapid infusion of 2 g cephalothin resulted in high initial serum levels, which declined rapidly. Equilibration between intraand extravascular compartments occurred about 60-80 minutes after start of infusion. At that time the infused dose resulted in a cephalothin level of about 30 mug/ml in ECV and plasma, or about 30% of the initial concentration. Despite the prophylactic infusion of cephalothin, the frequency of wound infection in treated patients was the same as in the controls. Subdivision of the material according to type of surgery performed did not reveal any difference between untreated patients and controls. No shift towards cephalothin-resistant strains was observed in isolates from septic wounds in the treatment group.

Adolescent↗
PubMed1975

The function of polymorphonuclear leukocytes after surgical trauma.

The effect of surgical trauma on human polymorphonuclear leukocytes (PMN) was studied by measuring the hexosemonophosphate shunt (HMS) activity and myeloperoxidase mediated iodination during phagocytosis. Patients submitted to elective general surgery showed normal iodination capacity and normal HMS activity in their PMN cells postoperatively. This implies that postoperative infectious complications are not caused or promoted by defective PMN cell function. Iodination was found significantly (p less than 0.05) impaired in phagocytosing PMN cells from burned patients whereas it was found normal in traumatic and septic conditions. No direct relation between extent of injury and degree of leukocyte impairment was found. HMS activity remained normal in burned patients suggesting that the impaired iodination might depend on a defective mobilization of lysosomal enzymes.

Adolescent↗