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Biomedical subjects

M D Dinneen

Publications and source records attributed to M D Dinneen.

8 recordsLinked to original sources
PubMed1991

Controlled trial of polyglycolic acid versus catgut and nylon for appendicectomy wound closure.

Six hundred and fifty patients undergoing appendicectomy were included in a prospective randomized controlled trial. At operation patients were allocated to control (chromic catgut ligatures and muscle closure, nylon skin closure) or study (polyglycolic acid ligatures and muscle and skin closure) groups. Wounds were examined by an independent observer daily in hospital and 1 month after operation. Wound infection was defined as discharge of serous or purulent material, or a grossly inflamed wound without discharging pus, or any evidence of intra-abdominal sepsis. Of the 650 patients (335 men, 315 women, age 5-80 years, median 18 years), 615 have completed follow-up. Groups were well matched for age, sex, degree of sepsis at operation, histological diagnosis and surgeon. Infection was significantly reduced in the study (polyglycolic acid) group (12.0 per cent) compared with the control (chromic catgut/nylon) group (21.2 per cent) (chi 2 = 9.3, P = 0.002). Infection was significantly reduced in the polyglycolic acid group regardless of whether the appendix was inflamed or normal. These results indicate that suture material can influence the incidence of wound infection and that this is less frequent when polyglycolic acid sutures are used.

Adolescent↗
PubMed1991

Pedicle patch urethroplasty.

The pedicle patch urethroplasty provides an alternative single-stage vascularised graft procedure for the repair of moderately severe hypospadias. Over a 7-year period, 38 primary hypospadias repairs were performed employing this technique. The fistula rate was 18% in the 34 patients reviewed, but there were few other significant complications. The operation is recommended when the urethral plate can be preserved and the penis straightened in boys who are unsuitable for a meatal-based flap.

Age Factors↗
PubMed1991

Hypospadias: Duckett pedicle tube urethroplasty.

The Duckett transverse tube pedicle urethroplasty was used to repair the primary hypospadias of 190 boys over an 11-year period. The fistula rate was 34.4%. The majority of boys have obtained a satisfactory cosmetic and functional result with a single operation.

Adolescent↗
PubMed1991

Treatment of colonic anastomotic strictures with 'through the scope' balloon dilators.

Stricture occurs in 1.2-4.2% of colonic anastomoses. Symptomatic strictures have previously been treated by resection and re-anastomosis and more recently by radiographically guided dilatation by a modified Seldinger technique. This paper describes the endoscopic balloon dilatation of five symptomatic cases and three asymptomatic cases. Eight patients underwent balloon dilatation of colonic anastomotic strictures. Four patients had no symptoms post dilatation and the strictures remained patient on follow-up endoscopy. All the remaining patients required re-dilatation at approximately 2 months. One of these patients underwent dilatation but remained symptomatic, the dilatation was repeated and a colonic perforation occurred at this time. Of the other three, two continue to be followed up, and are well and one patient died of disseminated malignancy. Balloon dilatation with 'through the scope' dilators is a simpler technique than radiologically guided dilatation. These early results suggest that endoscopic dilatation may avoid further surgery in some patients with anastomotic stricture.

Adult↗
PubMed1990

Urethral strictures and aortic surgery. Suprapubic rather than urethral catheters.

Urethral strictures associated with the use of a urethral catheter may be more common after cardiac and aortic surgery when compared with other surgical procedures. The reasons for this are obscure. Fifty-two aortic procedures in males from 1980-1983 were reviewed with an incidence of urethral stricture of 21%. Forty anterior resections of the rectum in which a urethral catheter was used were also reviewed with an incidence of urethral stricture of only 5%. Since 1985 supra-pubic catheters have been used now in over 200 aortic procedures with no morbidity and no urethral stricture. Bacteriuria has been significantly reduced by the use of supra-pubic catheters and there would appear to be considerable advantages in the use of this technique.

Aged↗