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Biomedical subjects

P K Carlton

Publications and source records attributed to P K Carlton.

8 recordsLinked to original sources
PubMed2001

AFNC clarifies stance.

Explore the source record for details and available documents.

Education, Nursing, Baccalaureate↗
PubMed1979

Safe, cost-effective postoperative nutrition. Defined formula diet via needle-catheter jejunostomy.

To assess the safety and cost-effectiveness of needle-catheter jejunostomy for the purpose of feeding defined formula diet, we studied 199 consecutive patients who underwent major elective and emergency abdominal operations between July 1975 and June 1978 and in whom a needle-catheter jejunostomy was inserted. The complication rate was 2.5 per cent (1 per cent major and 1.5 per cent minor) during 7,238 patient-days of catheter exposure during which over 6 million calories were administered. There were no catheter-related deaths, bowel obstructions, bowel perforations, or intraperitoneal administration of feeding formula. The presence of a route of intestinal access and the use of defined formula diet in 111 patients who were unable to eat for over 10 days postoperatively resulted in a gross cost savings of almost $50,000 and a net savings of almost $33,000 by avoiding the necessity for central total parenteral nutrition. We belive the technique of needle-catheter jejunostomy is both safe and cost-effective in the administration of defined formula diet in the postoperative period, and we suggest that other surgeons gain experience with the technique to define its role in their own therapeutic armamentarium.

Adolescent↗
PubMed1978

Distal decompression and proximal feeding for nutritional support during bowel obstruction.

The treatment for acute mechanical intestinal obstruction is a timely operation. A select group of patients may, however, be nutritionally supported with continual administration of elemental diet proximal to long tube decompression under two sets of circumstances: 1. while awaiting spontaneous or treatment-induced resolution of the underlying process, and 2. while reversing catabolism during evaluation prior to operation. Eleven patients with chronic intermittent bowel obstruction were studied: six with obstruction involving radiated small bowel, three with an acute exacerbation of chronic inflammatory bowel disease, one with obstruction secondary to an intra-abdominal phlegmon and one with a segmental motility problem. They received nutritional support with continual gastrointestinal administration of elemental diet proximal to long tube decompression after initial observation for signs or symptoms of altered intestinal viability and stabilization of fluid and electrolyte status. Six of the 11 patients eventually required operation. All patients maintained body weight and three gained weight. Mean nutritional input was 1,873 calories and 12.6 gm nitrogen/day. There were no complications related to the technique of proximal feeding and distal decompression because of careful patient selection and appropriate administration of elemental diet under carefully controlled guidelines.

Adult↗
PubMed1978

Massive colonic diverticular hemorrhage in a transplant patient.

An infrequent colonic complication, massive diverticular hemorrhage, occurred in a high-risk renal transplant recipient. Arteriographic location of the bleeding site, colotomy and arterial ligation were used to successfully control the hemorrhage and gave a satisfactory longterm result.

Colectomy↗
PubMedDate not supplied

Closure of the pelvic and perineal wounds after removal of the rectum and anus.

Between January 1975 and July 1977, 26 patients, who underwent combined synchronous removal of the rectum and anus, were managed within guidelines aimed at achieving primary closure and healing of their operative wounds. The guidelines include preoperative mechanical and luminal antibiotic bowel preparation, perioperative systemic chemoprophylaxis, a combined synchronous ablative procedure in Lloyd-Davies position, short-term sump drainage of the presacral space, meticulous hemostatis, and primary closure of both the pelvic defect above (utilizing an omental pedicle graft to obliterate the pelvic dead space) and the perineal defect below (by primary suture or with gracilis myocutaneous flap). All wounds healed totally within the first six weeks postoperatively, with a mean time to healing of 3.5 weeks in the six patients whose wounds failed to heal primarily. There were no instances of late wound breakdown and follow-up from six months to two years.

Adult↗