This-study evaluates the effects of the transfusion of frozen-thawed blood protected by hydroxyethyl starch (HES) on shocked monkeys. Particular attention is directed toward the study of coagulation in view of previous reports of coagulopathies caused by hydroxyethyl starch. In vivo studies were done in 13 shocked monkeys that received either homologous or autologous blood which had been frozen and thawed with 14 per cent HES as the cryoprotective agent. Multiple coagulation studies were obtained on the monkeys, and histopathological evaluations were performed. There was no evidence of increased bleeding or bleeding tendencies in the monkeys transfused with HES preserved blood. Serum chemistry values were not significantly altered in animals that received blood preserved by HES nor in those that received large quantities of HES alone. Histopathological examination of biopsy and autopsy material demonstrated no changes which could be related to hydroxyethyl starch.

Animals↗

PubMedDate not supplied

Surgical management of congenital choledochal cyst.

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

Aorto-iliac reconstruction with Dacron double velour.

Dacron double velour grafts were evaluated in an animal preparation and utilized in 318 patients undergoing elective aortic reconstruction for aneurysmal and occlusive disease. Dacron double velour forms an adherent inner lining, preclots easily, is soft, pliable and easy to handle and suture. Clinical studies revealed excellent patency with a low incidence of prosthesis related complications. No clinical evidence of overt prosthesis failure, dilation, aneurysm formation, or pseudointimal embolization occurred during an average follow-up of 2.3 years.

Actuarial Analysis↗

PubMedDate not supplied

The challenge of benchmarking: surgical volume and operative mortality in Veterans Administration Medical Centers.

BACKGROUND: This study examines the relationship between hospital surgical volume and operative modality rate. Emphasis is placed on the role of referral patterns; the effects of variation in patient condition, operative procedures, and hospital characteristics, and the contribution of volume of related procedures, in addition to specific-procedure volume, the definition of operative mortality, and their influence on surgical outcome. METHODS: This cohort study included all Department of Veterans Affairs Medical Centers with surgery programs. All patients in five operation-diagnosis sets (colectomy for cancer, colectomy without cancer, amputation above the knee, coronary artery bypass grafting for old myocardial infarction, and open-heart valvuloplasty), discharged from 1987 through 1989, were assessed to determine the risk-adjusted 30-day postoperative morality rate. RESULTS: Only one of the studied groups, valvuloplasty, demonstrated a significant inverse relationship between hospital surgical volume and operative mortality rate. No additional effect on outcome owing to related procedure volume was noted. CONCLUSIONS: This study demonstrates some of the difficulties in assessing surgical results and that we should be skeptical of the intuitively attractive notion that high annual volumes of operations will necessarily result in improved outcomes. This is congruent with recent literature in which there is no broad-based evidence that hospital surgical volume affects operative mortality rate.

Amputation, Surgical↗