PubMed Health⌕ Search

Biomedical subjects

W H Brummelkamp

Publications and source records attributed to W H Brummelkamp.

At least 73 records · Page 4Linked to original sources
PubMed1982

The risk of central venous catheter-related sepsis in patients with surgical infections.

A prospective study on the incidence of central venous catheter-related sepsis (CRS) in patients with or without concomitant bacterial infections was performed. In 194 patients, 315 central venous catheters were placed, mainly for parenteral nutrition and CVP measurement. Catheter sepsis in patients with surgical sepsis was 4.0% compared with 3.6% in the non-infected group. CRS occurred exclusively in patients with an open distant infection. Subdivision of the group of patients with infection showed that those with 'open' infection had significantly more CRS than those without open wounds. The results strongly suggest an almost exclusive exogenous route for catheter contamination. It is concluded that risk of catheter sepsis is not enhanced by the presence of concomitant infections located elsewhere. The low incidence and relative benign course of catheter-related sepsis in seriously ill patients with a surgical infection tends to widen the indication for central venous catheterisation rather than to restrict it.

Catheters, Indwelling↗
PubMed1981

Clinical applications of magnetic rings in colorectal anastomosis.

Based upon experiments on animals, an anastomotic apparatus, consisting of two magnetic rings of polymer bonded, rare earth cobalt magnets embedded in polyester, was developed. There are three types of polyester device with diameters of 25, 28, and 30 millimeters, respectively. The force between the magnets varied between 2.5 Newtons at 4 centimer separation and 11.8 Newtons at union. For the low colorectal anastomosis, a magnet holder, connecting rod and spherical cap were developed. The aim of the technique is a quick restoration of the underbroken submucosal intestinal cylinder by optimal circular apposition of the submucosal layer. The working mechanism is based upon progressive compression, leading to necrosis of the intermediate mucosal and submucosal layers by increasing the magnetic force while intestinal healing takes place. After seven to 12 days, the magnets cut through the disappear from the anastomotic region by intestinal peristalsis. From the initial series of 21 patients, 11 resections of the sigmoid colon and nine low anterior resections were performed. Dehiscence of the suture line was noted in two instances. One patient required reoperation. The other patient had a small area of dehiscence at the suture line after evacuation of an infected hematoma with a further uncomplicated course. One patient died on the third postoperative day of recurrent myocardial infarction. In the other 18 patients, primary intestinal healing was demonstrated roentgenologically and sigmoidoscopically.

Aged↗
PubMed1981

The importance of the apposition of the submucosal intestinal layers for primary wound healing of intestinal anastomosis.

This study was undertaken to examine the importance of the apposition of the submucosal layers in healing of the intestinal anastomosis. On 18 mongrel dogs, weighing between 8 and 15 kilograms, four anastomoses were performed on the small intestine. Two with a conventional anastomosis and two with rings of polyester-polyethyleneterephtalate, containing small Ticonal magnets. The force between the rings with the magnets varied from 0-3 newton between, respectively, 15 millimeters and zero millimeter distance. After three to four days, the rings cut through and disappeared from the anastomosis. Morphologic and microangiographic studies, undertaken at ten days, revealed that, in instances of good submucosal apposition, direct bridging of the defect in the submucosal layer was seen with rapid restoration of the villous epithelium and an undisturbed vascular pattern in the anastomotic area. This we called primary intestinal healing. In instances of bad submucosal apposition, we saw indirect bridging of the submucosal layer defect by smaller and longer strands of newly synthesized collagen tissue in the outer intestinal layers with a collateral circulation from the submucosal plexus to the arterial plexuses in these layers. In all instances, an epithelial defect still persisted at ten days. This type of wound healing we called secondary intestinal healing. The results showed that, with the magnetic rings, a significantly better apposition of the intestinal layers was achieved.

Animals↗
PubMed1980

Penetrating thoracic trauma.

An analysis of 337 wilfully inflicted penetrating thoracic injuries is made. In 22 cases thoracotomy was performed; in 19 cases laparotomy was indicated, ten times for direct trauma and nine times for lesions caused by abdominal stabbing in addition to penetrating thoracic injuries. Eight patients died, one of whom was not operated on. A necrology is presented and it is also concluded from the recent literature that a more aggressive approach, e.g. immediate operation, is indicated for serious penetrating thoracic trauma.

Adolescent↗
PubMed1980

Roentgenological monitoring of the position of subclavian catheters introduced by the infraclavicular approach.

Roentgenological monitoring of 684 central venous catheters introduced by the infraclavicular route showed that in 11% of cases positioning was incorrect. In particular, deviation into the right internal jugular vein after catheterisation on this side occurs in 9% of the cases. Roentgenological monitoring of the position of a central venous catheter is a necessary measure and should never be omitted. In addition, other complications such as pneumothorax can be detected in this manner. Catheters without X-ray marker should no longer be used.

Catheterization↗
PubMed1978

Costochondritis of the costal arch.

Costochondritis is a rare and symptom-poor affliction which often remains unrecognized for a long time. The diagnosis depends upon the patient's history and the physician's acquaintance with the disease. Body temperature, X-ray examination including sinography, WBC count and bacterial examination may be non-informative. Local resection of the affected cartilage, excochleation, cauterisation, irrigation and antibiotic treatment most often lead only to recurrence of the ailment. The definitive treatment consists of total resection of one or both costal cartilaginous arches. The cases of two patients are described.

Aged↗