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Biomedical subjects

W Sandmann

Publications and source records attributed to W Sandmann.

At least 163 records · Page 9Linked to original sources
PubMed1976

[Septic complications in vascular surgery: a review (author's transl)].

The importance of vascular infection is determined by localization and extension, by the type of graft, by the type of bacteria and by subsequent complications. Prophylactic measures are: strict selection of patients (in obesity, diabetes), unyielding attention to hygiene and asepsis in the operating theater, use of adhesive plastic skin coverings, instrument preparation, short operation time, meticulous blood coagulation, intraoperative control of the hemodynamic result and adequate wound drainage. Antibiotics can be given preoperatively; their usefulness in the prevention of wound infection is not generally accepted. The use of a prosthesis in the perforating vascular trauma should be avoided; extra-anatomic reconstruction may be performed as the primary procedure. When the graft is removed and extra-anatomic reconstruction performed definitive healing cannot always be expected.

Anti-Bacterial Agents↗
PubMed1976

[Postoperative analgesia with continous epidural analgesia and with dolantin (author's transl)].

Hemodynamic reactions to the discontinuation of epidural analgesia and to the injection of Dolantin were studied in 16 patients. One of every three patients reacted to the postoperative pain with an increase in mean arterial pressure(+30%) and in the mean pressure in the arteria pulmonalis (+40%) associated with an increase in stroke volume (+41%) and cardiac output (+49%). The administration of Dolantin did not influence either pressure measurement. In such cases the administration of antihypertensive drugs (alpha-blocking agents) or the reinstitution of epidural analgesia is neccessary.

Analgesics↗
PubMed1976

[Study of turbulence in the normal and stenotic vessel].

Velocity measurements were performed at the test bench, in dogs and in patients with pulsed ultrasound. A new zero crossing counter was used to measure the different frequencies of the doppler spectrum in real time. The ratio of the standard deviation of the radial mean velocity to the radial mean velocity expressed as a percentage proved to be a useful turbulence index to describe stability of flow.

Animals↗
PubMed1976

[Wound infection following arterial surgery in the pelvis-leg region].

In a series of 581 reconstructions of the aorta to the leg arteries, 28 cases (4.8%) developed wound infection with positive microbiological identification. There were 24 monoinfections with significant prevalence of Staphylococcus aureus and S. epidermis. Thirteen patients with prosthetic implants and one patient with autologous saphenous vein bypass showed graft infection, which occurred in 13 patients as a complication of reoperation for bleeding or graft occlusion in the early postoperative period. The incidence of vascular infection in patients without reoperation was 0.4%. The risk of wound infection could not be lowered by the use of prophylactic broad spectrum antibiotics. Five (33%) patients with graft infection died because of sepsis and/or rupture of anastomosis. In the group of 9 survivors there were 3 patients with excision of the graft and limb preservation without reconstruction, and 3 patients with partial or total excision of the graft and successful simultaneous axillofemoral or obturator bypass. From this study it is assumed that improvement of indication and operative technique in reconstructive procedures is more promising in preventing wound infection than the extended administration of prophylactic antibiotic drugs. In case of vascular infection the excision of the graft is very urgent and consequent "extraanatomic" reconstruction can prevent loss of limb and life.

Adult↗
PubMed1976

[Ischemic necroses of the colon and rectum following alloplastic vessel substitution of the abdominal aorta].

Arterial insufficiency to the colon and rectum followed by ischemic necrosis of this bowel portion is considered to be a rare complication after resection of abdominal aortic aneurysms and alloplastic replacement of the abdominal aorta in arterial occlusive disease. The main symptom is diarrhea and mucus or blood in stool. Sigmoidoscopic examination is of diagnostic value; the treatment of choice has to be colostomy and resection. A causative factor for the development of large bowel necrosis is diminution of collateral blood supply, which is discussed in detail.

Aged↗
PubMed1976

[Lymph flow disorders following arterial surgery of the leg].

In a series of 342 arterial reconstructions of the iliacolic to popliteal arteries 24 patients with lymph vessel damage were observed. The diagnosis of lymphedema was established in 18 patients by clinical findings and in 2 of them the diagnosis was confirmed by lymphography with followup of 1 year. Three patients developed an internal lymphogenic cyst, 3 showed an external lymph fistula, and 1 patient developed an infection of a dacron bifurcation graft. The infection occurred when an additional occlusion of the left femoral artery was bypassed with an autologous saphenous vein graft and a lymph cyst in the groin, which was excised several times, became infected. The patient was treated successfully by excising the graft and performing an axillofemoral bypass. Although cases of surgical damage to lymph vessels following arterial reconstructions are rare in the literature, it is assumed that this complication occurs more often than reported, because of lack of lymphographic information.

Arterial Occlusive Diseases↗
PubMed1976

[Leiomyoma of the portal vein].

A case report of a 34-year-old female with leiomyoma of the portal vein is presented. The tumor was found accidentally, when laparatomy with diagnosis of cholelithiasis was performed. Total excision of the leiomyoma including a part of the anterior wall of the portal vein was necessary and could be carried out. The continuity of the portal vein could be preserved using continuous vascular suture. Microscopical examination of the tumor showed an increased proliferation rate in the leiomyoma; therefore the tumor was classified "semimalignant". A review of the literature concerning leiomyoma and leiomyosarcoma of the central and the peripheral veins showed 91 published cases and no other report of portal vein leiomyoma. The tumors of the vena cava inferior, which have been observed mostly, are listed in particular.

Adult↗
PubMed1975

[Surgical problems in the treatment of aneurysm of femoral artery bifurcation].

The different types and causes of aneurysm in the region of the femoral artery bifurication as well as the possibilities of surgical treatment are discussed on the basis of 4 patients, each with a differnt type of aneurysm. The examples show clearly that the basic of 4 patients, each with a different type of aneurysm. The examples show clearly that the basic disease can prevent successful surgical reconstruction of the arterial blood circulation. The use of synthetic prostheses is not possible in case of infection in this area because of the deleterious subsequences unless the entire infected area can be avoided with a bypass. (Fig. 2a). Trials with autologous veins and arteries, are , therefore, justified. The technical procedure for the use of the greater saphenous vein or deep femoral artery is described. In the authors' patients as well as those reported in the literature, it is clear than aneurysms in the region of the femoral artery bifurcation are sometimes difficult to treat. Hwerver, their localisation near the surface should allow early diagnosis and prompt treatment.

Aneurysm↗
PubMedDate not supplied

Incidence of asymptomatic extracranial arterial disease.

Investigations of the incidence and the extent of the asymptomatic early stages of extracranial arterial disease (EAD) have been restricted for methodical reasons. Direct Continuous Wave-Doppler examination has given highly accurate results in the location and correct estimation of the degree of EAD both for the carotid (97%) and the vertebral arteries (90%), as shown from a detailed comparison with carotid (n = 604) and vertebral (n = 426) angiograms. Compared with this degree of reliability, the validity of normal auscultation for the diagnosis of EAD is shown to be poor: if bruits are taken as the only signs of associated EAD in patients with systemic atherosclerosis, only 27.6% in a group of 123 patients would have been correctly diagnosed. This parallels the number of false-positives (22.6%) in patients with normal results. The frequency and degree of EAD was studied by the use of direct Doppler examination in 2009 neurologically asymptomatic patients admitted either with severe vascular (n = 375) or coronary atherosclerosis (n = 262) or with high-risk factors (n = 1370). The frequency was significantly higher (32.8%) in patients with peripheral vascular disease than in those with coronary artery disease (6.8%) and in risk-factor patients (5.9%). The combination and degree of vessel involvement are presented in detail and their possible prognostic significance discussed.

Aged↗
PubMedDate not supplied

Limits of coronary artery surgery. Clinical and postmortem findings.

In the first series of 90 continuous patients with coronary artery disease 9 patients died after aorto-coronary bypass procedures (10%). There were 7 operative deaths, and 2 postoperative deaths (respiratory failure after bronchopneumonia and bleeding duodenal ulcer; acute necrosis of the liver following hepatitis). The study of the deceased patients made evident that postoperative impairment of left ventricular function is caused by ventricular aneurysms. This fact can be shown by the poor ventricular function with an elevated left ventricular enddiastolic pressure (LVEDP) of more than 18 mm Hg. The results in patients with congestive heart failure could not be improved by multiple bypass-grafts. Probably the prolonged surgical intervention may cause additional stress to the predamaged myocardium. So, in our group the indication for using multiple grafts in cases with ventricular aneurysm is confirmed with great caution.

Autopsy↗