Top Search

• sengstaken-blakemore+tube
• surgically correctable causes of hypertension
• caput+medusae+cirrhosis
• what is a fissurotomy
• blakemore+tube
• Anorectal-pilonidal
• ileorectal anastomosis for diverticulosis
• penetrating trauma+gallbladder rupture+incidence
• Sengstaken
• conn syndrome diastolic
• Abdominoperineal resection rectal trauma
• SURGICAL ANATOMY OF ANORECTAL CANAL in neonates
• adominal tumors in children
• causes of surgically correctable hypertension
• "ed thoracotomy" for abdominal trauma
• euro-Ion in Dextrose 5% Water contraindication
• most common treatments of Lower GI Bleeding
• portal hypertension umbilical vein hvpg

Surgical Infectious Disease. Prophylaxis

PROPHYLAXIS

17. Should systemic antibiotic prophylaxis be used in elective colon resection?

Show answer
Yes, beyond any statistical shadow of a doubt. At least two dozen clinical trials have been carried out using placebo controls against a variety of antibiotics, principally those active against at least the anaerobic-predominant flora, and nearly all have shown a reduction in infectious complications in the antibiotic group. Never again should this point need repeating, and no patient should be placed at risk when systemic antibiotic prophylaxis has been established as the standard of care. No new clinical trials against placebo in this group of patients with known risk can be performed ethically given the confirmed risk reduction.
Other risk groups (e.g., cesarean section after membrane rupture) besides patients undergoing colon resection have been standardized by trials in large patient populations and have shown similar risk reduction. The benefit of prophylaxis has been demonstrated. In other groups of patients that cannot be standardized because of unusual contamination factors or unique factors of host resistance impairment, guidelines for rational prophylaxis should follow similar principles.

Properties In Evaluation Of The Acute Abdomen. Lab Stadies

LABORATORY STUDIES

15. How is a complete blood count helpful?

Show answer

1. Hematocrit. If the hematocrit is high (> 45%), the patient is most likely dry or may have chronic obstructive pulmonary disease. If it is low (< 30%), the patient probably has a more chronic disease (associated with blood loss-always do a rectal and test the stool for blood).
2. White blood cell count. It takes hours for inflammation to release cytokines and elevate the white blood cell count. A normal white blood cell count is entirely consistent with significant abdominal trouble.

InitialAssessment. Controversies

CONTROVERSIES

28. What is the role of the pneumatic antishock garment?

Show answer
The military antishock trouser (MAST) has fallen out of favor in most instances. The MAST suit is valuable for patients requiring long-distance transfer who have major bleeding from pelvic fractures. The MAST suit should be avoided in the presence of major thoracoabdominal trauma, especially if a diaphragmatic injury is suspected. The traction splints still are preferred for femur fracture transfer; they decrease bleeding and assist with pain control.