Current perspectives on antibiotic use in the treatment of surgical infections.


:Infections that involve the attention of the surgeon include those that require operations for cure as well as those that complicate emergency and elective surgical procedures. Mechanical correction is of paramount importance in the eradication of such infections with antibiotics serving an adjuvant role, primarily to clear lymphatics and prevent bacteremia and seeding of distant sites. Review of the current hospital antibiotic susceptibility profile is important to determine likely sensitivity to expected pathogens. Infection of the urinary tract remains the most common nosocomial infection, but in surgical patients the severe infections are pneumonia, fasciitis, and peritonitis. Often caused by the gram-negative Enterobacteriaceae, empiric broad spectrum antibiotic therapy is initiated after cultures are obtained. Bacterial infection of the respiratory tract is often difficult to diagnose in severely ill patients because the underlying fever, leukocytosis, and chest X-ray changes are often nonspecific. Reliance on sputum gram stain and culture is important to guide antibiotic therapy. Empiric treatment of peritonitis requires knowledge of the normal enteric flora and the likely pathogenic organisms. The most lethal agent against obligate anaerobic organisms is atmospheric oxygen, yet antibiotic coverage against these organisms appears wise, particularly when debridement or resection will be delayed or not performed. Staphylococcus aureus is still the most commonly cultured organism from our Surgical Intensive Care Unit and Burn Unit and S. aureus is often responsible for central line and burn wound infection. For patients in septic shock, we favor administration of a broad-spectrum penicillin or cephalosporin combined with an aminoglycoside, with subsequent narrowing of the antibiotic spectrum based on culture results. Antibiotic efficacy, toxicity, efficiency, and cost all must be weighed in the decision-making process.


Am J Surg


Cheadle WG




Has Abstract


1992-10-01 00:00:00




4A Suppl










  • The rational use of computed tomography scans in the diagnosis of appendicitis.

    abstract:BACKGROUND:Recently, limited abdominal computed tomography (CT) scans have been reported (Rao, New England Journal of Medicine, 1998) to have accuracy as high as 98%. We compare our hospital's CT accuracy ordered by emergency room (ER) physicians with that of experienced surgeons provided only with the ER history and p...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Morris KT,Kavanagh M,Hansen P,Whiteford MH,Deveney K,Standage B

    更新日期:2002-05-01 00:00:00

  • Selective neck dissection and the management of the node-positive neck.

    abstract:OBJECTIVE:To assess the oncologic effectiveness of the selective neck dissection (SND) in patients with both clinically and pathologically proven regional metastases. METHODS:A 4-year retrospective medical chart review was conducted in an academic tertiary care referral center. Twenty-nine patients with a newly diagno...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Traynor SJ,Cohen JI,Gray J,Andersen PE,Everts EC

    更新日期:1996-12-01 00:00:00

  • An ideal operation for diverticulitis of the colon.

    abstract::A review has been made of the records of 208 patients operated on for complications of diverticulitis of the colon. One hundred forty patients had emergency operations and 68, elective operations. Resection and anastomosis, with or without temporary diverting colostomy, practiced in the majority of emergency cases in ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Gregg RO

    更新日期:1987-03-01 00:00:00

  • In-line radiofrequency ablation to minimize blood loss in hepatic parenchymal transection.

    abstract:BACKGROUND:Intraoperative blood loss has been shown to be an important factor correlating with morbidity and mortality in liver surgery. A 5-cm long instrument with variably deployable metal electrodes using in-line radiofrequency ablation (ILRFA) energy was used for hepatic transection in an attempt to reduce bleeding...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Haghighi KS,Wang F,King J,Daniel S,Morris DL

    更新日期:2005-07-01 00:00:00

  • Response to radiotherapy of head and neck tumors in AIDS patients.

    abstract::Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologist...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Hommel DJ,Brown ML,Kinzie JJ

    更新日期:1987-10-01 00:00:00

  • Severe glomerular sclerosis is not associated with poor outcome after kidney transplantation.

    abstract:BACKGROUND:The increased utilization of expanded criteria kidney donors has necessitated the reevaluation of multiple donor risk factors to insure the best outcome from this valuable resource. Reports of decreased graft survival in recipients of kidneys from donors with > or =20% glomerular sclerosis (GS) have led many...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Lu AD,Desai D,Myers BD,Dafoe DC,Alfrey EJ

    更新日期:2000-12-01 00:00:00

  • Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision.

    abstract:BACKGROUND:This study aims to analyze the risk factors for anastomotic leakage after low anterior resection with the technique of total mesorectal excision (TME). METHODS:From September 1993 to November 1998, 196 patients with rectal cancer from 3 to 12 cm from the anal verge were treated with low anterior resection w...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Law WI,Chu KW,Ho JW,Chan CW

    更新日期:2000-02-01 00:00:00

  • Hürthle cell metaplasia on fine-needle aspiration biopsy is not by itself an indication for thyroid surgery.

    abstract:INTRODUCTION:The aim of this study was to assess the malignancy rate in patients with Hürthle cell metaplasia (HCM) on fine-needle aspiration biopsy (FNAB). METHODS:The pathology results of patients with benign colloid (BC) and HCM on FNAB were compared using a prospective database. RESULTS:One hundred fifty-three (6...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Hudak K,Mazeh H,Sippel RS,Chen H

    更新日期:2012-03-01 00:00:00

  • Preoperative evaluation of thyroglossal duct cysts: children versus adults--is there a difference?

    abstract:BACKGROUND:Thyroglossal duct cysts (TGDCs) are common in children but also present in adults. This study evaluates the preoperative management and postoperative outcomes in patients with a resected TGDC. METHODS:A retrospective analysis was performed on patients with a surgically treated TGDC. Clinicopathologic variab...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Bhama AR,Smith RJ,Robinson RA,Weigel RJ,Sugg SL,Howe JR,Lal G

    更新日期:2014-06-01 00:00:00

  • Is thyroid frozen section too much for too little?

    abstract:BACKGROUND:The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS. METHODS:Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the exten...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Richards ML,Chisholm R,Bruder JM,Strodel WE

    更新日期:2002-12-01 00:00:00

  • Supraphysiologic extracellular pressure inhibits intestinal epithelial wound healing independently of luminal nutrient flow.

    abstract:BACKGROUND:Luminal pressure may injure the gut mucosa in obstruction, ileus, or inflammatory bowel disease. METHODS:We formed Roux-en-Y anastomoses in 19 mice, creating proximal and defunctionalized partially obstructed limbs and a distal limb to vary luminal pressure and flow. We induced mucosal ulcers by serosal ace...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Flanigan TL,Owen CR,Gayer C,Basson MD

    更新日期:2008-11-01 00:00:00

  • Back so soon? Characterizing emergency department use after trauma.

    abstract:BACKGROUND:Trauma readmissions have been well studied but little data exists regarding Emergency Department (ED) utilization following an injury. This study was performed to determine the factors associated with a return to the ED after trauma. METHODS:A retrospective review of all adult trauma patients evaluated betw...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Abou-Hanna J,Kugler NW,Rein L,Szabo A,Carver TW

    更新日期:2020-07-01 00:00:00

  • The what? How? And Who? Of video based assessment.

    abstract:BACKGROUND:Currently, there is significant variability in the development, implementation and overarching goals of video review for assessment of surgical performance. METHODS:This paper evaluates the current methods in which video review is used for evaluation of surgical performance and identifies which processes ar...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Pugh CM,Hashimoto DA,Korndorffer JR Jr

    更新日期:2021-01-01 00:00:00

  • Anal pressures in hemorrhoids and anal fissure.

    abstract::Maximal anal pressures have been measured after proctoscopy in 145 patients with hemorrhoids, 48 patients with anal fissure, and 78 asymptomatic control subjects. Anal pressures in patients with hemorrhoids (106 +/- 40 cm H2O) and anal fissure (130 +/- 43 cm H2O) were very significantly higher than those of controls (...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Arabi Y,Alexander-Williams J,Keighley MR

    更新日期:1977-11-01 00:00:00

  • Prospective study using skin staplers in head and neck surgery.

    abstract:BACKGROUND:A prospective trial was undertaken to investigate the advantages and disadvantages of stapled skin closure versus conventional nylon sutures in head and neck surgery. PATIENTS AND METHODS:The study included 20 consecutive patients who underwent extensive surgery in which their skin was closed with staples. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: dos Santos LR,Freitas CA,Hojaij FC,Araújo Filho VJ,Cernea CR,Brandão LG,Ferraz AR

    更新日期:1995-11-01 00:00:00

  • Factors affecting initial and 6 month patency rates after intraarterial thrombolysis with high dose urokinase.

    abstract::Eighty-five patients who underwent 100 transcatheter intraarterial thrombolytic infusions for occlusions of suprainguinal and infrainguinal grafts and arteries were analyzed to determine the initial and 6 month results. Analysis demonstrated that suprainguinal occlusions of arteries and grafts were most likely to both...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: McNamara TO,Bomberger RA

    更新日期:1986-12-01 00:00:00

  • Decision making on surgical palliation based on patient outcome data.

    abstract:BACKGROUND:Strategies for the effective application of palliative procedures are infrequently standardized and incompletely understood. The effect on patient outcome as determined by elements such as resolution of chief complaints, quality of life, pain control, morbidity of therapy, and resource utilization should pre...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Miner TJ,Jaques DP,Tavaf-Motamen H,Shriver CD

    更新日期:1999-02-01 00:00:00

  • Surgical significance of the histopathology of the common bile duct.

    abstract::Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Schein CJ,Mahadevia P

    更新日期:1979-06-01 00:00:00

  • Regulation of gastric acid secretion by secretin and serotonin.

    abstract::We have tested the interaction between serotonin and secretin in pentagastrin-induced gastric acid secretion in six dogs prepared with Thomas gastric and duodenal cannulas. We further examined the effect of methysergide, a serotonin antagonist, on gastric acid secretion. The intravenous administration of serotonin or ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Mate L,Sakamoto T,Greeley GH Jr,Thompson JC

    更新日期:1985-01-01 00:00:00

  • The bispectral index, a useful adjunct for the timely diagnosis of brain death in the comatose trauma patient.

    abstract:BACKGROUND:The bispectral index (BIS) is a processed electroencephalographic value (awake = 100, isoelectric = 0). The relationship of BIS and brain death (BD) is assessed. METHODS:BIS was evaluated in GCS 3 head-injured patients with BD (no brain function including apnea) or near BD (no apnea or negative ancillary te...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Dunham CM,Katradis DA,Williams MD

    更新日期:2009-12-01 00:00:00

  • Establishment of a minimally invasive program at a Veterans' Affairs Medical Center leads to improved care in colorectal cancer patients.

    abstract:BACKGROUND:Despite significant advantages to patients, less than 5% of all colorectal surgeries for cancer are performed laparoscopically. A minimally invasive colorectal cancer program was created in our Veterans' Affairs hospital with the intent of increasing access and improving quality of patient care while maintai...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Wilks JA,Balentine CJ,Berger DH,Anaya D,Awad S,Lee L,Haderxhanaj K,Albo D

    更新日期:2009-11-01 00:00:00

  • Parotid gland tumors. Clinicopathologic study.

    abstract::The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among thes...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Sinha BK,Buntine DW

    更新日期:1975-06-01 00:00:00

  • Transplantation of the adult kidney into the very small child. Technical considerations.

    abstract::Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compar...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Miller LC,Lum CT,Bock GH,Simmons RL,Najarian JS,Mauer SM

    更新日期:1983-02-01 00:00:00

  • Adrenocorticotropic hormone and cortisol response to corticotropin releasing hormone in the critically ill-a novel assessment of the hypothalamic-pituitary-adrenal axis.

    abstract:BACKGROUND:The pathophysiology of adrenal insufficiency, common in surgical intensive care units, has not been fully elucidated. METHODS:Patients at risk (age > 55 years, in the surgical intensive care unit >1 week, baseline cortisol < 20 μg/dL) were enrolled. After measuring cortisol and adrenocorticotropic hormone (...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Schuster KM,Macleod JB,Fernandez JB,Kumar M,Barquist ES

    更新日期:2012-02-01 00:00:00

  • Primary carcinoma of the gallbladder. The role of adjunctive therapy in its treatment.

    abstract::Of forty-three patients with carcinoma of the gallbladder discovered ih a twenty-five year period (during which 10,349 patients were diagnosed as having cholelithiasis), eighteen patients (42 per cent) had no obvious tumor outside of the gallbladder at the time of operation, nineteen patients (44 per cent) had local s...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Treadwell TA,Hardin WJ

    更新日期:1976-12-01 00:00:00

  • Outcome in cirrhotic patients with acute alcoholic hepatitis after emergency portacaval shunt for bleeding esophageal varices.

    abstract::Operative liver biopsy findings were reviewed in 164 consecutive, unselected patients with alcoholic cirrhosis who had bleeding from esophageal varices and underwent emergency portacaval shunt. The survival rate up to 10 years in 49 patients with acute alcoholic hepatitis and alcoholic cirrhosis was not significantly ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Bell RH Jr,Miyai K,Orloff MJ

    更新日期:1984-01-01 00:00:00

  • Pathologic interactions between prosthetic aortic grafts and the gastrointestinal tract. Clinical problems and a new experimental approach.

    abstract::Twenty-one patients presented with pathologic interactions between the gastrointestinal tract and aortic grafts. Seventeen patients were managed by excision of the graft and axillobifemoral bypass. Six patients died. four deaths were due to disruption of the proximal aortic stump after initial therapy that appeared su...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Buchbinder D,Leather R,Shah D,Karmody A

    更新日期:1980-08-01 00:00:00

  • Repeal of the Michigan helmet law: early clinical impacts.

    abstract:BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Chapman AJ,Titus R,Ferenchick H,Davis A,Rodriguez C

    更新日期:2014-03-01 00:00:00

  • Targeted therapies for the treatment of cancer.

    abstract:BACKGROUND:In contrast to conventional cytotoxic chemotherapy and radiation therapy, a new method of targeted cancer therapeutics is being directed towards molecular pathways that underlie the malignant phenotype. These therapies target specific tumor cell receptors or signaling events that are critical to tumor progre...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Kim JA

    更新日期:2003-09-01 00:00:00

  • Does three-dimensional intraoperative specimen imaging reduce the need for re-excision in breast cancer patients? A prospective cohort study.

    abstract:BACKGROUND:Standard two-dimensional (2D) specimen radiography may guide intraoperative re-excision of margins in patients undergoing breast conserving surgery. We sought to determine the impact of three-dimensional (3D) specimen imaging in further reducing positive margin rates. METHODS:A prospective study of 100 pati...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Chagpar AB,Butler M,Killelea BK,Horowitz NR,Stavris K,Lannin DR

    更新日期:2015-11-01 00:00:00