Abstract：
BACKGROUND:Fournier's gangrene is a fulminant and destructive inflammation of the scrotum, penis, and perineum. The objective of this study was to compare 2 different approaches to wound management after aggressive surgical debridement. METHODS:Data from 35 patients with Fournier's gangrene were prospectively collected (1996-2007). Once the patients were stabilized following surgery, they were treated with either daily antiseptic (polyhexanide) dressings (group I, n = 16) or vacuum-assisted closure (VAC) therapy (group II, n = 19). RESULTS:The mean age of the patients was 58.2 years in group I and 57.2 years in group II. In both groups, the most common predisposing conditions were diabetes mellitus, chronic alcoholism, and obesity. Escherichia coli, streptococcal species, Pseudomonas aeruginosa, and Staphylococcus aureus were the most frequently isolated organisms. Length of hospital stay was 27.8 days +/- 27.6 days (mortality: 37.5%) in group I and 96.8 days +/- 77.2 days (mortality: 5.3%) in group II. Enterostomies were performed in 43.8% of group I patients and in 89.5% of group II patients. CONCLUSIONS:VAC was associated with significantly longer hospitalization and lower mortality. A partial explanation is that some patients with severe sepsis died within the first 3 days after admission and thus could not undergo vacuum therapy. Since our clinical experience has shown that vacuum dressings are particularly effective in the management of large wounds, we use VAC primarily for this indication despite the considerable material requirements involved.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Czymek R,Schmidt A,Eckmann C,Bouchard R,Wulff B,Laubert T,Limmer S,Bruch HP,Kujath Pdoi
10.1016/j.amjsurg.2008.07.053subject
Has Abstractpub_date
2009-02-01 00:00:00pages
168-76issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(08)00752-6journal_volume
197pub_type
杂志文章abstract：BACKGROUND:Capsule endoscopy (CE) is a new device that enables visualization of areas of the small bowel that were previously inaccessible through other noninvasive procedures. The purpose of this study is to evaluate this new diagnostic tool and its efficacy in finding occult GI tract pathology. METHODS:A single-inst...
journal_title：American journal of surgery
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doi：10.1016/j.amjsurg.2005.08.015
更新日期：2005-12-01 00:00:00
abstract：:We describe our experience with a supraumbilical skin-fold incision for pyloromyotomy in infants. Our technique uses a vertical fascial incision. This approach provides excellent exposure to the pylorus, allows greater operative flexibility, and results in a superior cosmetic outcome compared to the traditional right ...
journal_title：American journal of surgery
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abstract：BACKGROUND:Our objective was to compare the outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB) in morbidly obese (body mass index [BMI] <50) patients with super morbidly obese (BMI >50) patients. METHODS:A prospective analysis of 120 patients who underwent laparoscopic RYGB at a community based teaching hospi...
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abstract：BACKGROUND:Many trauma surgeons and trauma centers use routine exploration of Gerota's fascia (GE) for renal gunshot wounds (RGSW). The purpose of this study was to assess whether RGSW can be selectively explored for patients who undergo exploratory laparotomy. METHODS:Retrospective 10-year review of all patients who ...
journal_title：American journal of surgery
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abstract：:A combination of heparin and dihydroergotamine mesylate (Heparin-Dihydergot) has been shown to be more effective than either of these drugs alone in preventing postoperative venous thromboembolism. The possible mechanism for the synergistic effect of heparin and dihydroergotamine was assessed. Phlebograms obtained aft...
journal_title：American journal of surgery
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abstract：BACKGROUND:Primary laparoscopic repair of unilateral inguinal hernias has not achieved widespread recognition mainly because of concerns over safety. METHODS:Prospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program between 2005 and 2010. Complications in patients und...
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doi：10.1016/j.amjsurg.2013.10.017
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journal_title：American journal of surgery
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doi：10.1016/s0002-9610(05)80368-x
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journal_title：American journal of surgery
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journal_title：American journal of surgery
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abstract：BACKGROUND:We previously reported that a particular type of visual-spatial ability, mental rotation of visual forms, correlates with surgical performance in residents. In the current study, we used functional magnetic resonance imaging (fMRI) to identify patterns of cortical activation associated with mental rotation a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.11.011
更新日期：2007-04-01 00:00:00
abstract：:This review of the literature has revealed that isotonic fluids, such as 0.9 percent sodium chloride and Ringer's lactate, are effective plasma volume expanders. Despite the continued use of a variety of colloid solutions in resuscitation, there is no good evidence to document a benefit of these solutions over the cry...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(88)80106-5
更新日期：1988-03-01 00:00:00
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journal_title：American journal of surgery
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更新日期：1981-03-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2020.08.027
更新日期：2020-08-26 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90262-7
更新日期：1980-02-01 00:00:00
abstract：BACKGROUND:Although several methods of repair of extremity venous injuries have been shown to be efficacious, patency rates have varied significantly from center to center. METHODS:A retrospective review was made of treatment outcomes of adult and pediatric patients with major venous injuries of the lower extremity. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.006
更新日期：2003-12-01 00:00:00
abstract：:The type of endorectal pull-through described by Black was evaluated as an alternative method of anastomosis in 11 anterior resections in which anastomosis from above was impossible. The method is attractive from the standpoint of function because it preserves the distal rectum and leaves the anus intact. Technical po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90249-6
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abstract：BACKGROUND:Predictors of weight loss (WL) or weight regain (WR) after Roux-en-Y gastric bypass (RYGBP) are not established. The aim of this study was to analyze the usefulness of some baseline peptides (leptin, insulin, and ghrelin) as biomarkers of WL and WR in morbid obese patients after RYGBP at long term. METHODS:...
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journal_title：American journal of surgery
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journal_title：American journal of surgery
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journal_title：American journal of surgery
pub_type： 杂志文章,评审
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更新日期：2003-02-01 00:00:00
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journal_title：American journal of surgery
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.035
更新日期：2010-05-01 00:00:00
abstract：:Quercetin exhibits antitumor activity. We investigated the effect of quercetin on the in vitro and in vivo growth of two squamous cell carcinoma cell lines and a normal human lung fibroblast-like cell line. The in vivo effect was evaluated using implantable cell growth chambers implanted subcutaneously in immunocompet...
journal_title：American journal of surgery
pub_type： 杂志文章
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