Lister Technique for Emergency Surgery SIR,-I agree with Prof. R. J. Willan (Sept. 5, p. 291) that the revival of the Lister technique would be good for emergency operations, but I would add-for all accidents. There seems So be something wrong with the technique of aseptic surgery, judging by some articles in the Journal recently on hospital infection of operation wounds. My experience of the L...

Twenty-four cases of penetrating cardiac injuries due to stab wounds, which were seen over a 3-year period, are reviewed. Ten patients were treated by aspiration alone because tamponade was mild, or because they were seen more than 12 hours after injury. One patient with multiple stab wounds in the ventricles and left atrium died during emergency thoracotomy in the admission room. The mortality...

Retained loose bodies sometimes remain undetected in the initial evaluation of soft tissue wounds in the emergency room setting, especially if the loose body is localized deep to the skin surface or does not present as a radio-opaque density on radiography. Loose bodies retained in wounds may be associated with significant problems including inflammation, pain, and chronic infection refractory ...

OBJECTIVES Several trials have been published examining the role of antibiotics in dog bite wound management. A meta-analysis of these suggests that there is very little benefit to routine antibiotic prescription in these patients. All papers however incorporated rigorous wound care regimens involving large volume irrigation. METHODS The authors undertook a telephone survey to investigate wou...

Tetanus is an acute severe disease induced by an exotoxin, often lethal. All cases occur in untreated or inadequately vaccinated patients and mainly in elderly patients who accumulate many risk factors. The current management of wounds faced difficulties in the assessment of immunization status and wound risks status. Indeed, all injuries can potentially lead to tetanus. Minor risks and chronic...

Infections at the sites of surgery involving synthetic prostheses are challenging to treat. We present a case of a patient with multiple comorbidities who had undergone an aortobifemoral bypass 6 years previously and then re-intervention at the femoral anastomoses for restenosis 5 years previously. The patient presented with acute left inguinal pain and swelling and was diagnosed with a rupture...

I N general, traumatic wound therapy in civilians foIIows military practice. After WorId War II it was inevitabIe that the war time management of abdominal wounds should carry over into the peace time emergency rooms and operating theaters. The miIitary practice of routineIy performing earIy expIoration was based on the almost uniformly fatal outcome of non-operative treatment of patients with ...

BACKGROUND Cardiac penetration wounds have high mortality which need a rapid diagnosis and surgical intervention. METHODS Between May 1999 to May 2002, 196 thoracic penetration cases who were admitted to emergency department were examined and in 12 (6.1%) of them cardiac penetration was diagnosed. In this retrospective study, the cardiac penetration cases were evaluated. RESULTS All the cas...

Whether by accident or intention, penetrating trauma can result from a wide variety of weapons or instruments, and certain elements of therapy vary accordingly. The management of patients with penetrating trauma has changed dramatically since 1960, when Shaftan introduced the concept of selective laparotomy and serial observations. Before that time, surgery was mandatory. The careful integratio...

Emergency medical services (EMS) systems, and prehospital care are difficult to evaluate. Accordingly, the true efficacy and value of such systems are difficult to determine. The multitude of variations and combinations of involved factors makes standardisation and comparison difficult, and universal indicators are hard to develop. Various attempts have been made to determine valid indicators o...