Current Surgical Diagnosis and Treatment by Lawrence W. Way

By Lawrence W. Way

Collage of California, San Francisco. Lange scientific e-book sequence. new version of a Brandon/Hill clinical checklist first-purchase choice. Reference on ailments controlled through surgeons, for clinical scholars, citizens, and practitioners. 88 participants, eighty five U.S.

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The surgical infection control program should be coordinated closely with that of other services through a hospital infection committee set up to promulgate and enforce regulations. b. All significant infections must be reported immediately. A clean wound infection rate of more than 1% indicates a need for more effective control measures. The wound infection rate should be continuously monitored on the surgical services. 2. Cultures—Obtain culture and antibiotic sensitivity studies on all significant infections.

Angiogenesis, seen as the capillary budding in granulation tissue and collagen formation, is inhibited when these changes are well established, so that surgical wounds in heavily irradiated tissues will heal slowly or may break down in the presence of infection. When radiation is given prior to operation, it is generally agreed that there is an optimal delay period (2-12 weeks) after completion of the radiation therapy before operation is performed in order to minimize wound complications. Technical problems in correctly timed operations for cancer are not usually increased by low-dosage (2000- 4000 cGy) adjunctive radiotherapy.

Tourniquets are rarely required. Every victim of major blunt trauma should be suspected of having a vertebral injury capable of causing damage to the spinal cord unless rough handling is avoided. Some injuries are so life-threatening that action must be taken before even a limited physical examination is done. Penetrating wounds of the heart, large open sucking wounds of the chest, massive crush injuries with flail chest, and massive external bleeding all require emergency treatment before any further examination can be done.

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