The European journal of surgery. Supplement. : = Acta chirurgica. Supplement最新文献

{"title":"Powder contamination of extradural catheters and implications for infection risk.","authors":"M Green","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Previous papers in this supplement have addressed contamination of the peritoneal cavity by powder from the surgeon's gloves, or via airborne starch particles. This paper examines the possibility that medical devices placed inside patients may also become contaminated with powder from gloves during handling and insertion. In this way, glove powder may subsequently find its way into body cavities.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"39-40"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type I allergies to latex and the aeroallergenic problem.","authors":"A Heese,&nbsp;K P Peters,&nbsp;H U Koch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Between 1989 and 1995, a 12-fold increase in latex allergy was documented amongst our patients. Similar findings have been noted elsewhere. Increase in type I allergies to latex has become an international problem. The issues associated with latex allergy are described, including those posed by the ubiquitous nature of latex in medical equipment, and in commonplace domestic objects. The potential for allergic patients to cross react to a variety of fruits or plants is an added problem for sensitized patients. This paper concludes that the universal introduction of powder-free surgical gloves with low protein content would be a very important measure in the prevention of acquired latex allergy.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airborne particles from latex gloves in the hospital environment.","authors":"S W Newsom,&nbsp;P Shaw","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Air sampling studies are described which show high levels of airborne starch powder contamination in areas where powdered latex gloves are used. Furthermore, culture of collected samples show a clear association between starch particles and bacterial colonies in an experimental system suggesting that airborne particles could act as a vector for pathogens in the hospital environment.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"31-3"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of fibrinolysis in adhesion formation.","authors":"L Holmdahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Postsurgical abdominal adhesions and their sequelae continue to present major clinical and medicoeconomic problems. A complex network of mediators and responses affecting at least five interrelated biological systems, including the fibrinolytic system, are involved in the pathogenesis of postsurgical adhesions. The fibrinolytic system degrades fibrin through the action of the enzyme plasmin, which is stored as the inactive substrate plasminogen. Fibrinolysis, by mediating fibrin degradation, appears to play a pivotal role in adhesiogenesis. Tissue-type plasminogen activator (tPA) is the chief plasminogen activator in the blood, but its activity is restricted by plasminogen activating inhibitors type 1 (PAI-1) and type 2 (PAI-2). Inadequate peritoneal fibrinolysis may result from decreased tPA, increased PAI-1 and PAI-2, or both. The causal relationship between a reduction in fibrinolytic capacity and the formation of adhesions has been demonstrated in animals. In human studies, plasminogen activator activity (PAA) was significantly reduced in peritoneal biopsies from patients with peritonitis compared with those from normal patients. During surgery, PAA declined significantly in both normal and inflamed peritoneum. tPA was responsible for about 95% of PAA. Reduced fibrinolysis in human peritoneum associated with peritonitis and abdominal surgery correlates with increased adhesion formation and may thus be an important early biochemical event leading to adhesion formation. The regulation of plasmin-mediated fibrin degradation in the peritoneal cavity is poorly understood. However, new insights in the cellular distribution of fibrinolytic components in peritoneal tissue suggest that the mesothelium appears to have a principal role in fibrin regulation in the peritoneal cavity and in the early formation of adhesions.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 577","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20030980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost of latex device-related occupational illness, workmen's compensation and legal issues.","authors":"M Taylor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the United States, health care workers who become sensitised to latex face substantial problems. Their careers may prematurely come to an end, leaving them with a long struggle to achieve adequate compensation. This paper outlines some of those problems, and the actions necessary by employers, employees and worker disability groups to prevent future problems.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"49-51"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adhesions: pathogenesis and prevention-panel discussion and summary.","authors":"L Holmdahl,&nbsp;B Risberg,&nbsp;D E Beck,&nbsp;J W Burns,&nbsp;N Chegini,&nbsp;G S diZerega,&nbsp;H Ellis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article summarizes the discussions of the faculty and chairpersons on four major topics on postsurgical adhesions examined at the symposium, \"Adhesions: Pathogenesis and Prevention\". These topics are: 1) clinical significance; 2) pathogenesis; 3) research status and directions; and 4) recommendations for reduction or prevention. Abdominal postsurgical adhesions develop following trauma to the mesothelium, which is damaged often by surgical handling and instrument contact, foreign materials such as sutures and glove dusting powder, desiccation, and overheating. Postoperative adhesions occur after most surgical procedures and can result in serious complications, including intestinal obstruction, infertility, and pain. A long-term and unpredictable problem, postoperative adhesions impact the surgical workload and hospital resources, resulting in considerable health care expenditures. Although understanding of the pathogenesis of adhesions has improved recently, the molecular mechanisms involved continue to be delineated. Adhesions result from the normal peritoneal wound healing response and develop in the first five to seven days after injury. Adhesion formation and adhesion-free re-epithelialization are alternative pathways, both of which begin with coagulation which initiates a cascade of events resulting in the buildup of fibrin gel matrix. If not removed, the fibrin gel matrix serves as the progenitor to adhesions by forming a band or bridge when two peritoneal surfaces coated with it are apposed. The band or bridge becomes the basis for the organization of an adhesion. Protective fibrinolytic enzyme systems of the peritoneum, such as the plasmin system, can remove the fibrin gel matrix. However, surgery dramatically diminishes fibrinolytic activity. The pivotal events determining whether the pathway taken is adhesion formation or re-epithelialization are therefore the apposition of two damaged surfaces and the extent of fibrinolysis. Research in postsurgical adhesion formation and prevention abounds in a variety of avenues of investigation, including: 1) identification on a molecular level of the components involved in adhesiogenesis and their interactions; 2) clarification of the role of fibrin and fibrinolysis in adhesion formation; 3) standardization of design in preclinical and clinical studies of adhesion formation and prevention; 4) delineation of the relationship between adhesion formation and adhesive complications; and 5) elucidation of efficient, site-specific methods of prophylactic drug delivery. Currently, it seems logical to focus preventive research on development of barriers, fibrinolytic drugs, and selected agents such as phospholipids. The major strategies for adhesion prevention or reduction are adjusting surgical practice and applying adjuvants. Surgeons should adjust their major practices by: 1) becoming aware of the potential adhesive complications of a procedure; 2) minimizing the invasiveness of surgery; and 3","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 577","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20030894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapy--the facts and fantasies of prophylaxis and combined therapies.","authors":"F Scaglione","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 578","pages":"11-5"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20114452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of local antibiotic therapy.","authors":"N Rushton","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 578","pages":"27-30"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20114454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost implications of allergy and recent Canadian research findings.","authors":"M Cameron","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The cost to hospital's managing latex allergy problems, and of instituting a co-operative response to the problem is estimated, and compared with the estimated cost of ignoring the problem. The costs and benefits of the interventional strategies, i.e. complete elimination of powdered latex gloves in favour of powder free latex gloves, are described in detail. It is demonstrated that the chosen interventional strategy not only reduced overall costs, but surprisingly, also reduced glove purchase costs.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"47-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative peritoneal adhesions and foreign bodies.","authors":"J J Duron,&nbsp;N Ellian,&nbsp;O Olivier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the proven causes of adhesions is foreign microbodies which are present in up to 93% of all re-operated patients in which adhesions are analysed for evidence of external contamination. Studies are described which show the changing nature of foreign microbodies with time, associated with the development of new surgical practices. This paper concludes that although foreign bodies found today may not be the same as those found 30 years ago, they remain prominent in the aetiology of adhesions--the main cause of postoperative intestinal obstruction. Every effort should be made to minimise tissue contamination during operations with particulate debris such as glove powder.</p>","PeriodicalId":77418,"journal":{"name":"The European journal of surgery. Supplement. : = Acta chirurgica. Supplement","volume":" 579","pages":"15-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20140972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}