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Frequency of surgical wound infections in patients treated with a barrier procedure. Multicentric study
No full textEffectiveness of defibrotide for prophylaxis of deep venous thrombosis after general surgery : a double-blind, placebo-controlled clinical trial
No full textThe prophylactic activity of defibrotide, a new extractive antithrombotic-thrombolytic agent of mammalian origin, was assessed by detection of deep venous thrombosis (DVT) in patients who underwent general elective surgery. 120 patients (aged 25-85 years, mean 55.6) were randomly assigned to defibrotide (60 patients) or to placebo (60 patients). The two groups were homogeneous for age, sex and risk factors for DVT. The active drug was given intravenously 200 mg four times a day, starting the day before the operation and then for the following 7 days. To detect DVT, 125I-fibrinogen was used, by conventional methods. Defibrotide reduced the frequency of DVT to 4/60 (7%) from 16/60 (27%) in the placebo group. The difference was highly significant (p less than 0.01). Neither side effects nor anticoagulant activity were observed. On the basis of this evidence, defibrotide may be considered an effective and well-tolerated drug for prevention of DVT
Effects of buflomedil in a group of patients with chronic peripheral arterial diseases. Clinical and hemorheological evaluation
No full textFifty-three patients suffering from chronic arterial diseases of the lower limbs were treated with buflomedil, a vasoactive drug with vasodilating and hemorheological action on the microcirculation. The patients suffered from pain on walking or pain at rest; they were given 300 mg buflomedil orally twice a day for a period of about 2 months. The walking distance before pain onset was checked in all patients before and after the trial. Blood and plasma viscosity, haematocrit and fibrinogen and a Doppler velocimetry were also recorded. A significant improvement of the walking distance before pain onset was observed in nearly all patients, and in most patients the morphology of the velocity waves improved, too. No clear correlation between the positive clinical results and the hemorheological parameters studied could be observed
Efficacia del Defibrotide nella profilassi delle trombosi venose profonde in chirurgia generale : studio clinico controllato in doppio cieco
No full text
The surgical treatment of abdominal wall hernias in day surgery: 5 years of experience
No full textINTRODUCTION: In our department of General Surgery and Oncological Surgery, a unit of ambulatory surgery was instituted in
January 1994, with the aim of reducing the waiting list and healthcare
costs.
METHODS: From January 1994 to October 1998, we operated in day-surgery 681 patients (536 males, mean age 56.3 and 145 females, mean age 48.8): 352 had indirect inguinal, 132 direct inguinal,
41 scrotal, 75 recurrent, 38 femoral, 32 umbilical and 12 epigastric hernias. At the day of the operation, a short term antibiotic prophylaxis 30 minutes before the operation was applied. One
hundred and forty-four patients (21.6%) were submitted to epidural, 529 pts (77.7%) to local and 8 pts (1.2%) to general anesthesia. We used a modified Lichtenstein procedure which consisted
of suturing the polypropylene mesh to Cooper’s ligament in
treatment of the inguinal hernia. We put moreover a polypropylene
plug into the internal inguinal ring, when dilated more than 2 cm,
and always in recurrent hernias. A duplication of the transverse
abdominal aponeurosis was done in all direct hernias, with apposition of a patch and occasionally a plug. In femoral hernias we put a plug in femoral approach and plug mesh in the inguinal approach.
In umbilical and epigastric hernias we set the mesh beneath
the fascia. Visits at 3, 7 days, 3 months and 1 year after operation.
RESULTS: Eight patients were converted to general anesthesia, due to local anesthesia intolerance. At 58th month follow up, we report 93.9% success rate. Post-operative complications rate were 6.0%: 4 seromas, 13 wound hematomas, 15 cases of neuritic pain
and 2 orchitis, which healed after medical treatment. We observed
moreover 5 recurrent inguinal hernias (due to mesh dislocation)
and 2 homolateral femoral hernias, occurring 6 months after the
operation. It was the first year of our experience when we also used the Trabucco procedure. Since then we have always used modified Lichtenstein procedure, applying a single stitch to connect the mesh to the Cooper’s ligament.
CONCLUSION: Our results are excellent with index of satisfaction
very good (98.8%). Further this technique reduces the phycological
stress with less post-operative discomfort and allows an early return
to daily occupation
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