Gas gangrene after abdominal surgery

This is a report on nine cases of gas-gangrene which developped after abdominal surgery. In five patients the diagnosis was made at the bedside, three of these patients survived. Cardinal symptoms were rapid deterioration of the general condition, severe pain around the incision, tachycardia, and the appearance of jaundice along with a fall of the hemoglobin.     

Total knee arthroplasty and high tibial osteotomy in osteoarthritis--results of a survey in traumatic surgery and orthopedic clinics

AIM: Knee arthroplasties, both total (TKA) and unicondylar, as well as high tibial osteotomy (HTO) represent the main treatment options in severe osteoarthritis of the knee. The aim of this study was to collect detailed information regarding the current treatment strategies in Germany. METHODS: 220 departments of orthopaedic surgery and 250 departments of trauma surgery were asked about their treatment strategies in an anonymous nation-wide survey regarding the different operative procedures in HTO, TKA, revision TKA and related issues. Univariate analyses were performed and means, medians and rates were calculated. RESULTS: Questionnaire forms were answered by 54 % of the departments. The survey represents 31 138 TKA for the year 2002. In the mean 137 TKA were performed in each department. Posterior cruciate ligament retaining components were used in 67 %, resurfacing of the patella was performed in 19 % of cases. The incidence of revision TKA is about 10 % compared to the primary TKA cases. In comparison to a different survey from the year 1995, the absolute number of primary and revision TKA has increased by a factor of nearly three. Compared to the number of TKA, the proportion of HTO has declined to 12 % and the number of unicondylar knee arthroplasties represents 7 % of all cases. CONCLUSION: In the surgical treatment of severe osteoarthritis, TKA shows a highly increasing number, whereas HTO is decreasing. An increasing number of revision TKA can be observed. There is trend towards the cemented implantation technique. Patella resurfacing is not performed routinely in most German hospitals.     

3D打印技术用于创伤骨科手术的护理配合

目的探讨3D打印技术在创伤骨科个性化手术应用的配合要点。方法对6例创伤骨科的患者应用3D打印技术实行个性化手术治疗。结果 6例患者手术均成功,无一例出现与手术相关的严重并发症。结论参与术前讨论,配合预演手术过程,提前熟悉手术方式,知晓定制器械的正确使用方法,熟练配合手术医生的术中操作是其配合要点。     

Tourniquets in orthopedic surgery

Tourniquets are commonly used in limb surgeries, be it orthopedic or plastic surgeries. But the inflation pressures, the duration, and release guidelines are still not clear. According to a survey, majority of orthopedic surgeons inflate the tourniquet to fixed pressures for the upper and the lower limbs without considering the baseline blood pressure of the patient on whom the tourniquets are being applied. This review was designed to recall and review the safe use of tourniquets and the various techniques that can be employed to minimize the complications of tourniquet use. Google, science direct, and pubmed were searched for appropriate literature and relevant articles were identified.     

Thromboprophylaxis in orthopedic surgery

More than 2 million people undergo major orthopedic surgery each year, and this rate is expected to continue rising as our population ages. Our patients are at particularly high risk for deep vein thrombosis (DVT) and pulmonary embolism. The latest guidelines from the American College of Chest Physicians recommend thromboprophylaxis for high-risk orthopedic surgery patients. Although specific recommendations vary by type of surgery, low-molecular-weight heparin, fondaparinux, warfarin, and sometimes low-dose unfractionated heparin are effective alone or with mechanical prophylaxis. Goals of treatment are to prevent proximal and distal DVT, pulmonary death, chronic pulmonary hypertension, and postthrombotic syndrome.