Do plastic adhesive drapes prevent post caesarean wound infection?

We conducted a prospective randomized controlled double-blind trial at a regional referral centre for the Eastern Cape area, (Livingstone Hospital) to determine whether the use of plastic adhesive drapes intraoperatively would prevent Post Caesarean Section Wound Infection. A total of 620 patients undergoing Caesarean section (CS) were enrolled for randomization in the trial. Fifteen patients were excluded, while 305 received drapes (test group) and 300 did not (control group). Two patients in the control group were subsequently excluded. The primary outcome measure was the presence of Post Caesarean Wound Infection. A secondary outcome measure was the number of days in hospital post operation. The study and control groups were comparable at entry. Results show that 34 patients in the test group (N= 305) developed wound sepsis (11.1%) compared with 30 in the control group (N= 298) (10.1%) (difference not significant; Fisher's exact test 0.6933). Average days spent in hospital postoperatively were similar for both test (infected cases: mean 10.56 SD 3.84; non-infected cases: mean 5.21 SD 1.3) and control groups (infected cases: mean 10.18 SD 3.81; non-infected cases: mean 5.2 SD 0.93) (NS). We concluded that the use of plastic adhesive skin drapes did not avert PCWS or decrease the length of post operative stay in hospital for septic cases.

The natural history of carcinoma of the cervix in young women.

Invasive carcinoma of the cervix was treated in 1,522 patients over a 10-year period at Groote Schuur Hospital. Data for each patient included place of residence, pathological characteristics of the tumour, nodal spread, histological evidence of human papillomavirus (HPV) infection, disease stage, treatment type, treatment complications, site of recurrence and survival time. Patients aged under 35 years comprised 11.6% of the total patient group. A retrospective cohort study compared women aged under 35 years of age at the time of entry into the study and women aged 35 years or more. In all, 82 eligible young patients were compared with random sample of 82 eligible older patients. Contingency tables, life tables and proportional hazards analysis were used where appropriate. There was no significant difference across the two age groups in the incidence of non-squamous tumours, or in the grades of squamous tumours. Similarly there was no evidence of differences in lymph node involvement or HPV infection. Young patients appeared to enter the study at significantly earlier stages of the disease, and a greater proportion of them underwent surgical treatment (diff = 36.4% +/- 13.5%). In both groups treatment complications were less frequently observed after surgery than after radiotherapy. Sites of tumour recurrence were similar in both groups, and there was no apparent difference in survival times.

Infraumbilical-ring capillary abdominocentesis in late presentation ectopic pregnancy: a prospective study.

Infraumbilical-ring capillary abdominocentesis was compared with culdocentesis in 75 cases of suspected ruptured ectopic pregnancy, with patients serving as their own controls. There were 43 proven ectopic cases and the diagnosis was known in the remaining 32. The accuracy of results was equivalent: P greater than 0.15 for false positives and P greater than 0.63 for false negatives. For combined testing the positive predictive value reached 97%. The new method was easier to perform and should be preferred.

Prevalence of Chlamydia trachomatis IgG and IgA antibody in gynaecology inpatients as determined by serum indirect immunoperoxidase assay.

Chlamydia trachomatis is common; at times the organism acts as a pathogen and can cause significant disease. Specific detection has always been difficult in a clinical setting and a variety of new tests have been developed for this purpose. The local prevalence of the infection is not well known nor are its significant associations. The serum of 98 patients in a gynaecology ward was assayed using an immuno-enzyme technique (indirect immunoperoxidase assay). Infection was detected in 59% of patients overall, compared with 87.5% of patients with pelvic inflammatory disease and 39.1% of pregnant patients. The statistical associations are discussed.