A clinical and bacteriologic evaluation of cefamandole therapy in serious skin and skin structure infections.

The results of this study suggest that the enhanced in vitro spectrum of cefamandole may be clinically advantageous, particularly when complex mixtures of aerobic and aerobic-anaerobic bacteria are present in the lesions of serious skin and skin structure infections. The reported incidence of satisfactory clinical and bacteriologic responses appears to justify the use of cefamandole as a single agent for the treatment of these infections.

Cephalothin-tobramycin as a preventive antibiotic combination.

Antimicrobial therapy should never be used indiscriminately, nor can it take the place of meticulous surgical technique. Appropriate antimicrobial agents administered within the critical time period and in the recommended dosage to achieve adequate serum concentrations effectively reduce the incidence of postoperative wound and other systemic infections. The low incidence of infection and virtual absence of adverse effects strongly suggest that cephalothin-tobramycine combination therapy is a valuable adjunct in emergency surgical procedures.

Treatment of second degree burns: nitrofurazone, povidone-iodine, and silver sulfadiazine.

Nitrofurazone (N), povidone-iodine (P), and silver sulfadiazine (S) were compared in the emergency department outpatient treatment of 84 patients suffering second degree burns over less than 15% (adults) or 5% (children) of their total body surface area. Indices of healing were percent of healing, degree of dryness, crust separation, eschar separation, tissue granulation, and wound pain. Statistical analysis indicates that healing in N-treated patients was superior to that in S-treated patients: tissue granulation began sooner, crusts separated more rapidly, wounds were dryer, and the amount of healing at two weeks was greater. Results in P-treated patients were equivalent to those in N-treated when cases with complications were excluded from analysis. Among patients with less serious burns, N-treated patients suffered less pain than S-treated, but there was no significant difference in pain between N and P or between P and S. In patients with more serious second-degree burns there was more pain with P than with N, but neither P nor N differed significantly from S in this regard.

Falciform ligament. A possible twist?

Abdominal pain radiating to the right upper quadrant, producing peritoneal signs, developed in a 30-year-old pregnant woman. At surgery, she was found to have an infarction of the falciform ligament that was excised.