RESUMO
Considerable progress in conservative surgery of the spleen and kidney has been achieved in recent years by wrapping the organ in absorbable mesh. Following an experimental study, this technique has been used in 5 cases of rupture of the liver. Each injured lobe can be wrapped in an absorbable prosthetic sheet which is sutured in such a way as to form a purse applied onto the tissue, to control bleeding and bile leakage. The purse is then sutured to the falciform ligament detached from the diaphragm. Under drainage and provided the liver is watched for cavitation by scanning methods, this technique is simple and consistently effective. It avoids sutures, which are imperfect, and resections, which are fraught with dangers when performed in an emergency.
Assuntos
Fígado/lesões , Telas Cirúrgicas , Humanos , RupturaRESUMO
The risk of tetanus is universal, but it depends on numerous factors (socio-economic, environmental and biological) which combine to determine the force of infection. Tetanus is a murderous and costly disease. Its morbidity has greatly regressed in industrialized countries (less than 1 case per 100,000, involving mainly aged persons). On the contrary, developing countries are still severely affected (10 to 50 cases per 100,000, involving mainly neonates and children). Tetanus vaccine is one of the most effective, best tolerated and least expensive vaccines. Vaccination is the main weapon for starting disease control in developing countries, and the only way of eradicating tetanus in developed countries. Whatever the socio-economic level may be, some evaluations show that immunization cost is approximately equal to avoided treatment and seroprevention expenditures. The essential benefit of vaccination is the prevention of death, suffering and disability.
