OBJECTIVE To investigate the risk factors of infection of incisional wound in abdominal region.(METHODS) The clinical data of 224 cases of surgical infection in the First Hospital of Songyan County from 2000 to 2004 were retrospectively analyzed.There were 58 cases with incisional infection among them.RESULTS Several risk factors were found;the infection rate in age more than 55 years was 11.99%,and 10.71% in less than 14 years,14.8% after emergency operation;operation time more than 2h were 12.73%;the incisions′ length more than 12cm were 11.80%;incisions without washing by antibacterials were 15.32%.Compared to control group,the difference was significant.CONCLUSIONS Age,irrational use of antibacterials,long time operation,length of incisional wound,and operation category are all found to be the risk factors of incisional wound infection.

OBJECTIVE The head of malleus (HOM) was regarded as the landmark for the middle cranial fossa approach,and its relationship with internal auditory meatus(IAM) was measured. The purpose of this study was to find a safe method to locate IAM. METHODS Twelve heads of adult cadaver fixed with 10 % formaldehyde (23 sides) were microsurgically dissected from the middle cranial fossa approach. The foramen spinosum,Ferrein's foramen,greater petrosal nerve,lesser petrosal nerve,facial nerve,HOM,arcuate eminence,superior petrosal sinus,semicircular canal,and IAM were exposed. First,blue lines method was used to locate IAM. Second,HOM as the landmark was used to locate IAM. RESULTS The angles between the SSC and the longitude axis of IAM are 58.52??4.84?。 A perpendicular line (AB) was drew from the center of HOM to the longitude axis of the temporal bone (the longitude axis of the superior petrosal sinus),line BC was drew from the anterior 30?(28.93?? 6.07?) to the line AB. On the line BC,fundus of IAM can be located (6.69?1.10) mm medial to HOM,the center of the internal acoustic pore can be located (20.1?1.48)mm medial to HOM. CONCLUSION In the middle cranial fossa surgery,HOM can be used to locate IAM and its surroundings structures when traditional landmarks are unrecognized.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*