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OBJECTIVE The authors compare open and laparoscopic appendectomy in a randomized fashion with regard to length of operation, complications, hospital stay, and recovery time. METHODS Adult patients (older than 14 years of age) with the diagnosis of acute appendicitis were randomized to either open or laparoscopic appendectomy over a 9-month period. All(More)
OBJECTIVE The purpose of this study was to evaluate the sensitivity, specificity, and predictive value of diagnostic laparoscopy (DL) in a large group of stable patients with abdominal gunshot wounds (ABGSWs). DESIGN This study was a prospective case series developed by management protocol. MATERIALS AND METHODS In a 2 1/2-year period, DL was performed(More)
BACKGROUND After trauma, up to 60 per cent of immobilized patients have been reported to develop a silent deep vein thrombosis (DVT). No large, prospective randomized trials have tested the efficacy of intermittent pneumatic compression (IPC) devices in these patients. METHODS A prospective randomized trial was performed of 442 patients who received(More)
OBJECTIVE To determine whether computed tomography (CT) is an accurate diagnostic modality for the triage of hemodynamically stable patients with gunshot wounds of the abdomen and flank. METHODS A chart review of 83 trauma patients for whom abdominal CT was used as initial screening. RESULTS In 53 patients, CT revealed no evidence of peritoneal(More)
Extremity vascular trauma is common in most urban trauma centers and controversy remains about the optimal management of arterial injuries. We examined the records of 188 patients who had lower extremity arterial trauma from September 1987 to April 1992 to help clarify these issues. There were 142 (75.5%) gunshot wounds, 18 (9.6%) stab wounds, 5 (2.7%)(More)
OBJECTIVE To evaluate the morbidity and hospital stay resultant from negative exploratory laparotomy (NL) for abdominal gunshot wounds (ABGSWs) and the potential impact the use of diagnostic laparoscopy (DL) could have on these variables. DESIGN A retrospective study was conducted. MATERIALS AND METHODS The charts of all patients with ABGSWs over a(More)
We present a series in which videothoracoscopy was used to evaluate and manage patients after thoracic trauma. We used this technique in 11 patients with thoracic injuries. We describe 5 representative cases. It was used successfully in 10 of 11 patients. Indications included evaluation of ongoing hemothorax, evacuation of clotted hemothorax and empyema,(More)
OBJECTIVE To determine the optimal method of wound closure for dirty abdominal wounds. SUMMARY BACKGROUND DATA The rate of wound infection for dirty abdominal wounds is approximately 40%, but the optimal method of wound closure remains controversial. Three randomized studies comparing delayed primary closure (DPC) with primary closure (PC) have not(More)