Richard F. Edlich

Studies in management of the contaminated wound: I. Technique of closure of such wounds together with a note on a reproducible experimental model

Abstract A readily reproducible experimental wound infection model has been developed to assess the determinants of infection in primarily closed contaminated wounds. The needle puncture tract, the suture material, the diameter and quantity of suture remaining within the wound, and the tightness with which each suture is tied have been identified as factors which enhance the inflammatory response of the contaminated wound to infection. The increased likelihood of infection attending primary closure of contaminated wounds with percutaneous sutures gives strong support to the thesis that percutaneous sutures should be avoided in the closure of contaminated wounds.

Gastric blood flow

Summary The role of gastric distention in regulating blood flow and its distribution within the gastric microcirculation was determined by the radiorubidium clearance technic. Gastric distention produces a profound and selective reduction in blood flow to the mucosa and submucosa of the corpus without altering blood flow to the adjacent muscularis. It is suggested that these changes in gastric blood flow result from lengthening and narrowing of the submucosal vessels of the distended corpus.

Tumor blood flow. II. Distribution of blood flow in experimental tumors.

From the Department of Surgery, University of Texas Medical School at San Antonio, Texas, and the Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota. This work was supported in part by a research grant (T-156) from the American Cancer Society. The present blood-borne cancerocidal drugs and tumor antisera depend on contact of the agent with tumor cells. Therefore, knowledge of the circulation to solid cancer tissue is of fundamental interest.

A gastric lavage assembly for rapid evacuation of the stomach

A gastric lavage assembly has been developed for rapid evacuation of blood clots or pills from the stomach. The design specifications allow irrigation of the stomach to be accomplished with maximal evacuation efficiency. Using the gastric lavage assembly, particulate matter has been evacuated rapidly from the stomachs of 50 patients.

Radioactive microspheres. Effect of their physical properties on vascular distribution.

Summary The distribution of ceramic, glass, and carbonized microspheres within the gastric micorcirculation has been compared following simultaneous left ventricular injection. No significant differences between the extraction of the 3 types of microspheres by the vessels of the stomach were apparent. This similar distribution of the different microspheres within the stomach suggests that physical properties of the microspheres do not affect their distribution.

Gastric blood flow. II. Its distribution during systemic hypothermia.

Summary The role of systemic hypothermia in altering blood flow and its distribution within the gastric microcirculation was determined by the radiorubidium clearance technic, Systemic hypothermia produced a selective reduction in blood flow to all tissue layers of the corpus. The perfusion rate of the antrum in the hypothermic animals remained unchanged from the control level. The difference between the response of the corpus and antrum to systemic cooling may reflect disparities in the vascular patterns of these two regions.

Effect of epinephrine on coronary collateral blood flow following coronary artery occlusion.

From the Department of Surgery, University of Minnesota Hospitals, Minneapolis, Minnesota 55455. The purpose of this study was to test the value of epinephrine in augmenting coronary collateral blood flow to ischemic myocardium in order to avoid the serious consequences of myocardial infarction. The problem is a composite one involving the quantitation of the hemodynamic changes which occur as a result of coronary occlusion and the measurement of the vascular actions that the

Blood flow to a canine sarcoma during regional perfusion

An experimental tumor perfusion system has been developed to assess the changes in blood flow to a tumor-implanted hind limb during regional perfusion. Using the Rb86 clearance technique, blood flow to a Katsumis sarcoma and adjacent skin and muscle in intact hind limbs and tourniquet-ligated hind limbs perfused by the intact femoral artery or by an extracorporeal pump oxygenator system was determined. In the intact limb or tourniquet-ligated hind limb perfused by the femoral artery the blood flow to the tumor was uniform in its distribution and significantly greater than the flow to adjacent tissue. Following regional perfusion by an extracorporeal pump oxygenator system, the blood flow to the tumor was markedly reduced, nonuniform in its distribution, and not significantly greater than the flow to the adjacent tissue. This alteration in normal tumor: tissue perfusion ratio during regional perfusion is suggested as an explanation for the disappointing clinical response of spontaneous and transplantable tumors to cytotoxic drugs administered by regional perfusion.

Gastric secretion and iron deficiency anaemia

SummaryThe effects of iron deficiency anaemia on the gastric secretion of the rat are observed. No significant alteration in secretion in the presence of anaemia was found. It is thought from these findings that anaemia is the result rather than the cause of gastric hyposecretion.