Efficacy of an antibiotic mouthwash in contaminated head and neck surgery

Article Abstract:

Bacterial infections commonly develop and often delay the healing process after surgical treatment of head and neck cancers. This type of surgery requires entry through the upper aerodigestive tract (mouth) which is unsterile and provides a direct route for bacterial contamination, hence the term contaminated head and neck surgery. Bacterial infections have been reduced or eliminated in other clinical settings by use of either topical or oral antibiotics. Therefore, a study was designed to determine the effectiveness of an antibiotic mouthwash on bacteria count and the incidence of infection after head and neck surgery. Twelve patients with advanced or recurrent disease were entered into the double-blind study; seven used the antibiotic mouthwash whereas five used a placebo (not medically active) mouthwash. In either case, the mouthwash was used four times during the 12-hour period before surgery. Bacterial cultures were taken before the first and after the last washes for comparison. The bacterial count decreased greatly after use of the antibiotic mouthwash, but actually increased significantly after use of the placebo mouthwash. Additionally, none of the seven patients who used antibiotic mouthwash had wound complications after surgery, but two of the five patients who received placebo mouthwash experienced complications (pneumonia in one and tissue necrosis, or deterioration, in the other). Although the sample size was small in this study, it appears that treatment with antibiotic mouthwash before head and neck surgery reduces the risk of bacterial contamination and subsequent infection. After further testing, this may become an accepted method in the effective management of head and neck surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Innovations, Antibiotics, Prevention, Surgical wound infections, Preoperative care, Mouthwashes, Head and neck cancer

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Surgical needle sharpness

Article Abstract:

The authors evaluated the sharpness of surgical needles using a model of the skin (laminated synthetic membrane) and examined the needles by a method of surface electron microscopy (using a scanning electron microscope). The products of several manufacturers are reviewed and are reported in order of sharpness: Ethicon (the sharpest), Davis & Geck and then Deknatel. Measurements of various physical properties including tensile strength were also made. The superior sharpness of the Ethicon surgical needles could be explained by their use of a particular and superior stainless steel alloy which also allowed the manufacture of longer, narrower points.

Equipment and supplies, Suturing

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Hepatic resection technique

Article Abstract:

A surgeon reported how he used a laser and ultrasonic scalpel to remove both anatomic segments of the liver and also other areas of the liver which did not conform to anatomic borders. The author shows that the technique is both safe and accurate.

Methods, Liver, Lasers in surgery, Laser surgery

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