No abstract

The effects of nylon sutures and metal skin clips on the tensile properties of healing skin wounds have been studied in the pig. Wounds closed with clips have significantly poorer mechanical properties at 5, 7 and 14 days after wounding than similar wounds in the same animal closed with interrupted nylon sutures. This difference increased progressively with the period of retention of the clips. It is also shown that in equivalent groups of 14-day wounds, those in which clips were retained after the seventh day had a lower tensile strength, poorer ability to absorb energy and a lower elastic modulus than similar wounds where clips had been removed early. No such adverse effect was noted with nylon sutures.

A breast FNA cytology service for palpable breast lumps was commenced in 1989 using the cytospin method. Over the following 6 years 2314 aspirates were received. The results were audited in detail in 1990, 1991/1992 and 1994. Multidisciplinary clinical audit meetings followed each audit cycle. Practice change was agreed after each audit. Each audit cycle was followed by demonstrable improvement in the complete sensitivity of the technique, being respectively 79%, 88% and 96%. The cytospin method is a viable alternative to the conventional smear method.

Ammonia absorption was studied from Thirty-Vella colon loops in 6 dogs. Four underwent an end-to-side portacaval shunt and it was shown that absorption of ammonia from the colon significantly increased postoperatively. Absorption of ammonia from various solutions was also measured before and after portacaval shunt and it was shown taht absorption was increased from a high pH solution and from a solution with a high bicarbonate content and reduced from a low pH, low osmolality and high osmolality solution. Increased deposits of stainable iron were demonstrated in the livers of dogs following portacaval shunt.

For the initial control of haemorrhage from oesophageal varices, two methods of vasopressin administration have been compared--the conventional bolus of 20 units and a low dose infusion of 0.4 units per minute. Twenty patients bleeding from oesophageal varices, confirmed by endoscopy, were allocated into either treatment group (10 in each). Vasopressin infusion stopped bleeding in 86 per cent of the episodes in contrast to 12.5 per cent (P less than 0.01) with bolus doses. Balloon tamponade with a Sengstaken-Blakemore tube was used to control bleeding in only 2 episodes in patients on infusion and in 10 episodes in patients on bolus doses of vasopressin (P less than 0.05). Our study confirms that low dose vasopressin infusion in more effective in controlling bleeding from oesophageal varices than conventional bolus doses.