J R Jamieson

University of Louisville

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The ‘sandwich technique’ in the management of the open abdomen

British journal of surgery (1986)

M Schein R Saadia J R Jamieson G Decker

Abstract A management technique of the open abdominal wound is described. It consists of a ‘sandwich’ composed of a Marlex mesh and an Op-Site wound dressing with interposition of suction tubes. Such a technique prevents evisceration, protects the skin, decreases evaporation, allows accurate fluid replacement, facilitates nursing and adds to the patient's comfort.

Evisceration (ophthalmology)

Abdominal wound

10.1002/bjs.1800730514

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Citations (97)

Notes of a Case of Vaginal Rupture.

PubMed (1875)

J R Jamieson

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Peritonitis in the immunosuppressed female--possible role of the IUCD.

PubMed (1985)

David O’Donnell J R Jamieson Botha

Primary bacterial peritonitis is a rare condition and one which carries a mortality rate in excess on 50%. Recently a patient with clinical features of primary bacterial peritonitis who had had an IUD in situ while receiving immunosuppressive drugs was treated. The 13-year-old white girl underwent successful renal transplantation in 1979 for renal failure due to chronic glomerulonephritis. After an uneventful pregnancy in 1984 she was provided with a copper-containing IUD for contraception. In April 1985 she presented with abdominal pain fever and signs of peritopnitis which was confirmed at laparotomy. The cause of the peritonitis could not be established at laparotomy and in particular the fallopian tubes were macroscopically normal. Bacteriological cultures of the peritoneal pus grew Strepococcus pyogenes Staphylococcus epidermidis and eptostreptococcus spp. but preparation of endocervical cultures of a profuse yellow-green vaginal discharge was delayed until removal of the IUD after commencement of antibiotic therapy and yielded no growth. Response to antibiotic therapy was complete. Primary bacterial peritonitis is a bacterial infection of the peritoneum which develops in the absence of evidence of direct extension from abdominal organs. It appears that depressed defense mechanisms are a prerequisite for its development. The patient was maintained on an immunosuppresive regimen of prednisone and azathioprine and is therefore likely to have been predisposed to develop infection. The IUD also may have played a role by providing a source of infection. The organisms isolated from the peritoneal fluid cultures are consistent with a vaginal source and although the patient denied gynecological symptoms a profuse yellow-green vaginal discharge was noted on removal of the IUD. Therapeutic serum antibiotic levels precluded laboratory confirmation of the vaginal presence of these same organisms. It is now the policy of these physicians to avoid the IUD as a means of contraception in female transplant recipients and to advise instead the use of barrier methods and oral contraceptives when temporary contraception is desired.

Pelvic Infection

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Spontaneous oesophageal rupture

British journal of surgery (1985)

M Schein R Saadia J R Jamieson W. S. G. Walker E W Cameron

We have no doubt that SVA is a useful pre-operative investigation in patients with undiagnosed gastrointestinal bleeding.Pre-operative diagnosis is always an advantage over inaccurate 'time honoured' procedures at laparotomy.Like many District General Hospitals we have a 24h upper gastrointestinal service but not an early lower gastrointestinal endoscopy service.It is reported that visualization can be particularly difficult during the latter procedure when bleeding is acute.In the 11 out of 386 patients in 2 years in whom SVA was done, it is true that the 4 tumours could have been found at blind laparotomy.However, it is highly unlikely that the bleeding points would have been found in the others, in whom the external surface of the bowel looked normal.It is notoriously dificult to localize angiodysplasia and A-V malformations by naked eye.Pre-operative localization with SVA enabled limited resection of the bleeding site.Often these patients are not bleeding at operation and so distension of a segment does not occur leaving the impossible question of how much to resect blindly.Angiography was estimated in 1980' to be available within 4 h in 17 per cent, and within 24 h in 36 per cent of UK centres.However, the actual equipment for the investigation is probably widely available in District General Hospitals.

10.1002/bjs.1800720937

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Citations (1)

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

British journal of surgery (2024)

William Xu Gordon Liu Chris Varghese Cameron I. Wells Nicolas P. Smith

Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.

10.1093/bjs/znad421

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Spontaneous perforation of the renal pelvis after transplantation. A report of 2 cases and a review of 8 cases previously reported.

PubMed (1986)

J R Jamieson J. R. Botha Jan J. van Wingerden Pieter Nel Johann Pretorius

Renal pelvis

Perforation

Kidney pelvis

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