Steriele handschoenen bij kleine chirurgie niet nodig

According to the practice guideline of the Dutch Workingparty on Infection Prevention (WIP) sterile gloves have to be worn during minor surgery by the general practitioner. This is based on the microbiological principles of Spaulding and is not supported by other evidence. Current literature suggests that using clean, nonsterile gloves, instead of sterile gloves, does not result in a greater risk of wound infection in primary closed wounds after minor surgery. Also, in daily practice, only 24% of general practitioners actually wear sterile gloves. We therefore propose to modify the guideline: using clean, nonsterile gloves during minor surgery is sufficient

Incidence and Risk Factors for Upper Extremity Climbing Injuries in Indoor Climbers

The purpose of this study was to describe the prevalence, incidence and risk factors for climbing-related injuries of the upper extremities in recreational climbers. A total of 426 recreational climbers were recruited from indoor climbing halls. The baseline questionnaire included questions on potential risk factors for climbing injuries: personal factors, climbing-related factors and upper extremity injuries that had occurred in the previous 12 months. Follow-up questionnaires collected information on new injuries that occurred during the follow-up period. The incidence of climbing-related injuries during one-year follow-up was 42.4% with 13 injuries per 1000h of climbing. The finger was the most frequently affected injury location (36.0%). The following risk factors were associated with the occurrence of upper extremity injuries: higher age (OR 1.03, 95%CI 1.01;1.05), performing a cooling-down (OR 2.02, 95%CI 1.28;3.18), climbing with campus board (OR 2.48, 95%CI 1.23;5.02), finger strength middle finger (OR 1.12, 95%CI 1.05;1.18) and previous injuries (OR 3.05, 95%CI 2.01;4.83). Climbing injuries of the upper body extremities are very common among recreational climbers in indoor halls and several risk factors can be identified that are related to a higher injury risk

Haemobilia 2 weeks after a low thoracic stab wound

Background. Haemobilia occurs in only 1.2–5% of patients with accidental liver trauma. We describe an unusual case 2 weeks after penetrating thoracic injury. Case outline. A 27-year-old man underwent laparotomy for hepatic bleeding after a low thoracic stab wound. Two weeks later rectal blood loss occurred. CT scan and angiography revealed intrahepatic contrast extravasation at the previous stab wound site. Coils were successfully placed into two branches of the right hepatic artery. Discussion. Haemobilia should be considered in patients presenting with gastrointestinal blood loss after liver injury. It is diagnosed with angiography and preferably treated by embolisation