Methicillin-resistant Staphylococcus aureus: an update.

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious threat to patients in health care facilities and the community. A MRSA infection can be much more severe than other bacterial infections and can be life-threatening. Resistance to common antibiotics makes treating MRSA costly and difficult.

Malignant phyllodes tumor in an 11-year-old premenarchal girl.

Phyllodes tumor is uncommon in children, and the malignant form is rare. There have only been a few cases of benign phyllodes tumor reported in peripubertal children and only one malignant case. We report the second case of malignant phyllodes tumor in a premenarchal 11-year-old girl.

Managing a chest tube and drainage system.

Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily.

Retaining a nonfunctional synthetic arterial bypass graft as a tunnel for future bypass using a vein graft: technical note.

Reoperation after infrainguinal arterial bypass may be difficult because of scar tissue from the previous bypass operation and usually involves removal of the old synthetic bypass graft. The authors describe a novel method of retaining the old thrombosed, externally reinforced polytetrafluoroethylene graft and using it as a tunnel for redo bypass using a vein.

Chemical sympatholysis: indications, technique and complications.

Chemical sympatholysis is commonly performed for palmar or plantar hyperhidrosis, Buerger's disease, critical lower limb ischaemia where there is no revascularization option available and palliation of pain. The outcome varies from symptomatic improvement to failure, which may result in limb loss in the case of ischaemic limbs.

'Indirect VAC': a novel technique of applying vacuum-assisted closure dressing.

Vacuum-assisted closure (VAC) wound dressing is increasingly used to assist closure in various wounds ranging from simple finger pulp defect to complex wounds such as laparostomy or infected sternotomy. The traditional application of direct vacuum therapy can cause discomfort and put the patient at risk of injuring the affected area while mobilising. We describe a novel technique of applying VAC therapy indirectly which is much more comfortable and convenient for the patient while mobilising.

Ruptured jejunal diverticulum due to a single-band small bowel obstruction.

Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon.

Acute gallbladder torsion: an unexpected intraoperative finding.

Gallbladder torsion is an uncommon clinical entity and a difficult condition to diagnose preoperatively. Since its first description in 1898 by Wendel there have been over 500 documented cases in the literature. It is known to occur when there is rotation of the gallbladder along the axis of the cystic duct and vascular pedicle.