Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis.

Background: Since the patient's skin is a major source of pathogens that cause surgical-site infection, optimization of preoperative skin antisepsis may decrease postoperative infections. We hypothesized that preoperative skin cleansing with chlorhexidine-alcohol is more protective against infection than is povidone-iodine.

Methods: We randomly assigned adults undergoing clean-contaminated surgery in six hospitals to preoperative skin preparation with either chlorhexidine-alcohol scrub or povidone-iodine scrub and paint.

Balloon tamponade of hemorrhage after uterine curettage for gestational trophoblastic disease.

Background: Uterine bleeding frequently complicates gestational trophoblastic disease, particularly after uterine evacuation. Hysterectomy and other procedures used to control this bleeding incur significant risk and can limit fertility.

Case: We present a case of massive hemorrhage complicating uterine curettage performed for metastatic gestational trophoblastic disease.

Necrotizing fasciitis after tension-free vaginal tape (TVT) placement.

A 62-year-old homemaker underwent an uneventful TVT (tension-free vaginal tape) procedure. Eleven days postoperatively she presented to the Emergency Department with agonizing low abdominal pain, elbow pain, fever, and drainage from her suprapubic puncture sites. Her evaluation was consistent with a diagnosis of necrotizing fasciitis and she was started on antibiotics and taken to surgery for exploration and debridement, where the diagnosis was confirmed.