The clinical and experimental investigations described in this thesis were carried out in the Experimental Surgical Laboratories of the Royal Victoria Hospital and McGill University. These studies vere carried out from July 1, 1961, to July 1, 1962. The finding of both a long and short duration of esophageal acidity following gastroesophageal reflux was an original contribution and this was reported at the Forum on Fundamental Surgical Problems during the Forty-eighth Annual Clinical Congress of the A.merican College of Surgeons in Atlantic City in October, 1962#. [...]

The authors Thesis--Columbia University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 185-193).

Thesis--University of Minnesota. / "Authorized facsimile ... produced ... in 1976 by Xerox University Microfilms." eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 94-96).

Thesis--Catholic University of America. / Includes bibliographical references (leaves 118-124).

Thesis--University of Minnesota. / "Authorized facsimile ... produced ... in 1976 by Xerox University Microfilms." eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 94-96).

Thesis (M.S.)--Catholic University of America. / Includes bibliographical references.

The authors Thesis--Columbia University. / Includes bibliographical references (leaves 185-193).

Thesis -- Catholic University of America. / Bibliography: ℓ. 118-124.

Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 49-54).

Objective: This study aims to identify the microorganisms and antibiotic resistance patterns in necrotising fasciitis. Methods: This is a retrospective audit over two consecutive years (June 2015 - July 2017) of all patients who had surgery for necrotising fasciitis at an ACS unit. Results: Necrotising fasciitis accounted for 15% of all skin and soft tissue sepsis that required surgery. There were 10 male (52.6%) and nine female (47.4%) patients. The most common co-morbidity was diabetes mellitus in 10 (52.6%) patients, the compliance and control were monitored by glycosylated haemoglobin (HbA1C) in 50% of the diabetic group, with a mean of 8.98 (Range 5-12.9). Fifteen percent of cases (n=3) had a confirmed diagnosis of HIV, with a negative result in eight (42%). ICU was required in three patients two of whom were on inotropes and one patient required renal replacement therapy. Surgery was performed within 24 hours for 11 (57%) patients. The most common anatomical site for debridement was perineum in nine patients (47%). Monomicrobial infection was the most common subtype of necrotising fasciitis with methicillin sensitive staphylococcus aureus in five (26%) as the predominant microbe. Gram-negative organism Escherichia-coli was the second most common monomicrobial infection. All Gram-positive organisms were sensitive to cloxacillin and coamoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to co-amoxiclavulanic acid. The 30 day mortality was 15%. Conclusion- Necrotising fasciitis is a rare but lethal infection. In our limited series, monomicrobial infection is the most common subtype. 15% of the community acquired organisms were resistant to the empiric antibiotic of choice co-amoxiclavulanic acid.