November 1958

Surgical Care in Post-Traumatic Renal Failure

Author Affiliations

Baltimore; U. S. Army; U. S. Army
From the Departments of Surgery of the Baltimore City Hospitals and The Johns Hopkins University School of Medicine, and the Renal Insufficiency Center, Surgical Research Team, Korea.

AMA Arch Surg. 1958;77(5):807-815. doi:10.1001/archsurg.1958.01290040155020

The presence of crushed, necrotic, and infected tissues in a patient with acute renal failure can enormously complicate the management of the patient's hospital course and, in many cases, can lead to a much more rapid progression of uremia and potassium intoxication. This situation has been abundantly documented in recent years.1-3 While it is generally agreed that necrotic tissue should be immediately debrided in these patients,4,5 it has been noted that at times little benefit seems to accrue from this procedure.4 The following cases are offered as examples of what may be expected of surgery under various circumstances in post-traumatic acute renal failure.

Clinical Material  These patients were treated at a specialized treatment center in Korea where casualties who developed post-traumatic renal insufficiency were referred. An artificial kidney was employed as an adjunct in controlling uremia and potassium intoxication. Many of these patients had received massive wounds.

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