Vascular reconstructive surgery with the placement of prosthetic material caudal to the diaphragm is occasionally associated with postoperative wound infection. These infections often lead to amputation and can be lethal. Only a few published reports contain information on the value of prophylactic antibiotic treatment with these operations, but its use is common throughout the world. To investigate this problem, a prospective, double blind, randomized study of vancomycin versus placebo in 128 vascular graft operations caudal to the diaphragm was conducted from June, 1982 to July, 1984. The difference in infection rate was significant (2 p = 0.0008) in favor of the vancomycin group. Fourteen wound infections (21.2%) were found in the placebo group, 3 of which (4.5%) were prosthesis infections. Among the 62 vancomycin-treated patients, one case of superficial wound infection (1.6%) and no cases of prosthesis infection were found. The most common pathogen was Staphylococcus aureus. The study has demonstrated that vancomycin, a narrow spectrum antibiotic, in an ultra-short regimen (one gram one hour before surgery and one gram 4 hours later) is an effective prophylactic agent against postoperative wound infection. Temporary and, in most cases, doses-related side effects were seen in 7.9% of the patients treated with vancomycin.

transplantation in the treatment of osteochondritis dissecans. Scand J Med Sci Sports 1992: 2: 32-36.Osteochondritis dissecans in the femoral condyle of the knee in 3 patients was treated with periosteal transplantation. The cavities were curetted to cancellous bone and a tibial periosteal graft was lined to the excavation and fixed with human tissue glue (Tisseel R). By clinical and radiographic follow-up, we find this modality of treatment as a hopeful prospect in severe cases, though a demarcation of indication is still a challenge for investigation.The advocated treatment of a large osteochondritis dissecans (OD) process in the femoral condyles consists of replacement of the fragment and preparation of the bed to secure revascularization, since established juvenile or adult OD does not always heal spontaneously (1).Fixation of the fragment with Kirschner wires and cancellous bone grafting is often necessary to bring the fragment in level with the surrounding surface. Lipscomb et al.(2) used this procedure with a postoperative plaster immobqization period of 12.5 weeks (3-28) and a non-weight-bearing period of 10 weeks (6-16).Inspired by the excellent results obtained by Niedermann et al. (3) in the treatment of OD with periosteal transplantation to the excavated and t.

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