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Öğe ARE ABDOMINAL PAIN AND DISTENTION SYMPTOMS OF BREAST CANCER?(Aves, 2012) Girgin, Sadullah; Onder, Akin; Kapan, Murat; Firat, Ugur; Arikanoglu, Zulfu; Kucukoner, MehmetBreast cancer usually metastasizes to bone, lungs, liver and central nervous system. Rarely, atypical metastases may occur. Isolated peritoneal metastasis of breast cancer is very uncommon. On systemic examination of a 50-yearold woman who presented to our outpatients' clinic with the complaints of abdominal pain and distention, abdominal ascites and a breast mass were found. Biopsy from the breast mass revealed invasive ductal carcinoma and laparoscopic peritoneal biopsy showed peritoneal metastasis of the breast cancer. Palliative chemotherapy was planned. The patient rejected the treatment and has been under follow-up for 6 months does not have any other metastasis now.Öğe Are abdominal pain and distention symptoms of breast cancer?(2012) Kapan, Murat; Önder, Akın; Arıkanoğlu, Zülfü; Girgin, Sadullah; Fırat, Uğur; Küçüköner, MehmetMeme kanseri genellikle kemik, akciğer, karaciğer ve santral sinir sistemine metastaz yapar. İzole peritoneal meme kanseri metastazı oldukça nadir görülür. Kliniğimize karınağrısı şikayeti ile baş vuran hastanın sistemik muayenesinde, abdominal distanssiyon, asit ve memede kitle tespit edildi. Memeden alınan bşyopsi invazif duktal karsinom ve laparoskopik peritoneal biyopsi sonucu ise meme kanseri metastazı olarak değerlendirildi. palyatif kemoteripi plannanan hasta tedaviyi kabul etmedi. Altı ay takip edilen hastada başka bir metastaz gelişmedi.Öğe Ascaris lumbricoides'e bağlı granülomatöz peritonit(2000) Aldemir, Mustafa; Girgin, Sadullah; Yılmaz, Gülşen; Akgün, Mehmet Yılmaz[Abstract Not Available]Öğe Associated organ injuries in pancreatic injuries, morbidity, and mortality(Tubitak Scientific & Technological Research Council Turkey, 2012) Onder, Akin; Gumus, Metehan; Kapan, Murat; Boyuk, Abdullah; Arikanoglu, Zulfu; Girgin, SadullahAim: Pancreatic injuries are rarely seen due to the retroperitoneal location of the organ. Associated organ and vascular structures usually accompany injury. In this study, the effect of ductal injury and associated organ injuries on morbidity and mortality was investigated. Materials and methods: Between January 2004 and October 2010, 26 patients with abdominal trauma who developed pancreatic injury and underwent surgery at the Dicle University General Surgery Department were evaluated retrospectively. Results: Of the 26 patients, 20 were males (76.9%) and 6 (23.1%) were females. The mean age of the patients was 24.96 +/- 9.4 (14-56) years. Of the injuries, 21 (80.8%) were related to penetrating trauma and 5 (19.2%) were related to blunt trauma. Of the patients, 6(23.1%) were stage I, 12(46.2%) were stage II, 5 (19.2%) were stage III, and 3 (11.5%) were stage IV The most commonly injured associated organs were the stomach (50%) and vascular structures. Eighteen patients underwent primary suturing, 5 underwent distal pancreatectomy, 3 underwent Roux-en-Y pancreaticojejunostomy., Common postoperative complications included intraabdominal abscess and pancreatic fistula. Mortality occurred in 3 (11.5%) patients, 2 of them due to hemorrhagic shock resulting from vascular injury and 1 of them as a result of fistula-induced sepsis and multi-organ failure. Conclusion: A good exploration should be done in all abdominal traumas, remembering that pancreatic injury could occur. Mortality may increase during the early period in patients who have vascular injuries. Morbidity and late mortality may increase in patients with ductal injuries.Öğe Benign hematolojik hastalıklarda splenektomi sonuçlarımız(2009) Baş, Birsel; Girgin, Sadullah; Gedik, Ercan; Taçyıldız, İbrahim HalilGiriş Dalağın cerrahi hastalıklarının çoğunluğunu medikal tedaviye dirençli ve şiddetli seyreden benign hematolojik hastalıklar oluşturur. Bu çalışmada, benign hematolojik nedenlerle kliniğimizde splenektomi yapılan hastalar ve sonuçlarını sunmayı amaçladık. Materyal-Metod Hematolojik hastalık nedeniyle splenektomi yapılan 115 hasta retrospektif olarak incelendi. Yaş, cins, hematolojik hastalık nedeni, aksesuvar dalak varlığı ve yerleşimi, operasyon süresi, kan transfüzyonu sayısı, hastanede yatış süresi, uzun süreli takip sonuçları, morbidite ve mortalite açısından değerlendirildi. Bulgular Yaş ortalaması 41.08±17.90 olup, %67.8 hasta kadın ve %32.2 hasta ise erkek idi. En sık splenektomi yapılan hematolojik hastalık İTP (%56.6) idi. Ameliyat sırasında %26 hastada aksesuvar dalak tespit edildi. Anemi nedeniyle ameliyat edilen 6 hastaya safra taşı nedeniyle kolesistektomide yapıldı. Komplikasyon %9.56 hastada gelişti ve en sık görülen komplikasyon atelektazi idi. Postsplenektomik sepsis gelişen bir hasta kaybedildi. Sonuç Nüksleri önlemek için aksesuvar dalak gözden kaçırılmamalı, aşılama ve antibiyotik proflaksisi yanı sıra antikoagulan proflaksisi de bu hastalarda unutulmamalıdır.Öğe Bilateral giant morgagni hernia causing cardiac shifting(2009) Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Avcı, AlperYetmiş altı yaşında, 114 kg ağırlığında bayan hasta iki yıldır kötüleşen göğüs ağrısı ve efor ile nefes darlığı şikayetleri ile başvurdu. Öyküsünde travma yoktu. Düz ve kesitsel görüntülemede kardiyak posterior itilmeye neden olan dev anterior diyafragmatik herni saptandı. İleri tetkik ve tedavi için genel cerrahi bölümüne sevk edildi. Herniye bölümlerin redüksiyonu ve bilateral diyafragmatik defektin onarımı laparotomi kullanılarak yapıldı. Posterior kardiyak itilmeye neden olan bilateral dev Morgagni hernisi çok nadir bir olgudur.Öğe Bilateral Giant Morgagni Hernia Causing Cardiac Shifting(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Avci, Alper; Girgin, Sadullah; Gedik, Ercan; Onat, SerdarA 76-year-old woman weighing 114 kg presented with shortness of breath and worsening chest pain for 2-year duration. There was no history of trauma. Plain and cross-sectional imaging identified a giant anterior diaphragmatic hernia which caused cardiac posterior shifting. She was transferred to general surgery department for further investigations and treatment. Reduction of herniated contents and repairing of bilaterally diaphragmatic defect were performed via laparotomy. Bilateral, giant Morgagni hernia which causes cardiac shifting to the backward is extremely rare.Öğe Coexistence of Behcet's disease and colonic diverticulitis: Is it causal or just a coincidence?(Aves, 2013) Arikanoglu, Zulfu; Taskesen, Fatih; Onder, Akin; Kapan, Murat; Boyuk, Abdullah; Gul, Mesut; Girgin, Sadullah[Abstract Not Available]Öğe Coexistence of Behcet’s disease and colonic diverticulitis: Is it causal or just a coincidence?(2013) Girgin, Sadullah; Kapan, Murat; Önder, Akın; Arıkanoğlu, Zülfü; Böyük, Abdullah; Taşkesen, Fatih; Gül, Mesut[Abstract Not Available]Öğe Comparison of the early complications of total and subtotal thyroidectomy in the multinodular goitre(Aves, 2011) Durgun, Cemalettin; Boyuk, Abdullah; Girgin, Sadullah; Kapan, Murat; Onder, Akin; Gumus, Metehan; Tacyildiz, Ibrahim HalilPurpose: In the recent years, total thyroidectomy is increasingly being accepted in the surgical treatment of benign multinodular goitre due to the high rate of recurrence after bilateral subtotal thyroidectomy. The aim of this study is to compare early postoperative complications of total and bilateral subtotal thyroidectomy in benign multinodular goitre. Materials and Methods: In our study, the findings of 419 patients operated due to multinodular goitre between January 2005 - December 2009 in Dicle University Medical School Department of General Surgery were retrospectively evaluated. Patients were divided into two groups as total thyroidectomy and bilateral subtotal thyroidectomy. Results: The mean age of patients was 41.72 +/- 12.55. 329 (78.5%) patients were women and 90 (21.5%) were men. A total of 263 (62.8%) patients underwent total and 156 (37.2%) patients bilateral subtotal thyroidectomy. Six (2.3%) of total thyroidectomy patients and 3 (1.9%) of bilateral subtotal thyroidectomy patients had recurrent laryngeal nerve injury. Bilateral subtotal thyroidectomy group revealed no permanent damage whereas in total thyroidectomy group one (0.4%) patient did. Hypocalcemia was observed in 40 (15.2%) patients in the total thyroidectomy group and in 27 (17.3%) patients in the bilateral subtotal thyroidectomy group. One (0.4%) patient in total thyroidectomy group suffered from permanent hypocalcemia whereas it wasn't observed in bilateral subtotal thyroidectomy group. Haematoma occurred in 3 (1.9%) patients treated with bilateral subtotal thyroidectomy and in 3 (1.1%) treated with total thyroidectomy, wound infection occured in one (0.6%) patient subjected to bilateral subtotal thyroidectomy and 3 (1.1%) patients treated with total thyroidectomy. Conclusion: In conclusion, our study supports total thyroidectomy for multinodular goitre involving both lobes as a safe technique with low complication rate.Öğe A conservative approach to rectus sheath haematomas(Tıp Araştırmaları Derneği, 2011) Önder, Akın; Kapan, Murat; Gümüş, Metehan; Böyük, Abdullah; Tekbaş, Güven; Girgin, Sadullah; Taçyıldız, İbrahimAim: Rectus sheath haematoma (RSH) is the result of a rupture of epigastric vessels or rectus muscle occurring mostly in infraumblical region. Etiological factor is predominantly trauma and rarely spontaneous. Generally, misdiagnosed or delays in diagnosis result in unnecessary surgical intervention. Method: Between December 2008 and September 2009, five patients diagnosed for RSH in our hospital retrospectively analyzed in terms of the demographical characteristics, clinical and radiological findings and length of stay in hospital. Result: The average age of the patients was 67 (59-76) years and all were female. At least one of the patients had a systematic disease. All the patients were using anticoagulant and none of them had trauma story. On physical examination, we determined palpable masses loca ted as follows; in left lower quadrant of three patients, in right lower quadrant of one patient and in left upper quadrant of one patient. The types of RSH in radiological imaging were Type 1 in one patient, Type 2 in three patients and Type 3 in one patient. Anticoagulant treatments were stopped and all patients were treated conservatively. The average stay in hospital time of the patients was 8 days. The computed tomography control at the end of the first month revealed that the mass disappeared in cases with Type 1 RSH while the other four cases had a marked decrease in the mass size. Conclusion: RSH should be taken into consideration in differential diagnosis when elder patients - especially females - with anemia, palpable mass, anticoagulant medication history admitted to clinics with acute abdomen. Early diagnosis of RSH provides the preventing of the unnecessary surgical interventions and determines the success of conservative treatment.Öğe Dental abseye bağlı servikomammarian nekrotizan yumuşak doku enfeksiyonu: Olgu sunumu(2000) Geyik, M. Faruk; Taçyıldız, İbrahim; Kutsal, Tamer; Girgin, Sadullah; Yılmaz, Gülşen; Aldemir, Mustafa[Abstract Not Available]Öğe Effect of a 50-Hz Sinusoidal Electromagnetic Field on the Integrity of Experimental Colonic Anastomoses Covered with Fibrin Glue(Wroclaw Medical Univ, 2009) Girgin, Sadullah; Ozturk, Hayrettin; Gedik, Ercan; Akpolat, Veysi; Kale, Ebru; Ozturk, HulyaBackground. Low-frequency magnetic fields have been shown to affect biological processes. In this article the effects of 50-Hz sinusoidal magnetic field (MF) stimulation and application of fibrin glue on the healing of experimental colonic anastomoses were investigated. Material and Methods. Twenty-eight rats were divided into four groups. Group 1 underwent 2-cm left colonic resection and primary anastomosis. Group 2 underwent normal resection anastomosis and the area was covered with fibrin glue. Group 3 underwent normal resection anastomosis and the rats were exposed to a 50-Hz sinusoidal MF. Group 4 underwent normal resection anastomosis, the anastomosis area was covered with fibrin glue, and the rats were exposed to a 50-Hz sinusoidal MF. Investigations included bursting pressure measurement, hydroxyproline content, and histopathological changes. Results. Tissue hydroxyproline levels and anastomotic bursting pressures of groups 2, 3, and 4 were significantly higher than in group 1. Collagen deposition and fibroblast infiltration in groups 2, 3, and 4 had higher scores than in group 1. Furthermore, these results were significantly higher in group 4 rats than in the other groups. Histopathological examination of the anastomosis revealed significantly better healing patterns for group 4 than for groups 1, 2, and 3. Conclusions. A50-Hz sinusoidal MF stimulation and application of fibrin glue provided a significant gain in anastomotic healing in the large intestine. A combination of a 50-Hz sinusoidal MF and fibrin glue has significantly favorable effects on healing of experimental colon anastomosis (Adv Clin Exp Med 2009, 18, 1, 13-18).Öğe The Effective Factors on Morbidity Due to Penetrating Small Intestine Injuries(Aves, 2012) Onder, Akin; Kapan, Murat; Basol, Omer; Boyuk, Abdullah; Gumus, Metehan; Gul, Mesut; Girgin, SadullahObjective: In this study, we aimed to investigate the effective factors on morbidity due to small intestine penetrating injuries. Material and Methods: Between January 2006 and December 2010, 114 patients who underwent surgery due to penetrating small intestine injuries were retrospectively reviewed. Results: The mean age was 32.8 +/- 12.3years (15-77), and there were 96 patients, (84.2%) male and 18 (15.8%) female patients. The most common etiologic cause was gun-shot injuries (66.7%).Fifty-one (44.7%) patients had isolated small intestine injuries and 63 (55.3%) had small intestine and additional organ injuries. Colon was the most common additional organ injured (66.7%) Most commonly, 68 (59.7%) patients underwent primary suture. T Postoperative morbidity occurred in 30 patients (25%) and the most common complication was wound infection. The morbidity was significantly higher in the patients with small intestine and additional organ injuries (p=0.006). The morbidity was higher in patients who exhibited signs of peritonitis (p=0.048) and had colonic injuries (p=0.002). The number of blood transfusions was effective in mortality (p<0.001). The mean length of hospital stay was 6.9 +/- 2.9 (1-21) days, significantly longer in the patients who developed morbidity (p=0.002). Seven (6.1%) patients died due to hemorrhage in 6 patients and anastomotic leakage in 1 patient. Conclusion: Small intestine injuries significantly increase the postoperative morbidiy when accompanied by additional intraabdominal organ injuries, especially the colon.Öğe The effective factors on morbidity due to penetrating small intestine injuries(2012) Böyük, Abdullah; Girgin, Sadullah; Önder, Akın; Gümüş, Metehan; Kapan, Murat; Gül, Mesut; Başol, ÖmerAmaç: Bu çalışmada penetran travmaya bağırsak ince bağırsak yaralanmalarında morbidite üzerine etkili faktörlerin araştırılması amaçlandı. Gereç ve Yöntemler: Ocak 2006-Aralık 2010 tarihleri arasında penetran ince bağırsak yaralanmasına bağlı cerrahi uygulanan 114 hasta retrospektif olarak incelendi. Bulgular: Hastaların 96’sı (%84.2) erkek, 18’i (%15.8) kadın idi. Hastaların ortalama yaşları 32.8±12.3 (15-77) yıldı. En sık etiyolojik neden ateşli silah yaralanmasıydı (%66.7). Hastaların 51’inde (%44.7) izole ince bağırsak yaralanması, 63’ünde (%55.3) ince bağırsakla beraber intraabdominal yandaş organ yaralanması mevcuttu. Yandaş organ olarak en sık kolon yaralanmasının (%66.7) ettiği belirlendi. Hastalara en sık olarak 68’ine (%59.7) primer sutür uygulandı. Hastaların 30’unda (%26.3) morbidite gelişti. En sık görülen komplikasyon yara yeri enfeksiyonuydu. Yandaş organ yaralanmalarının eşlik ettiği ince bağırsak yaralanmalarında morbidite anlamlı olarak artmaktaydı (p=0.006). Kolon yaralanması (p=0.002) mevcut olanlar ile peritonit bulguları (p=0.048) nedeniyle opere edilen hastalarda morbidite anlamlı olarak daha yüksekti. Mortalite gelişimi üzerine kan tranfüzyon miktarı etkiliydi (p<0.001). Hastaların ortalama yatış süreleri 6.9±2.9 (1-21) gün olup, morbidite gelişen grupta anlamlı olarak uzundu. (p=0.002). Mortalite hastalarımızın 6’sında ilk 24 saat içinde hemorajiye ve 1’inde anastomoz kaçağına bağlı sepsis nedeniyle görüldü. Sonuç: İnce bağırsak yaralanmalarında özellikle kolon ve beraberinde intraabdominal diğer organ yaralanmalarının eşlik etmesi postoperatif morbidite anlamlı olarak arttırmaktadır. (JAEM 2012; 11: 204-7)Öğe Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats(Springer, 2009) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akbulut, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, SalihPurpose An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. Methods Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. Results The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. Conclusions In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.Öğe Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats (vol 54, pg 745, 2009)(Springer, 2010) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akpolat, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih[Abstract Not Available]Öğe Elektrik çarpması sonucu acil servise başvuran hastaların epidemiyolojik özellikleri(2006) Kara, İsmail Hamdi; Girgin, Sadullah; Al, Behçet; Aldemir, Mustafa; Güloğlu, CahferAMAÇ: Bu çalışma, elektrik çarpmalarının epidemiyolojik özelliklerini belirlemek, mortalite ve morbiditeye etkili olan faktörleri saptamak için planlandı. GEREÇ-YÖNTEM: Dicle Üniversitesi Tıp Fakültesi Acil Kliniğine Ocak 2003-Nisan 2004 tarihleri arasında elektrik çarpması şikayetiyle başvuran 165 hasta (126 erkek; 39 kadın; ort. yaş 21.1; dağılım 2.5-62) yaş, cinsiyet, elektik kaynağı ve gücü, yanık derecesi ve yüzdesi, oluşan komplikasyonlar, yapılan müdahaleler, eğitim durumu ve meslekleri bakımından değerlendirildi. BULGULAR: Hastaların, 60’ı (%36.4) 12 yaşın altında, 95’i (%57.6) genç ve erişkin yaşta ve 10’u (%6) ileri yaşta idi. Yirmi dokuz (%17.6) hasta okuryazar değil, 36’sı (%21.8) okuryazar ve 97’si (%58,8) halen eğitim görmekte idi. Yanıkların 99’u (%60) kaza, 66’sı (%40) ise dikkatsizlik ve ihmal sonucu oluşmuştu. Hastaların 69’u (%41.8) yüksek, 96’sı (%58.2) düşük voltaja maruz kalmıştı. On altı hastada birinci derece, 96 hastada ikinci derece ve 86 hastada üçüncü derece yanık meydana gelmişti. En sık görülen komplikasyonlar, ekstremitelerde kontraktür (%10.9) ve kompartman sendromu (%3.6) idi. Hastaların 10’una eskarotomi, 16’sına fasyotomi, 9’una amputasyon uygulanmıştı. Mortalite oranı %9.1 (n=15) idi ve bu olguların %80’i yüksek elektrik voltajına maruz kalmıştı. Gözlenen komplikasyonlar ile mortalite arasında pozitif bir korelasyon saptandı (p<0.001). SONUÇ: Elektrik sistemlerinin doğru kullanımı ile ilgili toplumsal eğitimin verilmesi, ev içi ve ev dışı elektrik hatlarının gizli döşenmesi gibi basit önlemlerin alınması ile kazalar en aza indirilebilecektir.Öğe The evaluation of 250 patients with thoracoabdominal injuries(Turkish Assoc Trauma Emergency Surgery, 2008) Ciftci, Fatih; Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Tacyildiz, Ibrahim Halil; Keles, CelalettinBACKGROUND Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated. METHODS Two hundred and fifty patients (227 males, 23 females; mean age 30.1 +/- 5.11; range 15 to 71 years) who had been exposed to thoracoabdominal injuries and underwent laparotomy between June 1996 and November 2005 were investigated retrospectively. Patients were assessed according to age, sex, trauma-operation interval, shock, hospitalization period, number of injured organs, blood transfusion, timing of closed thorax drainage, thoracotomy, Abdominal Trauma Index, Injury Severity Score, Abbreviated Injury Score, Revised Trauma Score, and complications. RESULTS Mortality and morbidity ratios were 15.6% and 53.5%, respectively. The factors effective on mortality were trauma-operation interval >= 3 hours (p=0.03), presence of shock (p=0.03), increase in the rate of blood transfusion (p=0.001), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005). Trauma-operation interval <3 (p=0.02), increase in the rate of blood transfusion (p=0.02), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005) were the factors effective on morbidity. CONCLUSION It was determined that trauma-operation period >= 3 hours, number of injured organs >= 3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.Öğe The evaluation of bacteriology in perianal abscesses of 81 adult patients(Contexto, 2010) Ulug, Mehmet; Gedik, Ercan; Girgin, Sadullah; Celen, Mustafa Kemal; Ayaz, CelalObjective: Treatment of perianal abscesses requires prompt surgical drainage and antimicrobial therapy. However, we should encourage the selective use of antimicrobial agents on a case-by-case basis, especially because there is no evidence that uncomplicated perianal abscesses can be safely treated only with drainage. For this reason, it is important to identify the causative organisms; therefore, we accessed the microbiological analysis of these patients. Patients and methods: In this study, 81 consecutive adult patients with perianal abscesses, who presented at a university hospital in Diyarbakir from January 2004 to December 2006, were included. Clinical and laboratory data, and results of microbiological analysis were recorded. Results: All specimens, except seven, yielded bacterial growth. Escherichia coli, Bacteriodes spp., coagulase-negative Staphylococci, and Staphylococcus aureus were the most common isolated organisms. Conclusion: In contrast to other investigators, this study demonstrated that aerobic organisms are the predominant isolates in these infections.
