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Surgical Infections

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https://www.readbyqxmd.com/read/29327977/status-and-challenges-of-predicting-and-diagnosing-sepsis-in-burn-patients
#1
Mile Stanojcic, Roohi Vinaik, Marc G Jeschke
Burns are a common form of trauma that account for more than 300,000 deaths each year worldwide. Survival rates have improved over the past decades because of improvements in nutritional and fluid support, burn wound care, and infection control practices. Death, however, remains unacceptably high. The primary cause of death has changed over the last decades from anoxic causes to now predominantly infections and sepsis. Sepsis and septic complications are not only major contributors to poor outcomes, but they further result in longer hospital stay and higher healthcare costs...
January 12, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29315023/sepsis-screening-current-evidence-and-available-tools
#2
Natacha Villegas, Laura J Moore
BACKGROUND: Early recognition of sepsis is challenging, especially in the surgical patient. Because of the non-specific nature of the initial signs and symptoms, delays in recognition are all too common. To improve the early identification of sepsis, screening tools have been developed, and several papers have described their results. This article reviews the available sepsis screening tools. METHODS: A PubMed search was performed using the search terms "sepsis" and "shock," "electronic alert," "clinical decision support," and "early warning systems...
January 9, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#3
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29298133/epidemiology-and-risk-factors-for-isolation-of-multi-drug-resistant-organisms-in-patients-with-complicated-intra-abdominal-infections
#4
Francesco M Labricciosa, Massimo Sartelli, Lilian M Abbo, Pamela Barbadoro, Luca Ansaloni, Federico Coccolini, Fausto Catena
BACKGROUND: Patients with complicated intra-abdominal infections (cIAIs) caused by multi-drug-resistant organisms (MDROs) have been identified as being at increased risk for adverse outcomes. Prompt identification and stratification of these patients is essential in the clinical management, allowing the physician timely optimization of empiric antimicrobial therapy while awaiting results of intra-operative cultures to streamline antibiotic treatment. METHODS: The study is a secondary analysis from two prospective multi-center color surveillance studies...
January 3, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29272204/pharmacokinetics-and-pharmacodynamics-of-antimicrobials-in-critically-ill-patients
#5
Emily J Owen, Gabrielle A Gibson, Sara A Buckman
Critically ill patients with severe infections often have altered pharmacokinetic and pharmacodynamic variables that lead to challenging treatment decisions. These altered variables can often lead to inadequate dosing and poor treatment outcomes. The pharmacokinetic parameters include absorption, distribution, metabolism, and excretion. Pharmacodynamics is the relationship between drug serum concentrations and pharmacologic and toxicologic properties of the medication. In addition to these altered parameters, these critically ill patients frequently are receiving organ support in the forms of continuous renal replacement therapy or extra-corporeal membrane oxygenation...
December 22, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29261091/association-of-enterococcus-spp-with-severe-combat-extremity-injury-intensive-care-and-polymicrobial-wound-infection
#6
Rae A Heitkamp, Ping Li, Katrin Mende, Samandra T Demons, David R Tribble, Stuart D Tyner
BACKGROUND: Combat-related extremity wound infections can complicate the recovery of injured military personnel. The Enterococcus genus contains both commensal and pathogenic bacteria found in many combat wounds. We describe the patient population susceptible to Enterococcus infection, the characteristics of Enterococcus spp. isolated from combat-related wounds, and the microbiological profile of Enterococcus-positive wounds. METHODS: Patient and culture data were obtained from the Trauma Infectious Disease Outcomes Study...
December 20, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29261037/how-surgeons-deal-with-complications
#7
Joerg Schroeder
No abstract text is available yet for this article.
December 20, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#8
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29211657/open-to-air-is-a-viable-option-for-initial-wound-care-in-necrotizing-soft-tissue-infection-that-allows-early-detection-of-recurrence-without-need-for-painful-dressing-changes-or-return-to-operating-room
#9
Derek Yang, April Davies, Bailey Burge, Phillip Watkins, Sharmila Dissanaike
BACKGROUND: The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint...
December 6, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29194011/rapid-source-control-laparotomy-is-there-a-mortality-benefit-in-septic-shock
#10
James Vogler, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: In the 1990s, damage control laparotomy (DCL) became a proved approach to treat intra-abdominal injuries caused by trauma. In the ensuing two decades, this approach has been applied to non-traumatic abdominal processes as well. Although the benefits of DCL are clear, the benefit of rapid source-control laparotomy (RSCL) for non-traumatic abdominal diseases is much less clear. However, two recent cohort analyses identified significant increases in the mortality rate with RCSL compared with primary fascial closure (PFC)...
December 1, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29190173/detection-of-bacteria-colonizing-titanium-spinal-implants-in-children
#11
Leonie Wagner, Lena Braunschweig, Helmut Eiffert, Konstantinos Tsaknakis, Dirk Kamin, Elisa D'Este, Philipp K Messer, Anna Kathrin Hell, Heiko M Lorenz
BACKGROUND: Bacterial colonization of spinal implants may cause severe complications in patients with early-onset scoliosis. Correct diagnosis and detection of microbiologic formation is crucial to prevent delayed infections caused by bacterial colonization. The purposes of this study were to estimate the rate and risk factors of colonization of vertical expandable prosthetic titanium rib (VEPTR) implants in children and to compare the different methods for detecting microbiologic formation on the spinal implants...
November 30, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29173069/direct-detection-of-vibrio-vulnificus-vibrio-parahaemolyticus-and-vibrio-alginolyticus-from-clinical-and-environmental-samples-by-a-multiplex-touchdown-polymerase-chain-reaction-assay
#12
Ji-Fang Yin, Ming-Yi Wang, Ying-Jian Chen, Hong-Qiu Yin, Yan Wang, Ming-Qiang Lin, Ai-Yan Liu, Cheng-Jin Hu
BACKGROUND: Vibrio vulnificus, V. alginolyticus, and V. parahaemolyticus are commonly and opportunistically pathogenic to humans. METHODS: In this study, a novel multiple touchdown polymerase chain reaction method (MT-PCR) was developed to benefit rapid and simultaneous detection of the presence of the three Vibrio species from the enriched clinical and environmental samples. RESULTS: The method showed a sensitivity of 104 colony forming units (CFU)/mL for V...
November 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29148955/experience-of-tubo-ovarian-abscess-a-retrospective-clinical-analysis-of-318-patients-in-a-single-tertiary-center-in-middle-turkey
#13
Zeynep Ozturk Inal, Hasan Ali Inal, Umit Gorkem
BACKGROUND: The objective was to identify the clinical and laboratory parameters, ultrasonographic (USG) morphology, and to predict surgical treatment for patients with tubo-ovarian abscess (TOA). PATIENTS AND METHODS: Data for a total of 318 patients with a diagnosis of TOA between January 2005 and December 2016 were analyzed retrospectively at a referral center in Turkey. Patients requiring surgical treatment were compared with those who did not with respect to demographic characteristics and clinical, USG, and laboratory findings...
November 17, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29135348/development-of-a-surgical-infection-surveillance-program-at-a-tertiary-hospital-in-ethiopia-lessons-learned-from-two-surveillance-strategies
#14
Jared A Forrester, Luca Koritsanszky, Benjamin D Parsons, Menbere Hailu, Demisew Amenu, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical site infections (SSIs) are a leading cause of post-operative morbidity and mortality. We developed Clean Cut, a surgical infection prevention program, with two goals: (1) Increase adherence to evidence-based peri-operative infection prevention standards and (2) establish sustainable surgical infection surveillance. Here we describe our infection surveillance strategy. PATIENTS AND METHODS: Clean Cut was piloted and evaluated at a 523 bed tertiary hospital in Ethiopia...
November 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29099342/synovial-fluid-leukocyte-esterase-in-the-diagnosis-of-peri-prosthetic-joint-infection-a-systematic-review-and-meta-analysis
#15
Chi Wang, Rui Li, Qi Wang, Chengbin Wang
BACKGROUND: Peri-prosthetic joint infection (PJI) is a serious and frequent complication of total joint arthroplasty (TJA). Recently, synovial fluid leukocyte esterase (LE), measurement of which is convenient and fast, has been examined as a marker of PJI. We summarized the articles describing synovial fluid LE as a biomarker for the diagnosis of PJI and assessed its diagnostic value in patients suspected of having PJI. METHODS: We searched with appropriate key words in PubMed, Embase, Web of Science, the Cochrane database, and Science Direct...
November 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29064344/low-infection-related-re-admission-rates-in-a-retrospective-of-4725-children-with-appendicitis-using-a-clinical-pathway-in-a-tertiary-care-pediatric-center
#16
Nikolas E Marino, Kate Davenport, Mary Hilfiker, Simone Langness, Timothy Fairbanks, Erin Stucky Fisher, Robert Newbury, Allyson Andrews, Alan Wells, Juan D Chaparro, John S Bradley
BACKGROUND: Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway. METHODS: Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens...
October 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29058569/surgical-site-infections-after-appendectomy-performed-in-low-and-middle-human-development-index-countries-a-systematic-review
#17
Deshka Foster, Will Kethman, Lawrence Z Cai, Thomas G Weiser, Joseph D Forrester
BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Early intervention is associated with better outcomes. In low and middle Human Development-Index Countries (LMHDICs), late presentation and poor access to healthcare facilities can contribute to greater illness severity and higher complication rates, such as post-operative surgical site infections (SSIs). The current rate of SSIs post-appendectomy in low- and middle-index settings has yet to be described. METHODS: We performed a systemic review of the literature describing the incidence and management of SSIs after appendectomy in LMHDICs...
October 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29303688/a-multi-component-strategy-to-decrease-wound-complications-after-open-infra-inguinal-re-vascularization
#18
Nader Zamani, Sherene E Sharath, Elaine Vo, Samir S Awad, Panos Kougias, Neal R Barshes
BACKGROUND: Wound complications remain a significant source of morbidity for patients undergoing open infra-inguinal re-vascularization. The purpose of this study was to determine the impact of several infection-control strategies on post-operative wound complications after open infra-inguinal re-vascularization. METHODS: A retrospective cohort study was conducted among all patients who underwent an open infra-inguinal re-vascularization procedure before and after 2014...
January 2018: Surgical Infections
https://www.readbyqxmd.com/read/29303687/effect-of-the-abdominal-fascial-closure-with-triclosan-coated-sutures-in-fecal-peritonitis-on-surgical-site-infection-and-evisceration-a-retrospective-multi-center-study
#19
Jaime Ruiz-Tovar, Natalia Alonso, Aina Ochagavía, Antonio Arroyo, Carolina Llavero
BACKGROUND: Surgical site infection (SSI) is a frequent complication in dirty surgery, reaching rates of up to 40%. The incidence of SSI might be influenced by the suture used for closure of the abdominal fascia. Sutures coated with antibacterial substances may reduce the bacterial load in the incision. PATIENTS AND METHODS: A retrospective study of patients with intra-operative diagnosis of fecal peritonitis undergoing a laparotomy in three Spanish hospitals was performed...
January 2018: Surgical Infections
https://www.readbyqxmd.com/read/29303686/microbiologic-analysis-of-complicated-and-uncomplicated-acute-appendicitis
#20
Andrés García-Marín, Mercedes Pérez-López, Elena Martínez-Guerrero, Lorena Rodríguez-Cazalla, Antonio Compañ-Rosique
BACKGROUND: Microbiologic studies suggest that complicated (CAA) and uncomplicated (UAA) acute appendicitis are different entities. Routine peritoneal fluid cultures continue to be controversially related to a low positive rate, found mainly in UAA; to isolation of typical micro-organisms with expected susceptibilities; and to a community-acquired intra-abdominal infection. The aim of this study was to describe microbiologic isolates in CAA and UAA and the usefulness of peritoneal fluid cultures to determine the susceptibilities to our antibiotic therapy guidelines...
January 2018: Surgical Infections
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