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Surgical Infections

Jad Chamieh, Wen Hui Tan, Ricardo Ramirez, Eden Nohra, Chukwuma Apakama, William Symons
BACKGROUND: Synthetic meshes have been used with varying rates of success in a contaminated setting, although their use is not widely accepted because of concerns for infection. A biologic mesh (BM) is assumed to be more resistant to infection than a synthetic mesh; however, sparse clinical data support this theory. The hypothesis for this study: Uncoated polypropylene synthetic mesh (USM) can be used to obtain a durable repair in the setting of a contaminated abdominal wall reconstruction (AWR) in a single-stage procedure with comparable infectious outcomes to a biologic mesh repair...
October 18, 2016: Surgical Infections
Joseph D Forrester, Haiwei Henry Guo, Thomas G Weiser
BACKGROUND: Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. METHODS: Review of the English-language literature...
October 14, 2016: Surgical Infections
Max B van Gent, Wendeline J van der Made, Perla J Marang-van de Mheen, Koen E van der Bogt
OBJECTIVE: To analyze the rate of infections and complications after surgeon-performed, largely ultrasound-guided, central venous catheter (CVC) placement in a pediatric population and to identify patients at high risk of complications. METHODS: All children aged between 4 months and 19 years with a percutaneous CVC inserted between January 1, 2000, and July 31, 2013, were included. Patient records were reviewed retrospectively for the occurrence of infection and other complications until CVC removal or the last outpatient clinic visit and compared between patient groups and with the recent literature...
October 14, 2016: Surgical Infections
Yang Yang, Yang Lu, Xin He, Hongwei Zhao, Donghao Wang, Wanhua Wang
BACKGROUND: This study was conducted to observe the clinical efficacy of long-term piperacillin-tazobactam (TZP) infusion and identify the factors affecting its curative effect against pneumonia in patients who had undergone surgery for abdominal tumor. METHODS: The 100 patients were divided into four clinical groups according to the severity of their infection: Simple pneumonia, pneumonia with pleural effusion, pneumonia and atelectasis, and severe pneumonia. Each group of patients was then divided into control and treatment groups using a completely random design...
October 3, 2016: Surgical Infections
Charles E Edmiston, David J Leaper
BACKGROUND: Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure...
September 27, 2016: Surgical Infections
Brad S Oriel, Qi Chen, Kevin Wong, Kamal M F Itani
BACKGROUND: Selection of a pre-operative hand antisepsis agent has not been studied in relation to surgical site infection (SSI) culture data. In our hospital, we introduced an alcohol-based hand rub (ABR) in 2012 as an alternative to traditional aqueous surgical scrubs (TSS). It was the goal of this study to review any effect of this implementation on SSI pathogen characteristics. In addition, we sought to compare our SSI culture data with available National Healthcare Safety Network (NHSN) data...
September 23, 2016: Surgical Infections
Amanda J Hessels, Mansi Agarwal, Jianfang Liu, Elaine L Larson
BACKGROUND: Hip operation reduces pain and improves mobility and quality of life for more than 300,000 people annually, most of whom are more than 65 years old. Substantial increases in surgical volume are projected between 2005 and 2030 in primary total (174%) and revision (137%) procedures. This projection demands that the impact of increasing age on the relative risk of health-care associated infections (HAI) after hip surgical procedures be assessed. Our aim was to examine the incidence and risk factors of HAI among patients who underwent hip operations between 2006 and 2012...
September 21, 2016: Surgical Infections
Amit Velagapudi, Matthew McKay, Tasmin Barry, Simon Bann, Susrutha K Wickremesekera
BACKGROUND: Infected pancreatic necrosis develops in approximately one third of patients with necrotizing pancreatitis and can lead to significant morbidity and mortality rates. Historically, open necrosectomy has been the mainstay of management for these patients but is in itself a morbid procedure. In recent times, minimally invasive techniques have evolved to allow a less invasive approach to these patients. Percutaneous catheter drainage of infected pancreatic necrosis is a technique that has been demonstrated to be potentially useful in the treatment of this group of patients...
September 19, 2016: Surgical Infections
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Phillip A Efron, Alicia M Mohr
BACKGROUND: Despite the excellent negative predictive value of sterile respiratory cultures, antibiotics often are continued after negative endotracheal aspirate (ETA) or bronchoalveolar lavage (BAL) for critically ill trauma patients. We hypothesized that persistent elevation of the Clinical Pulmonary Infection Score (CPIS) would predict continued antibiotic therapy after a negative respiratory culture for intubated trauma patients, and that prolonged antibiotics would provide no benefit...
September 16, 2016: Surgical Infections
Jeffrey G Chipman, Matthew R Rosengart, Nabil Issa, Patrick J O'Neill, Jeffrey S Upperman
Hospital-acquired infections, sepsis, and critically ill patients cost the healthcare system billions of dollars every year. Many factors contribute to these problems, and the remedies are multifactorial. Education is an important component in resolving many of the issues related to better combating the economic, social, and personal costs associated with surgical infections. The Surgical Infection Society (SIS) convened a symposium to begin a dialogue on how the SIS can facilitate a better understanding of how to educate the surgical infection professionals and trainees...
September 16, 2016: Surgical Infections
Brendan T Wanta, Amy E Glasgow, Elizabeth B Habermann, Daryl J Kor, Robert R Cima, Elie F Berbari, Timothy B Curry, Michael J Brown, Joseph A Hyder
BACKGROUND: Surgical site infections (SSI) contribute to surgical patients' morbidity and costs. Operating room traffic may be a modifiable risk factor for SSI. We investigated the impact of additional operating room personnel on the risk of superficial SSI (sSSI). PATIENTS AND METHODS: In this matched case-control study, cases included patients in whom sSSI developed in clean surgical incisions after elective, daytime operations. Control subjects were matched by age, gender, and procedure...
September 6, 2016: Surgical Infections
Xiuwen Wu, Weiliang Tian, Nejla Zeynep Kubilay, Jianan Ren, Jieshou Li
BACKGROUND: There is still uncertainty regarding the use of prophylactic drainage in abdominal surgical procedures. This meta-review aimed to summarize systematic reviews and meta-analyses evaluating abdominal drain placement in patients undergoing abdominal procedures, with a focus on surgical site infection and death from infections. METHODS: Systematic reviews and meta-analyses identified in MEDLINE, EMBASE, CINHAL, Cochrane Central Register of Controlled Trials, World Health Organization Regional Medical Databases, and African Index Medicus were reviewed...
August 11, 2016: Surgical Infections
Gilbert Bader, Mohammed Al-Tarawneh, James Myers
BACKGROUND: Prosthetic joint infection from Listeria monocytogenes is rare. We decided to shed light on this illness and review the reported cases to better understand its characteristics. PATIENTS AND METHODS: We conducted a comprehensive review of the English literature using PubMed. We also included one case that we had managed. RESULTS: We found 25 cases of prosthetic joint infection from L. monocytogenes reported individually and a retrospective study of 43 cases of joint and bone listerial infection, including 34 with prosthetic joint infection, conducted in France...
August 11, 2016: Surgical Infections
Kembu Nakamoto, Motohiro Takeshige, Toshiyuki Fujii, Hiroshi Hashiyada, Kazuya Yoshida, Sadahiro Kawamoto
BACKGROUND: The empyema space is refractory to elimination of bacterial colonization. Electrolyzed saline (ES) was used as intra-pleural irrigation for rapid disinfection of the empyema space. PATIENTS AND METHODS: Twenty consecutive patients with para-pneumonic empyema were reviewed in this study from 2007 to 2015. The empyema space was irrigated by miniaturized thoracoscopic surgery (mini VATS), and the efficacy and safety of the use of ES were evaluated. RESULTS: Sixteen patients were male and four were female, with a mean age of 66...
August 11, 2016: Surgical Infections
Brad S Oriel, Kamal M F Itani
BACKGROUND: Surgical site infections (SSI) remain a significant problem to both the patients and the healthcare system. Value care and standardized quality measures continue to promote improvement in surgical asepsis, but certain debates remain unresolved in the field of surgical hand antisepsis. METHODS: Review of relevant accounts and literature. RESULTS: Controversy has existed regarding the U.S. Food and Drug Administration (FDA)'s 1994 Tentative Final Monograph (TFM), which defined how surgical hand antisepsis products are assessed...
August 10, 2016: Surgical Infections
Hossein Mahmoudvand, Razieh Tavakoli Oliaei, Seyed Reza Mirbadie, Farnaz Kheirandish, Amir Tavakoli Kareshk, Behrouz Ezatpour, Hormoz Mahmoudvand
BACKGROUND: Current scolicidal agents, which have been used for inactivation of protoscoleces during surgical procedures, are associated with adverse side effects including sclerosing cholangitis. This investigation aimed to evaluate the scolicidal effects of Bunium persicum (Boiss) essential oil against protoscoleces of hydatid cysts and also its toxicity in a mice model. METHODS: Protoscoleces were aseptically aspirated from sheep livers having hydatid cysts. Various concentrations of the essential oil (3...
August 8, 2016: Surgical Infections
Jeffrey M Tessier, Billy Moore, Bradley Putty, Rajesh R Gandhi, Therese M Duane
BACKGROUND: Data on antimicrobial prophylaxis for open fractures is limited, with many protocols based on expert recommendations. These protocols include aminoglycosides (AGs) for fractures with significant soft tissue injury, but these drugs are associated with acute kidney injury (AKI) in other settings; this risk has not been defined for open fracture prophylaxis. METHODS: We performed a retrospective study from May 2012 to October 2014 at our Level 1 trauma center...
August 8, 2016: Surgical Infections
Milena Kerin Povšič, Alojz Ihan, Bojana Beovič
BACKGROUND: Colorectal cancer surgery is associated with a high incidence of post-operative infections, the outcome of which may be improved if diagnosed and treated early enough. We compared white blood cell (WBC) count, C-reactive protein (CRP), and procalcitonin (PCT) as predictors of post-operative infections and analyzed their impact on long-term survival. METHODS: This retrospective study included 186 patients undergoing colorectal surgery. Post-operative values of WBC, CRP, and PCT were analyzed by the receiver operating characteristic (ROC) analysis...
August 3, 2016: Surgical Infections
James M Sanders, Jeffrey M Tessier, Robert G Sawyer, Pam A Lipsett, Preston R Miller, Nicholas Namias, Patrick J O'Neill, E P Dellinger, Raul Coimbra, Chris A Guidry, Joseph Cuschieri, Kaysie L Banton, Charles H Cook, Billy J Moore, Therese M Duane
BACKGROUND: Management of complicated intra-abdominal infections (cIAIs) includes broad-spectrum antimicrobial coverage and commonly includes vancomycin for the empiric coverage of methicillin-resistant Staphylococcus aureus (MRSA). Ideally, culture-guided de-escalation follows to promote robust antimicrobial stewardship. This study assessed the impact and necessity of vancomycin in cIAI treatment regimens. PATIENTS AND METHODS: A post hoc analysis of the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial was performed...
August 2, 2016: Surgical Infections
Linda C Smit, Marjan J Bruins, Gijs A Patijn, Gijs J H M Ruijs
BACKGROUND: Major resections for esophageal, gastric, hepatic, pancreatic, and colorectal cancer continue to be associated with a high peri-operative morbidity of up to 30%-40%. To a large extent, this morbidity is caused by infectious complications that add up to a considerable burden to patients and hospital costs. The objective of this large retrospective cross-sectional study was to determine independent patient and operation-related risk factors for infectious complications after major abdominal cancer operations to elucidate how infection rates can be reduced and improve health-care quality...
August 2, 2016: Surgical Infections
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