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Management of surgical site infection

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https://www.readbyqxmd.com/read/27912036/failure-to-redose-antibiotic-prophylaxis-in-long-surgery-increases-risk-of-surgical-site-infection
#1
Nongyao Kasatpibal, Joanne D Whitney, E Patchen Dellinger, Bala G Nair, Kenneth C Pike
BACKGROUND: Antibiotic prophylaxis is a key component of the prevention of surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase the risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk. METHODS: A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2015 at the University of Washington Medical Center. Peri-operative data extracted from hospital databases included patient and operation characteristics, intra-operative medication and fluid administration, and survival outcome...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27910210/microbiological-evaluation-of-the-extension-wire-and-percutaneous-epidural-lead-anchor-site-following-a-2-stage-cut-down-spinal-cord-stimulator-procedure
#2
Abdul Ghaaliq Lalkhen, Mahindra Chincholkar, Jiten Patel
OBJECTIVES: There are concerns regarding bacterial colonization of the temporary extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary extension wire and percutaneous epidural lead anchor site. MATERIALS AND METHODS: We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27905650/-aseptic-techniques-for-minor-surgical-procedures
#3
Marcela Concha-Rogazy, Catalina Andrighetti-Ferrada, Maximiliano Curi-Tuma
Aseptic techniques are those practices designed to reduce the risk of surgical site infection (SSI), defined as such, all those that occur within the first 30 days of the procedure. While the patient’s risk of developing an SSI in dermatologic surgery is low since many of the procedures are considered sterile, there are different factors associated with an increased or decreased risk of developing SSI. The characteristics of the surgical wound (such as involving infected or inflamed tissue or when breaks in the aseptic technique occur), patient characteristics (such as age, comorbidities, medication use and smoking) and procedure factors (such as setting, surgical technique, type of procedure, duration and body region involved)...
August 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27904754/polymethylmethacrylate-imbedded-with-antibiotics-cranioplasty-an-infection-solution-for-moderate-and-large-defects-reconstruction
#4
Paulo Valdeci Worm, Tobias Ludwig do Nascimento, Fabricio do Couto Nicola, Eduardo Farias Sanches, Carlos Fernando Dos Santos Moreira, Luiz Pedro Willimann Rogério, Marcelo Martins Dos Reis, Guilherme Finger, Marcus Vinicius Martins Collares
BACKGROUND: In cases where autologous bone graft reconstruction is not possible (such as comminuted fractures, bone graft reabsorption, or infection) and the use of synthetic material is required, polymethylmethacrylate (PMMA) use is a safe and efficient solution. Studies comparing the incidence of postoperative complications between autologous and synthetic cranioplasty are heterogeneous, not allowing a conclusion of which is the best material for skull defects reconstruction. Current medical literature lacks prospective well-delineated studies with long-term follow-up that analyze the impact of antibiotic use in PMMA cranial reconstruction of moderate and large defects...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27896159/intestinal-atresia-experience-at-a-busy-center-of-north-west-india
#5
Shilpi Gupta, Rahul Gupta, Soumyodhriti Ghosh, Arun Kumar Gupta, Arvind Shukla, Vinita Chaturvedi, Praveen Mathur
Objective: To evaluate the presentation, management, complications and outcome of intestinal atresia (IA) managed at our center over a period of 1 year. Materials and methods: Records of patients of IA admitted in our center from January 2015 to December 2015 were retrospectively analyzed. Demographic data, antenatal history, presenting complaints, location (duodenal, jejunoileal, colonic) of atresia, surgery performed and peri-operative complications were noted. Results: Total 78 cases of IA were included in the analyses...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27895368/does-obesity-affects-early-infection-after-total-knee-arthroplasty-a-comparison-of-obese-vs-non-obese-patients
#6
Waseem Ahmed, Riaz Hussain Lakdawala, Yasir Mohib, Aurangzeb Qureshi, Rizwan Haroon Rashid
Surgical site infection (SSI) is a disastrous complication after total knee arthroplasty (TKA) which can cause prosthesis loosening and may end up in septicaemia. The incidence of infection reported to be in the range of 0.3-12.4% for primary TKA. Significantly higher infection rate is found in the morbidly obese patients. The current study compared the immediate rate of post-total knee replacement wound infection in the obese versus non-obese population. The cross-sectional study was conducted at Aga Khan University Hospital (AKUH) and comprised patients undergoing TKA for primary knee osteoarthritis...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894239/do-the-biologic-agents-increase-the-risk-of-infection-in-patients-undergoing-lower-limb-arthroplasty-surgery
#7
N A Sandiford
BACKGROUND: Biologic agents have contributed significantly to the management of patients with in rheumatoid arthritis (RA). A significant proportion of patients with RA still require arthroplasty procedures however. It is unclear whether these agents increase the risk of post operative infection after lower limb arthroplasty . The aim of this review is to review the contemporary literature about this topic along with the recommendations from specialist societies. METHOD: A literature search was performed for articles published over the last 10 years in the English language examining the association between anti-tumour necrosis factor inhibitors and the incidence of post operative infection in patients with RA undergoing hip and knee arthroplasty procedures...
November 27, 2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27879951/multidisciplinary-management-of-spontaneous-spinal-infections-there-is-a-correlation-between-timing-type-of-treatment-and-outcome-a-multivariate-analysis-of-an-observational-cohort-study
#8
Alessandro Landi, Alessandro DI Bartolomeo, Nicola Marotta, Giancarlo Iaiani, Maurizio Domenicucci, Massimo Chiara, Maurizio Salvati, Roberto Delfini
BACKGROUND: Spontaneous Spinal Infections SSI represent a rare and serious pathological entity. We've tried to study a correlation between type of treatment, timing of treatment and clinical outcome through a multivariate analysis of an observational cohort study with the aim to define what is the optimal clinico-therapeutic management. METHODS: We perform a retrospective observational cohort study on all consecutive patients observed in our Institute in a period of 13 years; From 2001 to 2014 we enrolled 50 consecutive patients with symptomatic spontaneous spinal infections (no previous surgery or recent infection in other site), confirmed with diagnostic imaging...
November 23, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27878812/perioperative-blood-transfusion-does-it-influence-survival-and-cancer-progression-in-metastatic-spine-tumor-surgery
#9
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Balamurugan Vellayappan, Naresh Kumar
BACKGROUND: Despite advances in surgical techniques for spinal metastases, there is often substantial blood loss, resulting in patients requiring blood transfusion during the perioperative period. Allogeneic blood transfusion (ABT) has been the main replenishment method for lost blood. However, the impact of ABT on cancer-related outcomes has been controversial in various studies. We aimed to evaluate the influence of perioperative ABT on disease progression and survival in patients undergoing metastatic spinal tumor surgery (MSTS)...
November 22, 2016: Transfusion
https://www.readbyqxmd.com/read/27875033/comparison-of-preoperative-hair-removal-methods-for-the-reduction-of-surgical-site-infections-a-meta-analysis
#10
REVIEW
Dingmei Shi, Yao Yao, Weifei Yu
AIMS AND OBJECTIVES: To evaluate the efficacy of different methods of preoperative hair removal in reducing surgical site infections (SSIs). BACKGROUND: Surgical site infections (SSIs) are a major source of morbidity and prolonged hospitalization following surgery. However, there is a lack of data regarding the impact of different preoperative hair removal techniques on the incidence of SSIs. DESIGN: A systematic literature review and meta-analysis...
November 22, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27873145/use-of-refrigerant-spray-of-a-propane-butane-isobutane-gas-mixture-in-the-management-of-keratocystic-odontogenic-tumors-a-preliminary-study
#11
Eduardo Luis de Souza Cruz, Ana Karla da Silva Tabosa, Aline Semblano Carreira Falcão, Talita Tartari, Lucas Machado de Menezes, Edmar Tavares da Costa, José Thiers Carneiro Júnior
PURPOSE: Keratocystic odontogenic tumor (KCOT) is an aggressive benign tumor and the management by complete enucleation followed by cryotherapy maintains the inorganic bone matrix, resulting in better repair and reduces the rates of recurrence. A refrigerant spray with a propane/butane/isobutane gas mixture has been pointed to as an alternative to liquid nitrogen, because the device is easy to handle and contain within the cavity, providing better control and lower risk of injury to the adjacent soft tissue...
November 21, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#12
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27834617/a-multi-center-review-of-care-patterns-and-outcomes-in-necrotizing-soft-tissue-infections
#13
Iris Faraklas, Derek Yang, Michael Eggerstedt, Yan Zhai, Patrick Liebel, Gareth Graves, Sharmila Dissanaike, Michael Mosier, Amalia Cochran
BACKGROUND: Surgical debridement and broad-spectrum empiric antibiotics are first-line therapy for necrotizing soft tissue infections (NSTI). The objective of this multi-center retrospective review was to evaluate antimicrobial agent initiation and duration and compare outcomes in the treatment of patients with NSTI. PATIENTS AND METHODS: This review included adults with NSTI, as indicated by International Classification of Diseases, 9th Edition, Clinical Modification codes 728...
November 11, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27825917/intraoperative-hypothermia-and-surgical-site-infections-in-patients-with-class-1-clean-wounds-a-case-control-study
#14
Michael J Brown, Timothy B Curry, Joseph A Hyder, Elie F Berbari, Mark J Truty, Darrell R Schroeder, Andrew C Hanson, Daryl J Kor
BACKGROUND: Numerous surgical quality metrics focus on prevention of unintentional perioperative hypothermia due, in part, to the association between hypothermia and surgical site infections (SSI). However, few studies have comprehensively evaluated the relationship between these metrics and SSI. In this study, we evaluated individual components of one set of hypothermia metrics to determine their association with SSI. METHODS: Patients with clean (Type 1) wounds who developed a SSI within thirty days after surgery from January 2003-December 2012 in one of five surgical specialties were matched to specialty specific controls without SSI...
November 4, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27823364/medical-management-of-spinal-epidural-empyema-in-five-dogs
#15
Susana R Monforte Monteiro, Antonella Gallucci, Nicolas Rousset, Paul M Freeman, Edward J Ives, Gualtiero Gandini, Nicolas Granger, An E Vanhaesebrouck
CASE DESCRIPTION 5 dogs were examined because of clinical signs of myelopathy, including signs of pain associated with the spinal region and rapidly progressive neurologic deficits. CLINICAL FINDINGS In all dogs, results of MRI were consistent with spinal epidural empyema. Concurrent infectious processes were identified at adjacent or distant sites in all dogs, including diskospondylitis, prostatitis, dermatitis, paraspinal infection following a penetrating injury, urinary tract infection, and pyothorax. Bacteria were isolated from 3 dogs; Escherichia coli was isolated from blood, urine, and prostatic wash samples from 1 dog; a Pasteurella sp was isolated from a percutaneous aspirate from an adjacent infected wound in a second dog; and a Corynebacterium sp was isolated from a thoracic fluid sample from a third dog...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27788801/ureteral-complications-in-kidney-transplantation-analysis-and-management-of-853-consecutive-laparoscopic-living-donor-nephrectomies-in-a-single-center
#16
Y S Choi, K S Kim, S W Choi, W J Bae, S H Hong, J Y Lee, J C Kim, S W Kim, B H Chung, C W Yang, J I Kim, I S Moon, H J Cho
BACKGROUND: We report the incidence and nature of ureteral and surgical complications in our series of 853 consecutive living-donor renal transplants after laparoscopic living-donor nephrectomy. The aim of this study was to analyze the therapeutic approaches to ureteral complications in kidney transplantations and their relationship with recipient outcome. METHODS: The medical records of patients who underwent kidney transplantation from 2000 to 2014 were reviewed retrospectively...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#17
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27785636/the-association-between-illicit-drug-use-and-infectious-complications-among-trauma-patients
#18
V Agrawal, J D Amos
Management of patients with traumatic injury is a complex endeavor requiring a concerted effort of multi-organ stabilization and prevention of septic shock. Given that traumatic injury is frequently mediated by illicit drug use, which has previously been associated with immune suppression, it is hypothesized that infectious complications may occur more prevalently in this patient population. In this study, we evaluate the incidence of infectious complications in trauma patients who screened positive for illicit drug abuse...
October 26, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27785630/single-incision-laparoscopic-transabdominal-preperitoneal-mesh-hernioplasty-results-in-182-japanese-patients
#19
K Tanoue, H Okino, M Kanazawa, K Ueno
BACKGROUND: We introduced single-incision transabdominal preperitoneal (S-TAPP) herniorrhaphy (described herein) at our institution in June 2010. We recently conducted a retrospective study to assess the feasibility and safety of the procedure. METHODS: The study involved 182 patients (159 men, 23 women) who underwent S-TAPP herniorrhaphy between June 2010 and February 2015 for 202 groin hernias (162 unilateral hernias, 20 bilateral hernias). We examined patient characteristics, hernia type and presentation, operation time, conversion to another repair procedure, intraoperative blood loss, postoperative pain, morbidities, and postoperative hospital stay...
October 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27779799/diagnosis-and-long-term-outcome-of-renal-cysts-after-laparoscopic-partial-nephrectomy-in-children
#20
Ciro Esposito, Maria Escolino, Bernardita Troncoso Solar, Roberta Iacona, Rosanna Esposito, Alessandro Settimi, Imran Mushtaq
OBJECTIVE: To document the imaging follow-up of laparoscopic partial nephrectomy (LPN) in children and to investigate the natural history of cystic lesions following LPN. PATIENTS AND METHODS: We reviewed the ultrasonography (US) imaging reports performed during the follow-up of 125 children (77 girls, 48 boys; mean age 3.2 years) who underwent LPN in two centres of paediatric surgery in the period 2005-2015. RESULTS: A transperitoneal approach was adopted in 83 children and a retroperitoneal approach in 42...
October 25, 2016: BJU International
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