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Management of surgical site infection

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https://www.readbyqxmd.com/read/29454569/risk-of-recurrence-following-mesh-associated-incisional-hernia-repair-using-the-retromuscular-technique-in-patients-with-relevant-medical-conditions
#1
Maciej Stodolski, Marios Papadakis, Hubert Zirngibl, Peter C Ambe
BACKGROUND: Incisional hernia is a common problem following open abdominal surgery. Hernia repair in patients with relevant medical conditions is a topic of controversy due to the high risk of morbidity and recurrence. We investigated the risk of recurrence in patients with relevant medical conditions managed with a prosthesis in the retromuscular position. METHODS: A retrospective review of the data of patients undergoing midline incisional hernia repair was performed...
February 14, 2018: Asian Journal of Surgery
https://www.readbyqxmd.com/read/29437528/impact-of-surgical-site-infections-on-elective-incisional-hernia-surgery-a-prospective-study
#2
Montserrat Juvany, Carlos Hoyuela, Miguel Trias, Fernando Carvajal, Jordi Ardid, Antoni Martrat
BACKGROUND: Although incisional hernia repair is classified as a clean surgery, it still has a high incidence of surgical site infection (SSI) (0.7%-26.6%). The presence of an SSI could increase early recurrence rates after incisional hernia repair. PATIENTS AND METHODS: Patients undergoing elective incisional hernia repair with no bowel contamination between January and December 2015 were assessed prospectively. Demographic and surgical data, local post-operative complications, and one-year recurrence rates in patients with and without SSI were compared...
February 13, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29437076/transcatheter-pulmonary-valve-replacement-in-patients-with-congenital-heart-disease
#3
Shantelle Bartra
Transcatheter pulmonary valve replacement is now a feasible alternative to surgical pulmonary valve replacement in children and adults with dysfunctional right ventricular outflow conduits. Currently, 2 types of valves can be used for this application. This article provides an overview of the procedure and how it is performed, indications and contraindications for transcatheter pulmonary valve replacement, and short- and long-term outcomes. Nursing considerations mainly focus on educating patients, preventing bleeding and infection, monitoring renal function, and preventing injury to the catheter insertion site...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29433463/scedosporium-apiospermum-infectious-scleritis-following-posterior-subtenon-triamcinolone-acetonide-injection-a-case-report-and-literature-review
#4
REVIEW
Daisuke Todokoro, Junki Hoshino, Ayaka Yo, Koichi Makimura, Junko Hirato, Hideo Akiyama
BACKGROUND: Ubiquitous fungi of the Scedosporium apiospermum species complex (SASC) cause various opportunistic infections. Posterior subtenon triamcinolone acetonide (STTA) injection is a standard therapy for intraocular inflammation and macular edema. We report a case of Scedosporium apiospermum infectious scleritis after a posterior STTA injection. CASE PRESENTATION: A 75-year-old man received a posterior STTA injection to treat macular edema in his left eye...
February 13, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29430494/elastic-stable-intramedullary-nailing-of-femoral-shaft-fracture-experience-in-48-children
#5
Rajesh Govindasamy, Ramkumar Gnanasundaram, Saravanan Kasirajan, Syed Ibrahim, Jimmy Joseph Melepuram
Background: Femoral shaft fractures are an incapacitating pediatric injury accounting for 1.6% of all pediatric bony injuries. Management of these fractures is largely directed by age, fracture pattern, associated injuries, built of the child and socioeconomic status of the family. We retrospectively evaluated the use of elastic stable intramedullary nail (ESIN) in surgical management of femoral shaft fractures in children and its complications. Methods: Fifty two children were treated with titanium elastic nails (TEN) from June 2009 to June 2014 at our institution...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29429064/a-call-for-standardization-of-wound-events-reporting-following-ventral-hernia-repair
#6
I N Haskins, C M Horne, D M Krpata, A S Prabhu, L Tastaldi, Arielle J Perez, S Rosenblatt, B K Poulose, M J Rosen
INTRODUCTION: Postoperative wound events following ventral hernia repair are an important outcome measure. While efforts have been made by hernia surgeons to identify and address risk factors for postoperative wound events following VHR, the definition of these events lacks standardization. Therefore, the purpose of our study was to detail the variability of wound event definitions in recent ventral hernia literature and to propose standardized definitions for postoperative wound events following VHR...
February 10, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29428980/bone-flap-salvage-in-acute-surgical-site-infection-after-craniotomy-for-tumor-resection
#7
David J Wallace, Michael J McGinity, John R Floyd
Craniotomy surgical site infections are an inherent risk and dreaded complication for the elective brain tumor patient. Sequelae can include delays in resumption in adjuvant treatments for multiple surgeries if staged cranioplasty is pursued. Here, the authors review their experience in operative debridement of surgical site infections with single-stage reimplantation of the salvaged craniotomy bone flap. A prospectively maintained database of a single surgeon's neuro-oncology patients from 2009 to 2017 (JRF) was queried to identify 11 patients with surgical site infection after craniotomy for tumor resection...
February 10, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29422171/strict-versus-liberal-insulin-therapy-in-the-cardiac-surgery-patient-an-evidence-based-practice-development-implementation-and-evaluation-project
#8
Jacqueline M Gordon, Lori S Lauver, Harleah G Buck
BACKGROUND: Hyperglycemia post-cardiac surgery is associated with poor clinical outcomes. Recent studies suggest maintaining liberal glycemic control (<180mg/dL) using a continuous insulin infusion (CII) versus strict control achieves optimal outcomes and prevents hypoglycemia. PURPOSE: To develop, implement and evaluate a nurse managed liberal CII protocol. METHODS: Retrospective review of 144 strict CII patient records and 147 liberal CII patient records...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29422033/a-case-report-of-tubo-ovarian-abscess-caused-by-burkholderia-pseudomallei
#9
Pattaranit Nernsai, Areepan Sophonsritsuk, Srithean Lertvikool, Artit Jinawath, Maria Nina Chitasombat
BACKGROUND: Melioidosis, the disease caused by Burkholderia pseudomallei is endemic in the Northeastern part of Thailand, South-East Asia, and Northern Australia. The pelvic involvement of disease is rare even in an endemic area. Therefore, we describe in this report the clinical presentation, management, and outcome of the patient with primary tubo-ovarian abscess due to melioidosis. CASE PRESENTATION: A 31-year-old Thai cassava farmer woman presented with fever and abdominal pain at left lower quadrant for one month...
February 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29421969/management-and-outcome-of-prosthetic-vascular-graft-infections-a-single-center-experience
#10
Maxime Elens, Muzhakkir Dusoruth, Parla Astarci, Stefano Mastrobuoni, Michel J Bosiers, Jane Nardella, Valérie Lacroix, Julien Possoz, Robert Verhelst
BACKGROUND: Prosthetic vascular graft infection (PVGI) remains a severe and challenging complication in vascular surgery with high morbidity and mortality rates. Incidence has been reported between 1% and 6%. The aim of this study was to report our experience in terms of general and surgical management as well as outcome, over 15 years. METHODS: A retrospective consecutive study was conducted of all patients treated in our department for PVGI between January 2000 and December 2015...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29417348/perioperative-management-of-external-fixation-in-staged-protocols-an-international-survey
#11
Sandro Hodel, Björn-Christian Link, Reto Babst, W H Mallee, Philippe Posso, Frank J P Beeres
INTRODUCTION: Despite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities. MATERIALS AND METHODS: A 26-question survey was sent to 170 members of the Traumaplatform...
February 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29409414/postoperative-infection-related-with-the-total-elbow-arthroplasty-kudo-s-prosthesis-in-rheumatoid-arthritis
#12
Michio Minami, Makoto Kondo, Yasuhiko Nishio, Koji Suzuki, Sadatoshi Kato, Sumito Kawamura, Hiroyuki Kato, Akio Minami
BACKGROUND: Total Elbow Arthroplasty (TEA) for the rheumatoid arthritis (RA) has been popularized since 1980s. The outcomes of TEA using any type of implant design for RA has been satisfactory. On the other hand, many orthopedicians experience several postoperative complications. Among them, postoperative infection has still being the most troublesome and difficult to treat. This study is to clarify the causes of postoperative infection of TEA using Kudo's prosthesis for RA and discuss how to manage and prevent infection...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29406579/intraoperative-interventions-for-preventing-surgical-site-infection-an-overview-of-cochrane-reviews
#13
REVIEW
Zhenmi Liu, Jo C Dumville, Gill Norman, Maggie J Westby, Jane Blazeby, Emma McFarlane, Nicky J Welton, Louise O'Connor, Julie Cawthorne, Ryan P George, Emma J Crosbie, Amber D Rithalia, Hung-Yuan Cheng
BACKGROUND: Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro-organisms into incisions; and optimising the patient's own bodily functions to promote best recovery...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29401188/hospital-variation-in-mortality-after-emergency-bowel-resections-the-role-of-failure-to-rescue
#14
Ambar Mehta, David Efron, Kent Stevens, Mariuxi C Manukyan, Bellal Joseph, Joseph V Sakran
INTRODUCTION: Hospital variation in failure-to-rescue (FTR) rates has partially explained nationwide differences in mortality after elective surgeries. To examine the role of FTR among emergency general surgery, we compared nationwide risk-adjusted mortality, complications, and FTR rates after emergent bowel resections. METHODS: We identified patients who underwent emergent small or large bowel resections in the 2010-2011 Nationwide Inpatient Sample using the American Association for the Surgery of Trauma criteria...
February 3, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29395446/management-of-self-inflicted-gunshot-wounds-to-the-face-retrospective-review-from-a-single-tertiary-care-trauma-centre
#15
J A Murphy, S R McWilliams, M Lee, G Warburton
There are limited published data about the surgical management of self-inflicted facial gunshot wounds. The aim of this retrospective study was to review our management of subjects who initially survive such a wound and were admitted to a tertiary care trauma centre between 2002 and 2012. Only subjects with definitive evidence of a self-inflicted facial gunshot wound and who were admitted alive were included. Data collected included personal and clinical details, characteristics of the gunshot wound, and medical and surgical management...
January 27, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29391097/the-growing-utilization-of-laparoscopy-in-emergent-colonic-disease
#16
Sarath Sujatha-Bhaskar, Reza F Alizadeh, Christina Koh, Colette Inaba, Mehraneh D Jafari, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
Emergent colonic disease has traditionally been managed with open procedures. Evaluation of recent trends suggests a shift toward minimally invasive techniques in this disease setting. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2014 was used to examine clinical data from patients who emergently underwent open colectomy (OC) and laparoscopic colectomy (LC). Multivariate regression was utilized to analyze preoperative characteristics and determine risk-adjusted outcomes with intent-to-treat and as-treated approach...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29387302/systemic-preoperative-antibiotics-with-mandible-fractures-are-they-indicated-at-the-time-of-injury
#17
Andrew D Linkugel, Elizabeth B Odom, Rebecca A Bavolek, Alison K Snyder-Warwick, Kamlesh B Patel
Mandible fractures are the most common result of facial trauma. The proximity of oral flora to the site of both the injury and resulting surgical instrumentation makes managing infection a unique challenge. The benefit of antibiotic prophylaxis at the time of surgical treatment of mandible fractures is well established. However, the routine use of antibiotics between the time of injury and surgery is of unclear benefit. We aim to define the role of antibiotics in the preoperative period: from the time of injury to surgical intervention...
March 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29382247/antibiotic-loaded-cement-spacers-lessons-learned-from-the-past-20-years
#18
Konstantinos Anagnostakos, Bernd Fink
The use of antibiotic-impregnated cement spacers is an established method in the treatment of periprosthetic hip and knee joint infections. Over the past 20 years, the indications for spacer implantation have expanded, and various modified surgical techniques have been proposed to manage difficult anatomical situations. To ensure clinical success, knowledge about the cement impregnation and the pharmacokinetic properties of antibiotic-loaded bone cement is an indispensable premise. Areas covered: In this review, techniques for the fabrication of cement spacers, the incorporation of antibiotics into bone cement, elution kinetics, the clinical performance of spacers, individualized surgical techniques as well as possible postoperative complications are presented...
March 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29356798/staged-prone-supine-fixation-of-high-energy-multicolumnar-tibial-plateau-fractures-a-multicenter-analysis
#19
Elliot R Row, Stephen Kottmeier, David E Komatsu, John T Watson, Clifford Jones
PURPOSE: We present a surgical strategy to manage multicolumnar tibial plateau fracture variants by addressing the predominant posterior fragment employing a Lobenhoffer approach in the prone position followed by supine patient repositioning for anterolateral column access. DESIGN: Multicenter retrospective analysis. SETTING: Three academic Level 1 trauma centers. PATIENTS/METHODS: Twenty-eight cases (28 patients/28 knees) met inclusion criteria between 2003 and 2014...
January 5, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29356190/decreased-superficial-surgical-site-infections-shortened-hospital-stay-and-improved-quality-of-live-due-to-incisional-negative-pressure-wound-therapy-after-reversal-of-double-loop-ileostomy-improved-wound-healing-due-to-incisional-negative-pressure-wound-therapy
#20
Daniel Poehnert, Nils Hadeler, Harald Schrem, Alexander Kaltenborn, Juergen Klempnauer, Markus Winny
This single-center prospective, controlled observational study investigates the impact of incisional negative pressure wound therapy on wound healing processes and its potency to prevent superficial surgical site infections after reversal of a double loop ileostomy. Furthermore, this study gains insight in socio-economic aspects, like duration of hospital stay and, for the first time, patient's quality of life during the incisional negative pressure wound treatment. To address this question, an interventional group of 24 patients treated with incisional negative pressure wound therapy (Prevena® incisional wound management system, KCI, Germany) and a respective control cohort of 25 patients treated with a standard sterile dressing were observed for 30 days in the post-operative course...
January 22, 2018: Wound Repair and Regeneration
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