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Management of surgical site infection

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https://www.readbyqxmd.com/read/28729881/outcomes-following-repair-of-incarcerated-and-strangulated-ventral-hernias-with-or-without-synthetic-mesh
#1
Sameh Hany Emile, Hesham Elgendy, Ahmad Sakr, Waleed Ahmed Gado, Ahmed Aly Abdelmawla, Mahmoud Abdelnaby, Alaa Magdy
BACKGROUND: The use of synthetic mesh for ventral hernia repair under contaminated conditions is a controversial issue due to the considerable risk of surgical site infection (SSI). This study aimed to review the outcomes of repair of incarcerated and strangulated ventral hernias with or without synthetic mesh in compliance with established clinical guidelines regarding the incidence of SSI and hernia recurrence. METHODS: The records of patients with complicated ventral hernias who were treated with or without synthetic mesh repair were reviewed...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28727471/cutting-edge-implant-rehabilitation-design-and-management-a-tapered-abutment-approach
#2
Mark Bishara, Gregori M Kurtzman
Immediate implant placement can pose challenges surgically and, ultimately, restoratively. Yet immediate placement has become the standard when adequate bone is present to achieve primary stability and site infection is minimal. To avoid prosthetic complications and ensure the implant is encased in bone after healing, proper planning must consider that implant placement does not necessarily need to follow the trajectory of the root socket. As discussed in this article, maxillary anterior sites have potential issues related to the "triangle of bone" that are not encountered in molar sites and demand different approaches to ensure treatment success...
July 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/28727229/volatile-organic-compound-detection-as-a-potential-means-of-diagnosing-cutaneous-wound-infections
#3
Mohammed Ashrafi, Matt Bates, Mohamed Baguneid, Teresa Alonso-Rasgado, Riina Rautemaa-Richardson, Ardeshir Bayat
Chronic cutaneous wound infections and surgical site infections (SSIs) present a huge burden on the healthcare system and can lead to increased morbidity and mortality. Current diagnostic methods of identifying and confirming infection involve culture-based and molecular methods. Both techniques are time consuming and delays commonly lead to un-targeted empirical treatment. An ideal diagnostic method would be non-invasive and highly sensitive and detect pathogenic organisms with a high degree of accuracy in order to allow targeted treatment...
July 20, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28726312/spinal-cord-stimulator-related-infections-findings-from-a-multicenter-retrospective-analysis-of-2737-implants
#4
Markus A Bendel, Travis O'Brien, Bryan C Hoelzer, Timothy R Deer, Thomas P Pittelkow, Shrif Costandi, David R Walega, Gerges Azer, Salim M Hayek, Zhen Wang, Jason S Eldrige, Wenchun Qu, Joshua M Rosenow, Steven M Falowski, Stephanie A Neuman, Susan M Moeschler, Catherine Wassef, Christopher Kim, Tariq Niazi, Taher Saifullah, Brian Yee, Chong Kim, Christine L Oryhan, Daniel T Warren, Imanuel Lerman, Ruben Mora, Michael Hanes, Thomas Simopoulos, Sanjiv Sharma, Chris Gilligan, Warren Grace, Timothy Ade, Nagy A Mekhail, John P Hunter, Daniel Choi, Deborah Y Choi
INTRODUCTION: Surgical site infection is a potential complication of spinal cord stimulator (SCS) implantation. Current understanding of the epidemiology, diagnosis, and treatment of these infections is based largely on small clinical studies, many of which are outdated. Evidence-based guidelines for management of SCS-related infections thus rely instead on expert opinion, case reports, and case series. In this study, we aim to provide a large scale retrospective study of infection management techniques specifically for SCS implantation...
July 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28721771/picture-this-photos-improve-wound-management
#5
Elaine Cole
Harefield Hospital's clinical nurse specialist in surveillance Melissa Rochon introduced Photo at Discharge (PaD) to reduce the impact of surgical site infections (SSIs).
July 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#6
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28708024/quality-improvement-initiative-preventative-surgical-site-infection-protocol-in-vascular-surgery
#7
David Parizh, Enrico Ascher, Syed Ali Raza Rizvi, Anil Hingorani, Michael Amaturo, Eric Johnson
Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. SUMMARY BACKGROUND DATA: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28693849/impact-of-outpatient-management-following-appendectomy-for-acute-appendicitis-an-acs-nsqip-p-analysis
#8
Cristen N Litz, Laurie Stone, Roberta Alessi, Nebbie E Walford, Paul D Danielson, Nicole M Chandler
BACKGROUND: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. METHODS: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes...
June 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28684934/considerations-in-stoma-reversal
#9
REVIEW
Karen L Sherman, Steven D Wexner
Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28677576/methods-to-reduce-postoperative-surgical-site-infections-after-head-and-neck-oncology-surgery
#10
REVIEW
Richard B Cannon, Jeffrey J Houlton, Eduardo Mendez, Neal D Futran
Head and neck cancer surgery is often a complex multi-step procedure that includes major resections, vascularised tissue reconstruction, and extensive neck dissection. The upper aerodigestive tract mucosal lining is often disrupted during surgery, which requires the management of a clean-contaminated field and the need to reconstruct the mucosal lining. With bacterial contamination, surgical site infections (SSI) are a serious complication that can result in delayed wound healing, wound breakdown, fistula formation, and compromised tissue reconstruction...
July 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28671743/a-case-of-spinal-cord-stimulator-recharging-interruption-in-wound-healing
#11
Semih Gungor, Rohit Aiyer
OBJECTIVES: To illustrate the obstacles and problems with electrical fields (EFs) in treatment and management of skin wounds. Unlike the literature that gives evidence for EF promoting wound healing, there is relatively little research to illustrate the interference of wound healing with EFs. MATERIALS AND METHODS: This is a case report of a patient who underwent spinal cord stimulator implantation, and presented with delayed wound healing postoperatively. Postoperative workup for infection was negative...
July 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#12
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28658843/anatrophic-nephrolithotomy-in-the-management-of-large-staghorn-calculi-a-single-centre-experience
#13
Ramaiah Keshavamurthy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Jayaram Sreenivas, Girish Gurubasappa Nelivigi, Ananth Janarthan Kamath
INTRODUCTION: With advances in endourology, open stone surgery for staghorn calculi has markedly diminished. Anatrophic Nephrolithotomy (AN) is performed for complex staghorn stones which cannot be cleared by a reasonable number of Percutaneous Nephrolithotomy (PNL) attempts. AIM: To assess the indications and outcomes of AN in the modern era. MATERIALS AND METHODS: Between April 2008 and July 2015, AN was done in 14 renal units in 13 patients...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658756/unusual-severe-extra-intestinal-manifestations-of-a-common-enteric-pathogen-aeromonas-spp
#14
Barnini Banerjee, Mridula Madiyal, Lingadakai Ramchandra, Chiranjay Mukhopadhyay, Rahul Garg, Kiran Chawla
INTRODUCTION: Aeromonas spp. are halophilic, Gram-negative bacilli. They are widely distributed in the soil and aquatic environment and have been associated with various extra-intestinal infections, such as skin and soft-tissue infections, meningitis, bacteraemia etc. The most common species associated with extra-intestinal infection is Aeromonas hydrophila. AIM: To get the overview of clinical presentations, underlying predisposing factors associated with the extra-intestinal infections caused by Aeromonas species and their antimicrobial susceptibility pattern...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28657870/a-placebo-controlled-trial-of-antibiotics-for-smaller-skin-abscesses
#15
RANDOMIZED CONTROLLED TRIAL
Robert S Daum, Loren G Miller, Lilly Immergluck, Stephanie Fritz, C Buddy Creech, David Young, Neha Kumar, Michele Downing, Stephanie Pettibone, Rebecca Hoagland, Samantha J Eells, Mary G Boyle, Trisha Chan Parker, Henry F Chambers
BACKGROUND: Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear. METHODS: We conducted a multicenter, prospective, double-blind trial involving outpatient adults and children. Patients were stratified according to the presence of a surgically drainable abscess, abscess size, the number of sites of skin infection, and the presence of nonpurulent cellulitis...
June 29, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28654543/extended-versus-narrow-spectrum-antibiotics-in-the-management-of-uncomplicated-appendicitis-in-children-a-propensity-matched-comparative-effectiveness-study
#16
Danielle B Cameron, Patrice Melvin, Dionne A Graham, Charity C Glass, Stephanie K Serres, Matthew P Kronman, Jacqueline M Saito, Shawn J Rangel
OBJECTIVE: The aim of this study was to compare the effectiveness of extended versus narrow spectrum antibiotics in preventing surgical site infections (SSIs) and hospital revisits in children with uncomplicated appendicitis. SUMMARY OF BACKGROUND DATA: There is a paucity of high-quality evidence in the pediatric literature comparing the effectiveness of extended versus narrow-spectrum antibiotics in the prevention of SSIs associated with uncomplicated appendicitis...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28654355/a-prognostic-scoring-tool-for-cesarean-organ-space-surgical-site-infections-derivation-and-internal-validation
#17
Srisuda Assawapalanggool, Nongyao Kasatpibal, Supatra Sirichotiyakul, Rajin Arora, Watcharin Suntornlimsiri
BACKGROUND: Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. METHODS: Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool...
June 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28652788/economic-and-organizational-sustainability-of-a-negative-pressure-portable-device-for-the-prevention-of-surgical-site-complications
#18
Emanuela Foglia, Lucrezia Ferrario, Elisabetta Garagiola, Giuseppe Signoriello, Gianluca Pellino, Davide Croce, Silvestro Canonico
PURPOSE: Surgical-site complications (SSCs) affect patients' clinical pathway, prolonging their hospitalization and incrementing their management costs. The present study aimed to assess the economic and organizational implications of a portable device for negative-pressure wound therapy (NPWT) implementation, compared with the administration of pharmacological therapies alone for preventing surgical complications in patients undergoing general, cardiac, obstetrical-gynecological, or orthopedic surgical procedures...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#19
Martin J A Dahlberg, Emil H A Pieniowski, Lennart Å S Boström
Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014...
June 24, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#20
Chukwudubem Anibueze, Visesh Sankaran, Umar Sadat, Kelvin Tan, Yvonne G Wilson, Robert E Brightwell, Michael S Delbridge, Philip W Stather
BACKGROUND: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra-anatomical bypass grafting; however, the use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic hemorrhage, limb occlusion, and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 20, 2017: Annals of Vascular Surgery
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