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Management of surgical site infection

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https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#1
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
#2
C Anibueze, V Sankaran, U Sadat, K Tan, Y G Wilson, R E Brightwell, M S Delbridge, P W Stather
OBJECTIVE: 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 use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic haemorrhage, limb occlusion and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 19, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28625902/obesity-in-neurosurgery
#3
REVIEW
Mendel D Castle-Kirszbaum, Jin W Tee, Patrick Chan, Martin K Hunn
Obesity is an important consideration in neurosurgical practice. 28.3% of Australian adults are obese and it is estimated that over two-thirds of Australia's population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures demonstrated that, in patients undergoing spinal surgery, an increased BMI is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery and increased financial cost...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28623943/does-metabolic-syndrome-predict-surgical-complications-a-protocol-for-a-systematic-review-and-meta-analysis
#4
Philip Norris, Nicholas Ralph, Clint Moloney
BACKGROUND: Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations...
June 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28598758/management-of-fournier-s-gangrene-non-healing-wounds-by-autologous-skin-micrograft-biotechnology-a-new-technique
#5
M A Bocchiotti, P Bogetti, A Parisi, F Rivarossa, A Frenello, E A Baglioni
Fournier's gangrene is an acute bacterial infection producing necrosis of the perineum and external genitalia that generally affects elderly men. Although skin grafts and flaps are the standard procedure for reconstruction, sometimes wounds can become chronic. Rigenera Protocol is a new technique based on autologous skin micrografts that reactivates and supports wound healing. A 40-year-old male with Fournier's gangrene, due to a rectal microperforation following diarrhoea, was treated with surgical debridement, negative pressure wound therapy and subsequently coverage with skin grafts...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28594530/key-concepts-of-musculoskeletal-infection
#6
Scott B Rosenfeld, Lawson A Copley, Megan Mignemi, Thomas An, Michael Benvenuti, Jonathan Schoenecker
Over the past few decades, musculoskeletal infections have increased in both incidence and severity. The clinical manifestations of musculoskeletal infections range from isolated osteomyelitis to multisite infections with systemic complications. Although this increased incidence of musculoskeletal infections correlates with the increased incidence of methicillin-resistant Staphylococcus aureus infections, other nonresistant infectious organisms have been associated with severe musculoskeletal infections; this finding supports the likelihood that an antibiotic resistance profile is not a major factor in bacterial virulence...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28580210/immunosuppressive-medication-is-not-associated-with-surgical-site-infection-after-surgery-for-intractable-ulcerative-colitis-in-children
#7
Keiichi Uchida, Yoshikazu Ohtsuka, Atsushi Yoden, Hitoshi Tajiri, Hideaki Kimura, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Takeshi Tomomasa, Kosuke Ushijima, Tomoki Aomatsu, Satoru Nagata, Kohei Otake, Kohei Matsushita, Mikihiro Inoue, Takahiro Kudo, Kenji Hosoi, Kazuo Takeuchi, Toshiaki Shimizu
Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28571808/nanoparticle-loaded-biodegradable-light-responsive-in-situ-forming-injectable-implants-for-effective-peptide-delivery-to-the-posterior-segment-of-the-eye
#8
Rohit Bisht, Jagdish K Jaiswal, Ilva D Rupenthal
Diseases affecting the posterior segment the eye, such as age-related macular degeneration (AMD), are the leading cause of blindness worldwide. Conventional dosage forms, such as eye drops, have to surmount several elimination mechanisms and complex barriers to achieve therapeutic concentrations at the target site often resulting in low anterior segment bioavailability (ca. 2-5%) with generally none of the drug reaching posterior segment tissues. Thus, frequent intravitreal injections are currently required to treat retinal conditions which have been associated with poor patient compliance due to pain, risk of infection, hemorrhages, retinal detachment and high treatment related costs...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28541864/surgical-site-infection-rate-drops-to-0-using-a-vacuum-assisted-closure-in-contaminated-dirty-infected-laparotomy-wounds
#9
Gerardo Lozano-Balderas, Alejandro Ruiz-Velasco-Santacruz, José Antonio Díaz-Elizondo, Juan Antonio Gómez-Navarro, Eduardo Flores-Villalba
Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541808/executive-summary-of-the-american-college-of-surgeons-surgical-infection-society-surgical-site-infection-guidelines-2016-update
#10
Kristen A Ban, Joseph P Minei, Christine Laronga, Brian G Harbrecht, Eric H Jensen, Donald E Fry, Kamal M F Itani, E Patchen Dellinger, Clifford Y Ko, Therese M Duane
Guidelines regarding the prevention, detection, and management of surgical site infections (SSIs) have been published previously by a variety of organizations. The American College of Surgeons (ACS)/Surgical Infection Society (SIS) Surgical Site Infection (SSI) Guidelines 2016 Update is intended to update these guidelines based on the current literature and to provide a concise summary of relevant topics.
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28540473/innovative-use-of-single-incision-internal-fixation-of-distal-clavicle-fractures-augmented-with-coracoclavicular-stabilisation
#11
Rajpal Nandra, Tomasz Kowalski, Socrates Kalogrianitis
INTRODUCTION: The management of displaced fractures of the distal clavicle remains controversial, particularly in younger patients where there is no consensus as to which surgical intervention is best. Each surgical method has unique surgical complications and rates of persistent pain and post-traumatic arthritis. We report an innovative surgical technique using a plate fixation augmented with minimally invasive tension slide coracoclavicular fixation using a cortical tenodesis button (8...
May 24, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28540230/genital-tuberculosis-current-status-of-diagnosis-and-management
#12
REVIEW
Siddharth Yadav, Prabhjot Singh, Ashok Hemal, Rajeev Kumar
Genitourinary Tuberculosis (GUTB) is the second most common extra-pulmonary manifestation of tuberculosis (Tb) and an isolated involvement of genital organs is reported in 5-30% of the cases. Genital involvement results from primary reactivation of latent bacilli either in the epididymis or the prostate or by secondary spread from the already infected urinary organs. The epididymis are the commonest involved organs affected primarily by a hematogenous mode of spread. Tb is characterized by extensive destruction and fibrosis, thus an early diagnosis may prevent function and organ loss...
April 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#13
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#14
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28531930/in-reply-to-optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#15
https://www.readbyqxmd.com/read/28531929/optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#16
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#17
Alexander K Bartella, Mohammad Kamal, Jan Teichmann, Anita Kloss-Brandstätter, Timm Steiner, Frank Hölzle, Bernd Lethaus
OBJECTIVES: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. MATERIAL AND METHODS: In this prospective study 75 consecutive patients, who underwent major oncological head and neck surgery were included and divided in three groups, each containing 25 patients...
April 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#18
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28493210/in-search-of-the-optimal-wound-dressing-material-following-total-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#19
REVIEW
Gaurav Sharma, Sang Wook Lee, Oliver Atanacio, Javad Parvizi, Tae Kyun Kim
BACKGROUND: Various types of dressing materials are available for wound care following hip and knee arthroplasty. However, it is unclear if one material is more beneficial than the others in terms of wound complications and fluid handling capacity. RESEARCH QUESTIONS: We performed a meta-analysis of randomized controlled trials comparing alternative wound dressing materials for the post-operative management of wounds following THA and TKA with respect to (1) incidence of wound complications including infection and (2) fluid handling capacity...
May 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28491215/clinical-outcomes-of-posterior-spinal-stabilization-with-rigid-vertical-strut-and-spinal-process-wires-the-adeolu-s-technique-in-a-developing-country
#20
Taopheeq Bamidele Rabiu
INTRODUCTION: Conventional instrumentation for spinal stabilization is beyond the reach of many patients in developing countries. A low-cost and easily-available method of spinal stabilization using vertical struts and spinal process wires (Adeolu's technique) was recently introduced in Nigeria. We describe the clinical outcomes of a prospective series of patients managed using the technique. METHODS: From 2011 to 2012, we performed posterior spinal stabilization in eighteen patients using the technique...
2017: Pan African Medical Journal
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