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Management of surgical site infection

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https://www.readbyqxmd.com/read/29232685/surgical-management-of-deep-brain-stimulator-scalp-erosion-without-hardware-removal
#1
Michael D Staudt, Navid Pourtaheri, Gregory E Lakin, Hooman T Soltanian, Jonathan P Miller
BACKGROUND: Scalp erosion in patients with deep brain stimulation (DBS) hardware is an uncommon complication that lacks a clearly defined management strategy. Previous studies have described various therapies including conservative treatment with antibiotics and surgical debridement with or without hardware removal. OBJECTIVES: The aim of this study was to review the efficacy of a hardware-sparing management strategy for the treatment of scalp erosion. METHODS: Five patients with previous DBS implantation presented with scalp erosion and visible hardware exposure at the calvarial burr hole site, and underwent tension-free, vascularized, rotational scalp flap, with preservation of the leads under the pericranium...
December 13, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29227854/surgical-intervention-in-a-complicated-persistent-chyle-leak
#2
Bradley Curtis Tenny, Jeko Madjarov, Travis Shipe
INTRODUCTION: Chyle leak following cervical surgery has a reported incidence of around 2% annually, and the injury primarily favors a left sided involvement. Our patient presented with a right sided neck persistent chyle leak status post cervical neck dissection and radiation therapy. Infection complicated the patient's clinical course, and he inevitably required a right sided VATS thoracic duct ligation. PRESENTATION OF CASE: The patient was a 53-year-old African American male, with a past medical history of T1N0 right tonsil carcinoma status post chemo-radiation in 2016...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29214396/triple-management-of-cubitus-valgus-deformity-complicating-neglected-nonunion-of-fractures-of-lateral-humeral-condyle-in-children-a-case-series
#3
Yasser Abed, Khaled Nour, Yasser Roshdy Kandil, Abed El-Negery
BACKGROUND: Long standing nonunion of the lateral humeral condyle (LHC) usually results in elbow pain and instability with progressive cubitus valgus and tardy ulnar neuritis. Surgical treatment of long standing nonunion is still a controversial issue due to the reported complications, such as stiffness, loss of elbow motion, and avascular necrosis of the LHC fragment. In this study, we reported the outcomes of treatment of cubitus valgus deformity in long standing nonunion of the LHC in children treated with combined triple management (fixation of the nonunion site, dome corrective osteotomy, and anterior transposition of ulnar nerve) through a modified para-triceptal approach...
December 6, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29191213/modified-pedicle-screw-rod-fixation-versus-anterior-pelvic-external-fixation-for-the-management-of-anterior-pelvic-ring-fractures-a-comparative-study
#4
Chun Bi, Qiugen Wang, Jianhong Wu, Feng Zhou, Fei Zhang, Haipeng Liang, Fei Lyu, Jiandong Wang
BACKGROUND: Anterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture. METHODS: Either modified pedicle screw-rod fixation (modified PSRF group, N = 21) or anterior pelvic external fixation (APEF group, N = 22) was performed to 43 patients, with or without fixation of posterior ring...
December 1, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29191009/prediction-of-broad-spectrum-pathogen-attachment-to-coating-materials-for-biomedical-devices
#5
Paulius Mikulskis, Andrew L Hook, Adam Dundas, Derek J Irvine, Olutoba Sanni, Daniel G Anderson, Robert Langer, Morgan Russell Alexander, Paul Williams, David A Winkler
Bacterial infections in healthcare settings are a frequent accompaniment to both routine procedures such as catheterization and surgical site interventions. Their impact is becoming even more marked as the numbers of medical devices that are used to manage chronic health conditions and improve quality of life increases. The resistance of pathogens to multiple antibiotics is also increasing, adding an additional layer of complexity to the problems of employing safe and effective medical procedures. One approach to reducing the rate of infections associated with implanted and indwelling medical devices is the use of polymers that resist the formation of bacterial biofilms...
December 1, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29188131/an-outbreak-of-pseudomonas-aeruginosa-infection-linked-to-a-black-friday-piercing-event
#6
Peter MacPherson, Katherine Valentine, Victoria Chadderton, Evdokia Dardamissis, Ian Doig, Andrew Fox, Sam Ghebrehewet, Tom Hampton, Ken Mutton, Claire Sherratt, Catherine M McCann
Introduction: Outbreaks linked to cosmetic piercing are rare, but can cause significant illness. We report the investigation and management of a point-source outbreak that occurred during a Black Friday promotional event in North West England. Methods: Outbreak investigation was led by Public Health England, and included active case finding among individuals pierced at a piercing premises between 25/11/2016 (Black Friday) and 7/12/2016. Detailed epidemiological, environmental (including inspection and sampling), and microbiological investigation was undertaken...
October 16, 2017: PLoS Currents
https://www.readbyqxmd.com/read/29174454/closed-incision-negative-pressure-therapy-decreases-complications-after-periprosthetic-fracture-surgery-around-the-hip-and-knee
#7
H John Cooper, Gilbert C Roc, Marcel A Bas, Zachary P Berliner, Matthew S Hepinstall, José A Rodriguez, Lon S Weiner
INTRODUCTION: Periprosthetic fractures (PPFXs) are becoming increasingly common following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients sustaining PPFXs face considerable perioperative morbidity, with relatively increased rates of surgical site infection. We sought to evaluate the efficacy of closed-incision negative-pressure wound therapy (ciNPT) in decreasing perioperative wound complications following lower extremity periprosthetic fracture surgery. METHODS: We performed a retrospective review of 69 consecutive patients who underwent surgery to address lower extremity periprosthetic fractures around hip or knee implants performed over a 6...
November 14, 2017: Injury
https://www.readbyqxmd.com/read/29169546/telehealth-electronic-monitoring-to-reduce-postdischarge-complications-and-surgical-site-infections-after-arterial-revascularization-with-groin-incision
#8
RANDOMIZED CONTROLLED TRIAL
Albeir Y Mousa, Mike Broce, Elaine Davis, Barbara McKee, Michael Yacoub
It is intuitive that postdischarge surgical complications are associated with increased patient dissatisfaction, and are directly associated with an increase in medical expenditures. It is also easy to make the connection that many post-hospital discharge surgical complications, including surgical site infections (SSIs), could be influenced or exacerbated by patient comorbidities. The authors of a recent study reported that female gender, obesity, diabetes, smoking, hypertension, coronary artery disease, critical limb ischemia, chronic obstructive pulmonary disease, dyspnea, and neurologic disease were significant predictors of SSIs after vascular reconstruction was performed...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29169301/utilization-of-stent-grafts-in-the-management-of-arteriovenous-access-pseudoaneurysms
#9
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective Endovascular stent graft repair for exclusion of pseudoaneurysm is currently being explored to replace open surgical repair as current management. The objective of the study was to evaluate the clinical safety and efficacy of endovascular stent graft intervention in pseudoaneurysms complicating arteriovenous reconstructions in patients on chronic hemodialysis. Methods A retrospective analysis of all pseudoaneurysms treated with stent grafts at our institution over a period of five years was performed...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29168673/the-role-of-dalbavancin-in-the-multi-disciplinary-management-of-wound-infections-in-orthopaedic-surgery
#10
Fabio Arena, Emilio Romanini, Elia Rosi, Carlo Salomone, Gabriele Tucci, Ciro Pempinello, Massimo Fantoni
Antimicrobial resistance is continuously increasing among bacterial clinical isolates (especially methicillin resistance in Staphylococcus aureus, MRSA), negatively impacting on outcomes of patients with Surgical Site Infections (SSIs). A multi-disciplinary team work is essential for SSIs prevention and for the choice of antibiotic therapy of orthopaedic SSIs. In particular, an Antibiotic Stewardship (AS) approach is recommended for preserving the activity of old and new antimicrobials. Dalbavancin is a novel antimicrobial agent, belonging to the lipoglycopeptides family, recently approved by FDA for the treatment of ABSSSIs (Acute Bacterial Skin and Skin Structure Infections) and can be considered as a candidate for the treatment of orthopaedic superficial SSIs...
November 23, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/29162242/current-concepts-in-spondylopelvic-dissociation
#11
REVIEW
André Luiz Loyelo Barcellos, Vinícius M da Rocha, João Antonio Matheus Guimarães
INTRODUCTION: Spondylopelvic dissociation is an uncommon and complex injury that results from high-energy trauma with axial overloading through the sacrum. Due to the life-threatening nature of these injuries, standard Advanced Trauma Life Support® (ATLS) protocol must be used in the trauma setting as part of the initial management of these patients. The key to diagnosis is a good physical exam coupled with high level of suspicion. Radicular neurological deficits commonly are present in spondylopelvic dissociation (L5's roots) and should be documented for future evaluations...
November 2017: Injury
https://www.readbyqxmd.com/read/29158030/the-role-of-ayurveda-management-in-preventing-surgical-site-infections-instead-of-surgical-antibiotic-prophylaxis
#12
Subhash Yadav, Sanjay Jain, Jatinder Chaudhary, Rahul Bansal, Manoj Sharma
It is probably for the first time in the history of modern surgery that Benign Prostate Hyperplasia (BPH) surgery which belongs to 'clean contaminated' class and requires at least 3 doses of prophylactic antibiotic as per recommendations by American Urology Association, was done without the use of any as the patient had a history of severe intolerance to them. The case was an 83 year old male patient presenting with acute urinary retention. He was a known case of BPH being managed continuously on Ayurvedic therapy for many years...
November 17, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/29155250/surgical-management-of-acute-appendicitis-in-adults-a-review-of-current-techniques
#13
REVIEW
Maximilian Sohn, Ayman Agha, Stefan Bremer, Kai S Lehmann, Marcus Bormann, Alfred Hochrein
Acute appendicitis is one of the most frequent disorders in abdominal surgery. Therefore, appendectomy is a matter of significant interest in that field. Yet, four different techniques are available: open appendectomy, (conventional) laparoscopic appendectomy, single port laparoscopic appendectomy and NOTES-appendectomy with its different variations. To evaluate the current state of the art in appendectomy a bibliographic search was conducted. All prospectively randomized trials and national register cohort studies published between 1/2010 and 5/2016 were included into the analysis...
November 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29149456/effect-of-a-thermal-care-bundle-on-the-prevention-detection-and-treatment-of-perioperative-inadvertent-hypothermia
#14
Jed Duff, Kim Walker, Karen-Leigh Edward, Nicholas Ralph, Jo-Ann Giandinoto, Kimberley Alexander, Jeffrey Gow, John Stephenson
AIMS AND OBJECTIVES: To improve the prevention, detection, and treatment of perioperative inadvertent hypothermia (PIH) in adult surgical patients by implementing a Thermal Care Bundle. BACKGROUND: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections, and morbid cardiac events. The Thermal Care Bundle consists of three elements: 1) assess risk; 2) record temperature; and (3) actively warm...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#15
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29142557/outcome-of-burr-hole-aspiration-of-brain-abscess
#16
Shakeel Ahmad, Lal Rehman, Ali Afzal, Raza Rizvi
Objective: To determine the clinical outcome of burr-hole aspiration of brain abscess. Methods: We analyzed 100 cases of intracranial abscess, treated surgically from January 2015 and October 2016 at Jinnah Postgraduate Medical Centre (JPMC). All patients were treated with burr hole aspiration. Medical records were analyzed for demographics, clinical presentation, predisposing factors, abscess location on imaging and clinical outcomes were charted. Results: The study included 100 patients with 73 (73%) males and 27 (27%) females with a mean age of 36...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29137077/quality-of-life-and-complications-at-the-different-stages-of-bone-transport-for-treatment-infected-nonunion-of-the-tibia
#17
Hu Wang, Xing Wei, Ping Liu, Ya-Hui Fu, Peng-Fei Wang, Yu-Xuan Cong, Bin-Fei Zhang, Zhong Li, Jin-Lai Lei, Kun Zhang, Yan Zhuang
The aim of this study was to assess Physical Component Summary (PCS), Mental Component Summary (MCS) of the Mos 36-item Short Form Health Survey (SF-36) score, and the virtual Analogue Scale (VAS) of pain during the treatment period and the complication rate associated with infected nonunion of the tibia managed surgically by bone transport.This is a retrospective analysis of prospectively collected data in a consecutive patient cohort. Patients suffering from infected nonunion of the tibia were treated by bone transport from 2012 to 2014...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29126508/complications-in-children-with-ulcerative-colitis-undergoing-ileal-pouch-anal-anastomosis
#18
Dani O Gonzalez, Benedict C Nwomeh
Total colectomy with ileal pouch-anal anastomosis (IPAA) is considered the standard procedure for the surgical management of ulcerative colitis. Despite the widespread utility of the procedure, as many as 75% of patients who undergo IPAA, experience at least 1 complication. This review highlights difficult intraoperative scenarios and complications of pouch surgery in children, including intraoperative, postoperative, and functional complications. Intraoperative scenarios include insufficient mesenteric length and positive leak tests...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#19
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29119297/pyoderma-gangrenosum-after-orthopaedic-or-traumatologic-surgery-a-systematic-revue-of-the-literature
#20
REVIEW
Stephan Ebrad, Mathieu Severyns, Ahmed Benzakour, Benoit Roze, Christian Derancourt, Guillaume-Anthony Odri, Jean-Louis Rouvillain
INTRODUCTION: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis characterised by a painful ulceration mimicking infection of the operative site. To this day, there is still no general agreement on the medical and surgical treatment of PG. This systematic review of the literature aims to summarise recent studies about post-operative PG in orthopaedic surgery to improve its medical and surgical management. METHOD: In April 2017, we carried out an exhaustive review of the literature in MEDLINE, PubMed and Cochrane databases...
November 8, 2017: International Orthopaedics
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