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Management of surgical site infection

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https://www.readbyqxmd.com/read/28327980/frontal-sinus-breach-during-routine-frontal-craniotomy-significantly-increases-risk-of-surgical-site-infection-10-year-retrospective-analysis
#1
Joseph R Linzey, Thomas J Wilson, Stephen E Sullivan, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28315515/tailored-corneo-conjunctival-autografting-in-primary-and-secondary-pterygium-surgery
#2
Mahmoud M Genidy, Ahmed A Abdelghany, Jorge L Alio
PURPOSE: To describe the outcomes of a novel technique for pterygium removal: tailored corneo-conjunctival autograft, which offers the advantages of better postoperative cosmetic outcomes and recurrence prevention. METHODS: This retrospective interventional noncomparative study included 420 eyes in 370 patients (ages 25-60 years) (127 women, 243 men). We divided the patients into 2 groups. The first group included 348 primary pterygium; the second group included 72 recurrent pterygium...
February 28, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#3
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28299273/guidelines-for-patient-specific-jawline-definition-with-titanium-implants-in-esthetic-deformity-and-malformation-surgery
#4
Maurice Yves Mommaerts
CONTEXT: Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. AIMS: The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. SETTINGS AND DESIGN: University hospital - prospective registry...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28277989/dialkylcarbamoyl-chloride-dacc-coated-dressings-in-the-management-and-prevention-of-wound-infection-a-systematic-review
#5
J P Totty, N Bua, G E Smith, A E Harwood, D Carradice, T Wallace, I C Chetter
OBJECTIVE: Dialkylcarbomoyl chloride (DACC)-coated dressings (Leukomed Sorbact and Cutimed Sorbact) irreversibly bind bacteria at the wound surface that are then removed when the dressing is changed. They are a recent addition to the wound care professional's armamentarium and have been used in a variety of acute and chronic wounds. This systematic review aims to assess the evidence supporting the use of DACC-coated dressings in the clinical environment. METHOD: We included all reports of the clinical use of DACC-coated dressings in relation to wound infection...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28263778/evaluation-of-the-bundle-zero-surgical-site-infection-to-prevent-surgical-site-infection-in-vascular-surgery
#6
María Fernández-Prada, Carmen Martínez-Ortega, Livia Revuelta-Mariño, Ángeles Menéndez-Herrero, Juan F Navarro-Gracia
OBJECTIVE: To compare the incidence of Surgical Site Infections (SSIs) before and after the implementation of a bundle of care called 'Zero Surgical Site Infection'. Secondary goals included estimating measures of association and their potential impact, determining care management indicators in vascular surgery, and evaluating the level of compliance with the bundle. METHODS: This is a prospective observational study with a historic control group. The bundle included: 1) removal of body hair with clippers; 2) preoperative showering with chlorhexidine soap; 3) preparation of the surgical field with alcoholic chlorhexidine 2%; 4) adequacy of antimicrobial prophylaxis; 5) and 6) intra- and post-operative glycemic and central temperature control...
March 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28255256/postcesarean-wound-infection-prevalence-impact-prevention-and-management-challenges
#7
REVIEW
Sivan Zuarez-Easton, Noah Zafran, Gali Garmi, Raed Salim
Surgical site infection (SSI) is one of the most common complications following cesarean section, and has an incidence of 3%-15%. It places physical and emotional burdens on the mother herself and a significant financial burden on the health care system. Moreover, SSI is associated with a maternal mortality rate of up to 3%. With the global increase in cesarean section rate, it is expected that the occurrence of SSI will increase in parallel, hence its clinical significance. Given its substantial implications, recognizing the consequences and developing strategies to diagnose, prevent, and treat SSI are essential for reducing postcesarean morbidity and mortality...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28255152/follicular-thyroid-cancer-with-sternal-metastasis-challenges-and-outcomes
#8
M A Syazni, H S Gendeh, N R Kosai, A R Ramzisham, B S Gendeh, N H Basiron, F H Imran
Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28251830/disparities-in-the-management-and-prophylaxis-of-surgical-site-infection-and-pancreatic-fistula-after-pancreatoduodenectomy
#9
Francisco Igor B Macedo, Mia Mowzoon, Janak Parikh, Sandeep A Sathyanarayana, Michael J Jacobs
BACKGROUND: Pancreatoduodenectomy (PD) carries a high morbidity. Over time, pancreatic surgeons have altered their perioperative management in efforts to reduce morbidity rates, thereby creating major technical and management variations. We aim to evaluate the practice patterns of hepato-pancreato-biliary (HPB) surgeons across multiple regions worldwide. METHODS: Between May and August 2015, an anonymous 25-item survey questionnaire was electronically distributed to IHPBA (International Hepato-Pancreato-Biliary Association) members regarding practice patterns and perioperative care of patients undergoing PD...
March 2, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28241234/laparoscopic-total-pancreatectomy-with-islet-autotransplantation-and-intraoperative-islet-separation-as-a-treatment-for-patients-with-chronic-pancreatitis
#10
Caleb J Fan, Kenzo Hirose, Christi M Walsh, Michael Quartuccio, Niraj M Desai, Vikesh K Singh, Rita R Kalyani, Daniel S Warren, Zhaoli Sun, Marie N Hanna, Martin A Makary
Importance: Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective: To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants: Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015...
February 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28238586/developing-a-minimum-dataset-for-nursing-team-leader-handover-in-the-intensive-care-unit-a-focus-group-study
#11
Amy J Spooner, Leanne M Aitken, Amanda Corley, Wendy Chaboyer
BACKGROUND: Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. OBJECTIVES: The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. METHODS: This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited...
February 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28237739/collaboration-with-an-infection-control-team-for-patients-with-infection-after-spine-surgery
#12
Kazuyoshi Kobayashi, Shiro Imagama, Daizo Kato, Kei Ando, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Tetsuya Yagi, Yoshihiro Nishida, Naoki Ishiguro
BACKGROUND: The risk of infection, including surgical site infection (SSI), after spine surgery has increased due to aging and more immunocompromised hosts. An infection control team (ICT) is responsible for management of health care-associated infections at our institution. METHODS: The study subjects were 40 patients (18 men and 22 women with an average age of 54 years) referred to the ICT after spine surgery since 2010. Pathogenic bacteria and treatment in these cases were reviewed...
February 22, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28229061/central-myxoma-myxofibroma-of-the-jaws-a-clinico-epidemiologic-review
#13
Agbara Rowland, Fomete Benjamin, Obiadazie Athanasius-Chukwudi, Omeje Uchenna-Kevin, Samaila Modupeola-Omotara
INTRODUCTION: Myxomas are a group of benign rare tumors of connective-tissue origin that occur in both hard (central) and soft tissues of the body. The aim of this study is to highlight our experience in the management of central myxoma of the jaw, with emphasis on its clinic-epidemiologic features as seen in our environment. MATERIALS AND METHODS: All patients who were managed for central myxoma of the jaw at the Oral and Maxillofacial Surgery department of a regional University Teaching Hospital between September 1997 and October 2015 were retrospectively studied...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28229030/retroperitoneal-necrotizing-fasciitis-masquerading-as-perianal-abscess-rare-and-perilous
#14
Anandhi Amaranathan, Ashok Kumar Sahoo, Deepak Barathi, Gomathi Shankar, Sarath Chandra Sistla
Necrotizing fasciitis is one of the uncommon presentations of a rapidly spreading subcutaneous tissue infection. Although the actual cause is unclear in many cases, most of them are due to the rapid proliferation of microorganisms. Retroperitoneal necrotizing fasciitis is extremely rare. It is a potentially lethal infection that requires immediate and aggressive surgical care. Early diagnosis is the key to a better prognosis. The possibility of retroperitoneal necrotizing fasciitis should be suspected in patients with symptoms of sepsis that are disproportionate to clinical findings...
January 17, 2017: Curēus
https://www.readbyqxmd.com/read/28224191/predicting-the-post-operative-length-of-stay-for-the-orthopaedic-trauma-patient
#15
Deepak Chona, Nikita Lakomkin, Catherine Bulka, Idine Mousavi, Parth Kothari, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
PURPOSE: Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. METHODS: All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#16
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#17
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#18
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28215118/infection-after-fracture-osteosynthesis-part-i
#19
Christian Fang, Tak-Man Wong, Tak-Wing Lau, Kelvin Kw To, Samson Sy Wong, Frankie Leung
Bone and surgical site infections after osteosynthesis are notoriously difficult to manage and pose a tremendous burden in fracture management. In this article, we use the term osteosynthesis-associated infection (OAI) to refer to this clinical entity. While relatively few surgically treated fractures become infected, it is challenging to perform a rapid diagnosis. Optimal management strategies are complex and highly customized to each scenario and take into consideration the status of fracture union, the presence of hardware and the degree of mechanical stability...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#20
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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