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Surgical site infection

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https://www.readbyqxmd.com/read/28229205/-spectrum-of-pathogens-in-postoperative-complications-of-visceral-surgery-the-problem-of-multidrug-resistance
#1
A Kramer, J Pochhammer, P Walger, U Seifert, M Ruhnke, J C Harnoss
In general surgery the etiology of surgical site infections has not significantly changed over the last 30 years. Gram-positive bacteria, e.g. coagulase negative staphylococci (CNS), Staphylococcus aureus and Enterococcus spp. as well as Gram-negative bacteria, e.g. Escherichia coli, Enterobacter spp., Klebsiella spp. and Pseudomonas aeruginosa, are the most common findings. Although in general surgery 10% of the S. aureus causing postoperative wound infections were methicillin resistant (MRSA), no cases of multidrug-resistant Gram-negative (MRGN) bacteria were reported...
February 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28229061/central-myxoma-myxofibroma-of-the-jaws-a-clinico-epidemiologic-review
#2
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
#3
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/28228898/disseminated-coccidioidomycosis-with-multifocal-musculoskeletal-disease-involvement
#4
Michael F McConnell, Ann Shi, Todd M Lasco, Luke Yoon
We report a rare case of disseminated coccidioidomycosis with multifocal musculoskeletal involvement. The patient presented to the emergency department with left shoulder pain and swelling. Magnetic resonance imaging of the left shoulder revealed enhancing soft tissue masses, bony lesions, and fluid collections in and around the glenohumeral joint with involvement of the proximal humerus, glenoid, and rotator cuff musculature. Multiple additional areas of involvement were subsequently discovered. Fungal cultures confirmed coccidioidomycosis infection at all surgical sites with superimposed polymicrobial bacterial infection in the left shoulder...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228369/feasibility-of-implementing-a-patient-centered-postoperative-wound-monitoring-program-using-smartphone-images-a-pilot-protocol
#5
Sara Fernandes-Taylor, Rebecca L Gunter, Kyla M Bennett, Lola Awoyinka, Shahrose Rahman, Caprice C Greenberg, K Craig Kent
BACKGROUND: Surgical site infections (SSI) represent a significant public health problem as the most common nosocomial infection and a leading cause of unplanned hospital readmissions among surgical patients. Many develop following hospital discharge and often go unrecognized by patients. Telemedicine offers the opportunity to leverage the mobile technology to remotely monitor wound recovery in the transitional period between hospital discharge and routine clinic follow-up. However, many existing telemedicine platforms are episodic, replacing routine follow-up, rather than equipped for continued monitoring; they include only low-risk patient populations and those who already have access to and comfort with the necessary technology; and transmit no visual information...
February 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28228200/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#6
John Scott Roth, Amanda Zachem, Margaret A Plymale, Daniel L Davenport
Acellular dermal matrices (ADMs) are used in conjunction with complex hernia repair, but their efficacy is often debated. This study assesses clinical and quality of life (QOL) outcomes in multiply comorbid patients undergoing complex ventral hernia repair using ADMs. After obtaining institutional review board approval, a prospective study was conducted evaluating patients undergoing complex ventral incisional hernia repair with abdominal wall reconstruction (AWR) using either human (Flex HD) or porcine ADM (Strattice)...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28228047/visible-glove-perforation-in-total-knee-arthroplasty
#7
Lee Qunn Jid, Mak Wai Ping, Wong Yiu Chung, Wai Yuk Leung
PURPOSE: The risk of superficial surgical site infection (SSI) and periprosthetic joint infection (PJI) after glove perforation is not evident. This study was to identify risk factors for glove perforation in primary TKR (total knee replacement) and the risk of subsequent superficial SSI and PJI. METHODS AND MATERIALS: Results of visible glove perforation of both inner and outer gloves during TKR were reviewed. A case-control analysis was performed on the preoperative and operative variables to identify predictive risk factors for glove perforation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28225711/reactive-oxygen-therapy-a-novel-therapy-in-soft-tissue-infection
#8
Matthew Dryden
PURPOSE OF REVIEW: The global burden of disease in skin and soft tissue lesions is enormous. Many chronic, poorly healing lesions get treated with antibiotics despite the lack of evidence for long-term antibiotics. There is a global antibiotic resistance crisis driven largely by inappropriate use of large volumes of antibiotics. One solution is to reduce the selection pressure on bacteria by reducing the volume of antibiotic use in medicine, agriculture and the environment. There are few novel antimicrobials...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28224208/-prevention-of-postoperative-infections-evidence-based-principles
#9
F Pianka, A L Mihaljevic
BACKGROUND: Surgical site infections (SSI) are one of the most frequent postoperative complications worldwide and preventive measures are still an important research topic. High infection rates are not uncommon, especially in visceral surgery. At the same time, frequently not all evidence-based measures are carried out in a standardized manner. The aim of this article is to summarize the relevant literature on evidence-based measures for prevention of SSI. Although evidence-based medicine has already become well-established in surgery, the opinion of experts often still prevails...
February 21, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28224191/predicting-the-post-operative-length-of-stay-for-the-orthopaedic-trauma-patient
#10
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
#11
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/28224049/the-role-of-topical-antiseptic-agents-within-antimicrobial-stewardship-strategies-for-prevention-and-treatment-of-surgical-site-and-chronic-open-wound-infection
#12
Christopher D Roberts, David J Leaper, Ojan Assadian
Scope and Significance: The topical use of antiseptics for wound care has a role in an antimicrobial stewardship strategy. However, the details of this role need clarification. Further clinical research into the use of topical antiseptics in wound care would lower the risk of furthering antibiotic resistance and contribute to more effective antibiotic use. As part of this research, experimental and surveillance data are needed on the resistance and tolerance patterns associated with topical antiseptic use in wound infections...
February 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28223450/raising-the-alarmone-within-host-evolution-of-antibiotic-tolerant-enterococcus-faecium
#13
Daria Van Tyne, Michael S Gilmore
Enterococci are ancient commensal bacteria that recently emerged as leading causes of antibiotic-resistant, hospital-acquired infection. Vancomycin-resistant enterococci (VRE) epitomize why drug-resistant enterococcal infections are a problem: VRE readily colonize the antibiotic-perturbed gastrointestinal (GI) tract where they amplify to large numbers, and from there, they infect other body sites, including the bloodstream, urinary tract, and surgical wounds. VRE are resistant to many antimicrobials and host defenses, which facilitates establishment at the site of infection and confounds therapeutic clearance...
February 21, 2017: MBio
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#14
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#15
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular 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
#16
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/28222277/antibiotic-prophylaxis-in-blepharoplasty-review-of-the-current-literature
#17
REVIEW
Elie M Ferneini, Steven Halepas, Steven I Aronin
The purpose of this study was to provide an evidence-based overview of antibiotic prophylaxis in blepharoplasty. We performed a literature search that evaluated the risk of infection associated with blepharoplasty, as well as the risks and benefits of antibiotic prophylaxis. The overall infection rate associated with eyelid surgery is extremely low. However, the use of antibiotic prophylaxis has increased over the past 25 years in esthetic facial procedures. There is no standard of care for or against antibiotic prophylaxis, and routine practices vary widely...
February 1, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28220379/pulmonary-mucormycosis-clinical-features-and-outcomes
#18
Erica Lin, Teng Moua, Andrew H Limper
PURPOSE: Mucormycosis encompasses a group of opportunistic fungal infections caused by Zygomycetes, order Mucorales. Mucormycosis can manifest as rhino-orbito-cerebral, pulmonary, gastrointestinal, cutaneous, and disseminated infections. Pulmonary mucormycosis is the second most common presentation. This manuscript characterizes the demographics, clinical presentation, diagnostic procedures, radiologic findings, therapeutic interventions, and outcome in pulmonary mucormycosis. METHODS: We retrospectively reviewed clinical data of 35 patients with pulmonary mucormycosis from 2000 to 2015...
February 20, 2017: Infection
https://www.readbyqxmd.com/read/28219826/hot-topics-in-reactive-oxygen-therapy-antimicrobial-and-immunological-mechanisms-safety-and-clinical-applications
#19
REVIEW
Matthew Dryden, Jonathan Cooke, Rami Salib, Rebecca Holding, Sylvia Pender, Jill Brooks
Reactive oxygen species (ROS), when combined with various delivery mechanisms, has the potential to become a powerful novel therapeutic agent against difficult-to-treat infections, especially those involving biofilm. It is important in the context of the global antibiotic resistance crisis. ROS is rapidly active in vitro against all Gram-positive and Gram-negative bacteria tested. ROS also has antifungal and antiviral properties. ROS prevents the formation of biofilms caused by a range of bacterial species in wounds and respiratory epithelium...
February 17, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#20
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
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