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Surgical prophylaxis

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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
#1
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
#2
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#3
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28529866/which-orthopaedic-patients-are-infected-with-gram-negative-non-fermenting-rods
#4
Omid Jamei, Shpresa Gjoni, Besa Zenelaj, Benjamin Kressmann, Wilson Belaieff, Didier Hannouche, Ilker Uçkay
Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Results: Of the total 1840 surgical procedures in the study, 430 grew Gram-negative pathogens (23%), of which 194 (11%) were due to NFR and 143 (8%) to Pseudomonas aeruginosa...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#5
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28528712/timing-of-antimicrobial-prophylaxis-and-infectious-complications-in-pediatric-patients-undergoing-appendectomy
#6
Cristen N Litz, Jessica B Asuncion, Paul D Danielson, Nicole M Chandler
PURPOSE: Antibiotic administration within one hour prior to incision is a common quality metric; however, antibiotics are typically started at the time of diagnosis in pediatric patients with acute appendicitis. The purpose was to determine if antibiotic administration within one hour prior to incision reduces the incidence of surgical site infections (SSI) in pediatric patients with acute appendicitis started on parenteral antibiotics upon diagnosis. METHODS: A retrospective review was performed of 478 patients aged 0-18years who underwent appendectomy for acute appendicitis from 7/2013 to 4/2015...
May 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#7
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/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#8
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28522244/low-molecular-weight-heparin-and-the-relative-risk-of-surgical-site-bleeding-complications-results-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-of-venous-thromboprophylaxis-in-patients-after-total-joint-arthroplasty
#9
REVIEW
Kary Suen, Roger N Westh, Leonid Churilov, Andrew J Hardidge
BACKGROUND: Venous thromboembolism causes significant morbidity and mortality in patients after total joint arthroplasty. Although network meta-analyses have demonstrated a benefit of various thromboprophylactic agents, there remains a concern in the surgical community regarding the resulting wound complications. There is currently no systematic review of the surgical site bleeding complications of thromboprophylactic agents. The aim of this study was to systematically review the surgical site bleeding outcomes of venous thromboembolism prophylaxis in this population...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28516316/venous-thromboembolism-after-nephrectomy-incidence-timing-and-associated-risk-factors-from-a-national-multi-institutional-database
#10
Brian J Jordan, Richard S Matulewicz, Brian Trihn, Shilajit Kundu
PURPOSE: To evaluate the rate of venous thromboembolism (VTE) after nephrectomy with specific focus on event timing and location (before or after hospital discharge) in order to identify modifiable risk factors and establish benchmarks for preventive interventions. METHODS: Using the ACS-NSQIP database, we identified patients undergoing nephrectomy from 2006 to 2012. Patients were analyzed in two cohorts: collectively and by surgical approach [open vs. lap/robotic (MIS)]...
May 17, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28514319/prospective-external-validation-of-three-preoperative-risk-scores-for-prediction-of-new-onset-atrial-fibrillation-after-cardiac-surgery
#11
Matthew J Cameron, Diem T T Tran, Jean Abboud, Ethan K Newton, Houman Rashidian, Jean-Yves Dupuis
BACKGROUND: Postoperative atrial fibrillation (POAF) is associated with early and late morbidity and mortality of cardiac surgical patients. Prophylactic treatment of atrial fibrillation (AF) has been recommended to improve outcome in cardiac surgical patients at high risk of developing POAF. Reliable models for prediction of POAF are needed to achieve that goal. This study attempted to externally validate 3 risk models proposed for preoperative prediction of POAF in cardiac surgical patients: the POAF score, the CHA2DS2-VASc score, and the Atrial Fibrillation Risk Index...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504810/using-a-structured-checklist-to-improve-the-orthopedic-ward-round-a-prospective-cohort-study
#12
Adrian J Talia, James Drummond, Cameron Muirhead, Phong Tran
Comprehensive and timely documentation on orthopedic ward rounds continues to be problematic, leading to delayed or inappropriate patient care and miscommunication between health care providers. The authors introduced a simple checklist to improve the documentation on orthopedic ward rounds in their institution. A prospective cohort study was performed. Standard care was provided for cohort A. During a 2-week period, the documentation of patient care by physicians following a ward round was assessed in terms of venous thromboembolism prophylaxis, fasting status, wound or dressing plan, weight-bearing status, and important surgical details...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28497247/-medial-closed-wedge-osteotomy-of-the-distal-femur-in-biplanar-technique-and-a-specific-plate-fixator
#13
REVIEW
P Lobenhoffer, K Kley, D Freiling, R van Heerwaarden
OBJECTIVE: Correction of distal femur deformity by closed-wedge biplanar osteotomy. INDICATIONS: Metaphyseal frontal plane deformities of the femur. CONTRAINDICATIONS: Osteoarthritis of the contralateral compartment, total loss of the contralateral meniscus, acute/chronic infection, limited range-of-motion, poor soft-tissue conditions at site of surgery. SURGICAL TECHNIQUE: Skin incision at metaphyseal area of femur...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28492463/impact-of-an-alcohol-withdrawal-treatment-pathway-on-hospital-length-of-stay-a-retrospective-observational-study-comparing-pre-and-post-pathway-implementation
#14
Andrew J Muzyk, Rachel E Rogers, Gary Dighe, Jessica Hartung, Robert C Musser, Mary J Stillwagon, Sarah Rivelli
OBJECTIVE: To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care. METHODS: This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital...
May 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28488041/malunion-of-long-bone-fractures-in-a-conflict-zone-in-the-democratic-republic-of-congo
#15
Grace Bauhahn, Harald Veen, Rigo Hoencamp, Nelson Olim, Edward C T H Tan
INTRODUCTION: Malunion is a well-recognized complication of long-bone fractures which accounts for more than 25% of injuries in conflict zones. The aim of this study was to investigate the rate of malunion sustained by casualties with penetrating gunshot wounds in an International Committee of the Red Cross (ICRC) surgical substitution project in the Democratic Republic of Congo (DRC) and compare these results with current literature. METHODS: A retrospective cohort study was performed...
May 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28486386/fluid-overload-and-cumulative-thoracostomy-output-are-associated-with-surgical-site-infection-after-pediatric-cardiothoracic-surgery
#16
Anthony A Sochet, Aoibhinn Nyhan, Michael C Spaeder, Alexander M Cartron, Xiaoyan Song, Darren Klugman, Anna T Brown
OBJECTIVES: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. DESIGN: A single-center, nested, retrospective, matched case-control study. SETTING: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. PATIENTS: Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28484678/reduced-surgical-site-infection-rates-following-spine-surgery-using-an-enhanced-prophylaxis-protocol
#17
Alexa M Dessy, Frank J Yuk, Akbar Y Maniya, James G Connolly, John T Nathanson, Jonathan J Rasouli, Tanvir F Choudhri
BACKGROUND: Postoperative surgical site infection (SSI) is a common complication after spine surgery. Reduction of SSI has many benefits including, but not limited to, the reduced length of stay, readmission rates, and morbidity and mortality. OBJECTIVE: To determine whether an enhanced antibiotic prophylaxis reduced the rate of surgical site infections in spine surgery. METHODS: This is a retrospective observation study which analyzed the incidence of postoperative SSI following a consecutive series of 1,486 cervical, thoracic and lumbar spine operations performed at a single institution by the senior author between the dates of October 2001 to March 2014...
April 6, 2017: Curēus
https://www.readbyqxmd.com/read/28483725/opportunities-for-system-level-improvement-across-antibiotic-use-in-the-surgical-pathway
#18
E Charani, R Ahmad, C Tarrant, G Birgand, A Leather, M Mendelson, S R Moonesinghe, N Sevdalis, S Singh, A Holmes
Optimizing antibiotic prescribing across the surgical pathway (before, during, and after surgery) is a key aspect of tackling important drivers of antimicrobial resistance and simultaneously decreasing the burden of infection at the global level. In the UK alone, 10 million patients undergo surgery every year, which is equivalent to 60% of the annual hospital admissions having a surgical intervention. The overwhelming majority of surgical procedures require effectively limited delivery of antibiotic prophylaxis to prevent infections...
May 5, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28481857/the-evolution-of-pelvic-exenteration-practice-at-a-single-center-lessons-learned-from-over-500-cases
#19
Cherry E Koh, Michael J Solomon, Kilian G Brown, Kirk Austin, Christopher M Byrne, Peter Lee, Jane M Young
Considerable progress has been made in the management of patients with locally advanced or recurrent cancers of the pelvis over the past 60 years since the inception of pelvic exenteration. Early progress in pelvic exenteration was marred by the high surgical mortality and morbidity, which drew scepticism from the broader surgical community. Subsequent evolution in the procedure hinged on establishing surgical safety and a better understanding of outcome predictors. Surgical mortality from pelvic exenteration is now comparable to that of elective resection for primary colorectal cancers...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28480660/antibiotic-prophylaxis-in-radical-prostatectomy-comparison-of-2-day-and-more-than-2-day-prophylaxis
#20
Bosung Shin, Ho Seok Chung, Eu Chang Hwang, Seung Il Jung, Dong Deuk Kwon
The efficacy of antibiotic prophylaxis in radical prostatectomy (RP) remains to be established. We retrospectively compared the occurrence of perioperative infections after RP between the 2 different antibiotic protocols. This study involved 428 cases of laparoscopic radical prostatectomy (LRP). After excluding patients who had no perioperative urine culture data, 313 consecutive patients who underwent LRP for prostate carcinoma were classified into 2 groups according to the duration of antimicrobial prophylaxis...
June 2017: Journal of Korean Medical Science
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