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Antisepsis

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https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#1
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28526172/skin-antisepsis-it-s-not-only-what-you-use-it-s-the-way-that-you-use-it
#2
A L Casey, J M Badia, A Higgins, J Korndorrfer, C Mantyh, O Mimoz, M Moro
No abstract text is available yet for this article.
May 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#3
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28440583/topical-antibiotics-and-intravitreal-injections
#4
REVIEW
Alex P Hunyor, Rohan Merani, Archie Darbar, Jean-François Korobelnik, Paolo Lanzetta, Annabelle A Okada
There is increasing evidence that topical antibiotics, given before and/or after intravitreal injections, are ineffective in preventing endophthalmitis and are possibly harmful. In addition to the lack of efficacy and increased development of resistant organisms, the use of topical antibiotics adds significantly to the cost of delivering intravitreal therapy. Despite this, in many countries, it is still common practice to use pre- and/or postinjection topical antibiotics. This review outlines the general principles of effective antibiotic prophylaxis, and the evidence regarding topical antibiotic use as a prophylactic measure for endophthalmitis following intravitreal injections...
April 25, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28411947/central-line-associated-bloodstream-infections-in-the-nicu-successes-and-controversies-in-the-quest-for-zero
#5
Renée E Mobley, Matthew J Bizzarro
Central line-associated bloodstream infections (CLABSI) are among the most common healthcare-acquired infections in the neonatal intensive care unit (NICU) population and are associated with an increased risk of morbidity and mortality, as well as increased healthcare costs, and duration of hospitalization. Over the past decade, numerous local, statewide, and national quality improvement initiatives have resulted in a significant reduction in CLABSI rates. The majority of successful initiatives have utilized similar strategies to implement and sustain their efforts, including education of NICU staff in the principles of quality improvement, creation and implementation of central line insertion and maintenance bundles and methods for assessing compliance, formation of dedicated central line insertion and maintenance teams, and utilization of reliable and effective methods for collecting, analyzing, and displaying data...
April 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28410725/optimizing-the-antisepsis-protocol-effectiveness-of-3-povidone-iodine-1-0-applications-versus-a-single-application-of%C3%A2-povidone-iodine-5-0
#6
Megan R Silas, Richard M Schroeder, Richard B Thomson, William G Myers
PURPOSE: To determine the minimum effective concentration of povidone-iodine that reduces the bacterial load by 3-log10, the U.S. Food and Drug Administration requirement for antiseptic agents, and to study alternative dosing schedules of povidone-iodine to optimize its bactericidal effect. SETTING: Microbiology Laboratory, Evanston Hospital, Evanston, Illinois, USA. DESIGN: Experimental study. METHODS: A standard 0...
March 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28402706/optimum-operating-room-environment-for-the-prevention-of-surgical-site-infections
#7
Sara Gaines, James N Luo, Jack Gilbert, Olga Zaborina, John C Alverdy
BACKGROUND: Surgical site infections (SSI), whether they be incisional or deep, can entail major morbidity and death to patients and additional cost to the healthcare system. A significant amount of effort has gone into optimizing the surgical patient and the operating room environment to reduce SSI. METHODS: Relevant guidelines and literature were reviewed. RESULTS: The modern practice of surgical antisepsis involves the employment of strict sterile techniques inside the operating room...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#8
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28390848/-the-advent-of-a-newborn-specialty-19th-century-pediatrics
#9
Jean-Jacques Baudon
Pediatrics began under the most unfavorable conditions that are difficult to imagine nowadays. Children at the start of the 19th century were considered as negligible. The death rate was tremendous, increased by the work of children in factories as soon as 6 years of age in textile industries. In upper classes, infants were fed by a wet nurse, far from their parents and death rate was high as well. The emergence of pediatrics was the result of work carried out in adult medicine in the first half of the 19th century: clinical anatomic method, knowledge of contagious diseases even before the discovery of bacteria, birth of bacteriology...
April 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28383375/comparison-of-vaginal-hysterectomy-techniques-and-interventions-for-benign-indications-a-systematic-review
#10
Peter C Jeppson, Sunil Balgobin, David D Rahn, Kristen A Matteson, Alexis A Dieter, David R Ellington, Sarit O Aschkenazi, Cara Grimes, Mamta M Mamik, Ethan M Balk, Miles Murphy
OBJECTIVE: To create evidence-based clinical practice guidelines based on a systematic review of published literature regarding the risks and benefits of available preoperative, intraoperative, and postoperative technical steps and interventions at the time of vaginal hysterectomy for benign indications. DATA SOURCES: We systematically searched the literature to identify studies that compared technical steps or interventions during the preoperative, intraoperative, and postoperative periods surrounding vaginal hysterectomy...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28380162/positive-deviance-as-a-strategy-to-prevent-and-control-bloodstream-infections-in-intensive-care
#11
Francimar Tinoco de Oliveira, Maria Manuela Frederico Ferreira, Silvia Teresa Carvalho de Araújo, Amanda Trindade Teixeira de Bessa, Advi Catarina Barbachan Moraes, Marluci Andrade Conceição Stipp
OBJECTIVE: To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. METHOD: An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. RESULTS: In 90 days, 188 actions were observed, of these, 36...
April 3, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28277997/effect-of-antiseptic-irrigation-on-infection-rates-of-traumatic-soft-tissue-wounds-a-longitudinal-cohort-study
#12
B Roth, R Neuenschwander, F Brill, F Wurmitzer, C Wegner, O Assadian, A Kramer
OBJECTIVE: Acute traumatic wounds are contaminated with bacteria and therefore an infection risk. Antiseptic wound irrigation before surgical intervention is routinely performed for contaminated wounds. However, a broad variety of different irrigation solutions are in use. The aim of this retrospective, non-randomised, controlled longitudinal cohort study was to assess the preventive effect of four different irrigation solutions before surgical treatment, on wound infection in traumatic soft tissue wounds...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28277409/randomized-controlled-trial-of-two-alcohol-based-preparations-for-surgical-site-antisepsis-in-colorectal-surgery
#13
Robyn B Broach, Emily C Paulson, Charles Scott, Najjia N Mahmoud
OBJECTIVE: To compare 2 alcohol-based, dual-action skin preparations for surgical site infection (SSI) prevention in elective colorectal surgery. BACKGROUND: Colorectal surgery is associated with the highest SSI rate among elective surgical procedures. Although evidence indicates that alcohol-based skin preparations are superior in SSI prevention, it is not clear if different alcohol-based preparations are equivalent in clean-contaminated colorectal procedures. METHODS: We performed a blinded, randomized, noninferiority trial comparing iodine povacrylex-alcohol (IPA) and chlorhexidine-alcohol for elective, clean-contaminated colorectal surgery...
March 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28159079/guideline-implementation-hand-hygiene
#14
Judith L Goldberg
Performing proper hand hygiene and surgical hand antisepsis is essential to reducing the rates of health care-associated infections, including surgical site infections. The updated AORN "Guideline for hand hygiene" provides guidance on hand hygiene and surgical hand antisepsis, the wearing of fingernail polish and artificial nails, proper skin care to prevent dermatitis, the wearing of jewelry, hand hygiene product selection, and quality assurance and performance improvement considerations. This article focuses on key points of the guideline to help perioperative personnel make informed decisions about hand hygiene and surgical hand antisepsis...
February 2017: AORN Journal
https://www.readbyqxmd.com/read/28131655/a-return-to-the-basics-nurses-practices-and-knowledge-about-interventional-patient-hygiene-in-critical-care-units
#15
Azza H El-Soussi, Hayam I Asfour
BACKGROUND: The Nursing profession is struggling to return to basic nursing care to maintain patients' safety. "Interventional patient hygiene" (IPH) is a measurement model for reducing the bioburden of both the patient and health care worker, and its components are hand hygiene, oral care, skin care/antisepsis, and catheter site care. OBJECTIVES: To identify the level of nurses' practice and knowledge about interventional patient hygiene and identify barriers for implementing interventional patient hygiene in critical care units...
January 25, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28124850/a-quality-improvement-approach-to-reducing-the-caesarean-section-surgical-site-infection-rate-in-a-regional-hospital
#16
M O'Hanlon, C McKenna, E Carton, D Diviney, M R Costello, L O'Sullivan, J Fitzsimons, L Toland, G Dornikova, R Curran, C McCann, L O'Sullivan, T Doherty, C Crowley, S O'Coigligh
Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol...
September 9, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28121042/economic-case-for-intraoperative-interventions-to-prevent-surgical-site-infection
#17
REVIEW
B M Gillespie, W Chaboyer, A Erichsen-Andersson, R M Hettiarachchi, S Kularatna
BACKGROUND: Surgical-site infection (SSI) occurs in 1-10 per cent of all patients undergoing surgery; rates can be higher depending on the type of surgery. The aim of this review was to establish whether (or not) surgical hand asepsis, intraoperative skin antisepsis and selected surgical dressings are cost-effective in SSI prevention, and to examine the quality of reporting. METHODS: The authors searched MEDLINE via Ovid, CINAHL via EBSCO, Cochrane Central and Scopus databases systematically from 1990 to 2016...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28110287/aspirin-to-inhibit-sepsis-antisepsis-randomised-controlled-trial-protocol
#18
Damon P Eisen, Elizabeth M Moore, Karin Leder, Jessica Lockery, Emma S McBryde, John J McNeil, David Pilcher, Rory Wolfe, Robyn L Woods
INTRODUCTION: Sepsis is a leading global cause of morbidity and mortality, and is more common at the extremes of age. Moreover, the cost of in-hospital care for elderly patients with sepsis is significant. There are indications from experimental and observational studies that aspirin may reduce inflammation associated with infection. This paper describes the rationale and design of the AspiriN To Inhibit SEPSIS (ANTISEPSIS) trial, a substudy of ASPirin in Reducing Events in the Elderly (ASPREE)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28089672/isopropyl-alcohol-is-as-efficient-as-chlorhexidine-to-prevent-contamination-of-blood-cultures
#19
Jovanna Martínez, Juan H Macías, Virginia Arreguín, Jose A Álvarez, Alejandro E Macías, Juan L Mosqueda-Gómez
BACKGROUND: False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required. METHODS: Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals...
April 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28053064/scientific-knowledge-and-technology-animal-experimentation-and-pharmaceutical-development
#20
Lewis B Kinter, Joseph J DeGeorge
Human discovery of pharmacologically active substances is arguably the oldest of the biomedical sciences with origins >3500 years ago. Since ancient times, four major transformations have dramatically impacted pharmaceutical development, each driven by advances in scientific knowledge, technology, and/or regulation: (1) anesthesia, analgesia, and antisepsis; (2) medicinal chemistry; (3) regulatory toxicology; and (4) targeted drug discovery. Animal experimentation in pharmaceutical development is a modern phenomenon dating from the 20th century and enabling several of the four transformations...
December 2016: ILAR Journal
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