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Documentation of prophylactic antibiotics in Surgery

Lindsay Petersen, Kjirsten Carlson, Katherine Kopkash, Thomas Witt, Andrea Madrigrano
Many surgeons routinely use a single preoperative prophylactic dose of an antibiotic prior to needle-localized lumpectomy, despite the lack of evidence that this practice reduces the rate of infection. The aim of this study is to determine if antibiotic administration reduces wound infection for needle-localized lumpectomy. A retrospective chart review of patients that underwent needle-localized lumpectomy from 2010 to 2012 was conducted. Data regarding patient demographics, comorbid conditions, medical history, operative details, and pathology were collected...
September 12, 2016: Breast Journal
Said Zeiai, Agneta Nordenskjöld, Magdalena Fossum
PURPOSE: Concerns about antibiotic resistance, adverse drug reactions and questionable medical benefits have led to changes in prophylactic antibiotic management in hypospadias repair at our clinic. In March 2010 our guidelines were changed from continuous prophylaxis for 14 days to 1 dose preoperatively and another at removal of the stent. We analyze the effects of this new regimen. MATERIALS AND METHODS: We performed a prospective journal cohort study of all our hypospadias operations from June 2008 to December 2011...
October 2016: Journal of Urology
Ling Zhou, Jingjing Ma, Jie Gao, Shiqi Chen, Jianan Bao
Pharmacists' role may be ideal for improving rationality of drug prescribing practice. We aimed to study the impact of multifaceted pharmacist interventions on antibiotic prophylaxis in patients undergoing clean or clean-contaminated operations in cardiothoracic department. A pre-test-post-test quasiexperimental study was conducted in a cardiothoracic ward at a tertiary teaching hospital in Suzhou, China. Patients admitted to the ward were collected as baseline group (2011.7-2012.12) and intervention group (2013...
March 2016: Medicine (Baltimore)
Marie-Andrée Harvey, Marianne Pierce, Jens-Erik W Alter, Queena Chou, Phaedra Diamond, Annette Epp, Roxana Geoffrion, Marie-Andrée Harvey, Annick Larochelle, Kenny Maslow, Grace Neustaedter, Dante Pascali, Marianne Pierce, Jane Schulz, David Wilkie, Abdul Sultan, Ranee Thakar
OBJECTIVE: To review the evidence relating to obstetrical anal sphincter injuries (OASIS) with respect to diagnosis, repair techniques and outcomes. To formulate recommendations as to patient counselling regarding route of delivery for subsequent pregnancy after OASIS. OPTIONS: Obstetrical care providers caring for women with OASIS have the option of repairing the anal sphincter using end-to-end or overlapping techniques. They may also be involved in counselling women with prior OASIS regarding the route of delivery for future pregnancies...
December 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Davide Ferorelli, Fiorenza Zotti, Silvio Tafuri, Angela Pezzolla, Lidia Dalfino, Nicola Brienza, Alessandro Dell'Erba
This study describes the changes in the performance of health care workers regarding the control of health care-associated infection in a surgical ward of University Hospital Policlinico, Bari, Italy, before and after a training program and adoption of bundles on antibiotic therapy. There were 194 patients recruited (pre: n = 98; post: n = 96), of which 149 (76.8%) had undergone surgery. We documented a change in the proportions of patients who received in-ward prophylactic antibiotics (from 46/98 to 22/96, P < ...
November 2015: American Journal of Infection Control
Margaret I Liang, Adam C ElNaggar, Silpa Nekkanti, David M O'Malley, Erinn M Hade, Larry J Copeland, Jeffrey M Fowler, Ritu Salani, Floor J Backes, David E Cohn
OBJECTIVES: Ovarian cancer quality measures are being developed to improve health care delivery and outcomes. Our objective is to evaluate compliance with 8 quality indicators proposed by the Society of Gynecologic Oncology. METHODS: A review of 123 ovarian cancer patients who underwent primary surgical staging/cytoreduction and chemotherapy from 2010-2012 was undertaken. Medical records were reviewed, and descriptive statistics were performed to determine compliance...
September 2015: Gynecologic Oncology
Michael J Chuang, Jason J Jancosko, Vivian Mendoza, Wesley M Nottage
PURPOSE: To document the skin colonization and deep tissue inoculation rates associated with arthroscopic shoulder surgery and how these rates differ with procedural and demographic factors. METHODS: We prospectively recruited outpatient shoulder arthroscopy patients who agreed to participate and met the inclusion criteria from February 2013 to May 2014. All patients received routine antibiotic prophylaxis intravenously. Initial cultures were obtained before the skin preparation by swabbing the skin at the 3 standard portal sites: posterior, anterosuperior, and anterolateral...
September 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alan P Gehrich, Jason R Patzwald, Molly E Kern, Chris C Squires, Michael B Lustik
OBJECTIVE: To define the incidence of early and recurrent urinary tract infections (RUTIs) in the 12-month postoperative period following midurethral sling (MUS) operations and evaluate for risk factors. METHODS: This retrospective chart review compiled all urine analyses and urine culture results within 12 months of MUS surgery on all patients in the years 2006-2012 for which data were available. All coincident risk factors were tabulated. Statistical analysis was performed using SAS v 9...
November 2014: Military Medicine
Fukashi Yamamichi, Katsumi Shigemura, Mauso Yamashita, Kazushi Tanaka, Soishi Arakawa, Masato Fujisawa
The number of open radical prostatectomy (RP) surgeries has been decreasing owing to the spread of laparoscopic and robotic surgery, which has implications for postoperative wound healing. The purpose of this study was to investigate and document the current status of postoperative wound healing and superficial surgical site infection (SSI) in open RPs. One hundred and seventy-five antegrade RPs with the same or similar kinds of prophylactic antibiotic administration were divided into two groups: (i) 'no intervention' (wound covering group) and (ii) 'washing', using a washing solution from the second postoperative day to the day of skin staple removal (wound washing group)...
October 2016: International Wound Journal
Hede Yan, Jin He, Shuai Chen, Shiyang Yu, Cunyi Fan
BACKGROUND: With the improvements in wound healing through the use of intravenous prophylactic antibiotics and technical refinements, postoperative elbow infections have become less common but still occur in certain elective elbow surgeries. The objective of this study was to evaluate the safety and efficacy of prophylactic application of vancomycin into the operative site to reduce the incidence of infection after the open release of post-traumatic stiff elbows. METHODS: A retrospective review of 272 such patients during a 4-year period was performed...
May 2014: Journal of Shoulder and Elbow Surgery
Lindsay J May, Christopher A Longhurst, Natalie M Pageler, Matthew S Wood, Paul J Sharek, C Michelle Zebrack
OBJECTIVES: The optimal location for postoperative cardiac care of adults with congenital heart disease is controversial. Some congenital heart surgeons operate on these adults in children's hospitals with postoperative care provided by pediatric critical care teams who may be unfamiliar with adult national performance measures. This study tested the hypothesis that Clinical Decision Support tools integrated into the clinical workflow would facilitate improved compliance with The Joint Commission Surgical Care Improvement Project performance measures in adults recovering from cardiac surgery in a children's hospital...
June 2014: Pediatric Critical Care Medicine
Simon Bergman, Melina Deban, Vanessa Martelli, Michèle Monette, Nadia Sourial, Fadi Hamadani, Debby Teasdale, Christina Holcroft, Helena Zakrzewski, Shannon Fraser
BACKGROUND: Measuring the quality of surgical care is essential to identifying areas of weakness in the delivery of effective surgical care and to improving patient outcomes. Our objectives were to (1) assess the quality of surgical care delivered to adult patients; and (2) determine the association between quality of surgical care and postoperative complications. METHODS: This retrospective, pilot, cohort study was conducted at a single university-affiliated institution...
September 2014: Surgery
Daniel J Jones, Frances Bunn, Sophie V Bell-Syer
BACKGROUND: Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet there is no consensus on the use of prophylactic antibiotics for breast cancer surgery...
2014: Cochrane Database of Systematic Reviews
Brigid M Gillespie, Wendy Chaboyer, Evelyn Kang, Jayne Hewitt, Paul Nieuwenhoven, Nicola Morley
AIMS AND OBJECTIVES: To examine wound assessment and management in patients following surgery and to compare these practices with current evidence-based guidelines for the prevention of surgical site infection across one healthcare services district in Queensland, Australia. BACKGROUND: Despite innovations in surgical techniques, technological advances and environmental improvements in the operating room, and the use of prophylactic antibiotics, surgical site infections remain a major source of morbidity and mortality in patients following surgery...
November 2014: Journal of Clinical Nursing
Daniel W Nelson, Brad J Champagne, David E Rivadeneira, Brad R Davis, Justin A Maykel, Howard M Ross, Eric K Johnson, Scott R Steele
BACKGROUND: Hemorrhoidectomy is considered by many to be a contaminated operation that requires antibiotic prophylaxis to lower the incidence of surgical site infection. In reality, little evidence exists to either support or refute the use of antibiotic prophylaxis in this setting. OBJECTIVE: This study aimed to determine if antibiotic prophylaxis is associated with reduced incidence of postoperative surgical site infection following hemorrhoidectomy. DESIGN: This is a retrospective database review...
March 2014: Diseases of the Colon and Rectum
Lukas P Zebala, Tapanut Chuntarapas, Michael P Kelly, Michael Talcott, Suellen Greco, K Daniel Riew
BACKGROUND: Surgical site infection remains a complication of spine surgery despite routine use of prophylactic antibiotics. Retrospective clinical studies of intrawound vancomycin use have documented a decreased prevalence of surgical site infection after spine surgery. The purpose of the present study was to assess the efficacy of intrawound vancomycin powder in terms of eradicating a known bacterial surgical site contamination in a rabbit spine surgery model. METHODS: Twenty New Zealand White rabbits underwent lumbar partial laminectomy and wire implantation...
January 1, 2014: Journal of Bone and Joint Surgery. American Volume
Richard M Rosenfeld, Seth R Schwartz, Melissa A Pynnonen, David E Tunkel, Heather M Hussey, Jeffrey S Fichera, Alison M Grimes, Jesse M Hackell, Melody F Harrison, Helen Haskell, David S Haynes, Tae W Kim, Denis C Lafreniere, Katie LeBlanc, Wendy L Mackey, James L Netterville, Mary E Pipan, Nikhila P Raol, Kenneth G Schellhase
OBJECTIVE: Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. Despite the frequency of tympanostomy tube insertion, there are currently no clinical practice guidelines in the United States that address specific indications for surgery. This guideline is intended for any clinician involved in managing children, aged 6 months to 12 years, with tympanostomy tubes or being considered for tympanostomy tubes in any care setting, as an intervention for otitis media of any type...
July 2013: Otolaryngology—Head and Neck Surgery
Russell B Hawkins, Shauna M Levy, Casey E Senter, Jane Y Zhao, Kaitlin Doody, Lillian S Kao, Kevin P Lally, KuoJen Tsao
BACKGROUND: Despite increased compliance with Surgical Care Improvement Project infection measures, surgical-site infections are not decreasing. The aim of this study was to test the hypothesis that documented compliance with antibiotic prophylaxis guidelines on a pediatric surgery service does not reflect implementation fidelity or adherence to guidelines as intended. METHODS: A 7-week observational study of elective pediatric surgical cases was conducted. Adherence was evaluated for appropriate administration, type, timing, weight-based dosing, and redosing of antibiotics...
October 2013: American Journal of Surgery
Mohammad Taghy, Khorsandi Ashtiani, Mohammad Sadeghi, Babak Saedi, Gilda Givechi
OBJECTIVE: Patients who need major head and neck surgery like laryngectomy are at risk of postoperative wound infection. Although the role of antibiotics in prophylaxis of clean contaminated head and neck surgery has been well documented, controversy exists in the optimal antibiotic regimen. METHODS: In two tertiary referral hospitals (Imam Khomeini and Amir Alam hospital), 90 patients undergoing laryngectomy were prospectively randomized into two groups receiving cefazolin perioperative prophylaxis either for 2 days or for 5 days from June 2004 to March 2006...
January 2010: Indian Journal of Otolaryngology and Head and Neck Surgery
S Taneri, A Heiligenhaus
Apart from the classical indication of removing an opaque lens that is compromising vision, extraction of the crystalline lens is gaining increasing importance as a refractive procedure. This literature review which considers the present guidelines of various ophthalmological societies and recently published studies is intended to give an estimate of the incidence of postoperative endophthalmitis and evidence-based recommendations for its prophylaxis, diagnosis, and therapy. The incidence of endophthalmitis after cataract extraction is reported to be 0...
September 2012: Klinische Monatsblätter Für Augenheilkunde
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