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Prophylactic antibiotics audits in surgery

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INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
February 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
J A Greenberg, J Hsu, M Bawazeer, J Marshall, J O Friedrich, A Nathens, N Coburn, H Huang, R S McLeod
Despite existing evidence-based practice guidelines for the management of acute pancreatitis, clinical compliance with recommendations is poor. We conducted a retrospective review of 248 patients admitted between 2010 and 2012 with acute pancreatitis at eight University of Toronto affiliated hospitals. We included all patients admitted to ICU (52) and 25 ward patients from each site (196). Management was compared with the most current evidence used in the Best Practice in General Surgery Management of Acute Pancreatitis Guideline...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tori Sutherland, Jennifer Beloff, Marie Lightowler, Xiaoxia Liu, Luigino Nascimben, Alan D Kaye, Richard D Urman
BACKGROUND: The Surgical Care Improvement Project (SCIP) was launched in 2005. The core prophylactic perioperative antibiotic guidelines were created due to recognition of the impact of proper perioperative prophylaxis on an estimated annual one million inpatient days and $1.6 billion in excess health care costs secondary to preventable surgical site infections (SSIs). An internal study was conducted to create low cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration...
2014: Patient Safety in Surgery
S O'Neill, A G Robertson, A J Robson, C H Richards, G A Nicholson, D Mittapalli
PURPOSE: This audit assessed inguinal hernia surgery in Scotland and measured compliance with British Hernia Society Guidelines (2013), specifically regarding management of bilateral and recurrent inguinal hernias. It also assessed the feasibility of a national trainee-led audit, evaluated regional variations in practise and gauged operative exposure of trainees. METHODS: A prospective audit of adult inguinal hernia repairs across every region in Scotland (30 hospitals in 14 NHS boards) over 2-weeks was co-ordinated by the Scottish Surgical Research Group (SSRG)...
October 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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
Abubaker Ibrahim Elbur, Yousif M A, Ahmed S A El-Sayed, Manar E Abdel-Rahman
INTRODUCTION: Surgical site infections account for 14%-25% of all nosocomial infections. The main aims of this study were to audit the use of prophylactic antibiotic, to quantify the rate of post-operative wound infection, and to identify risk factors for its occurrence in general surgery. METHODOLOGY: A cross-sectional study was conducted in the General Surgery Department in Khartoum Teaching Hospital- Sudan. All Adult patients (age ≥18 years) admitted during March 1(st) to 31(st) October 2010 were recruited...
December 2013: Journal of Clinical and Diagnostic Research: JCDR
Charles S Bryan, William M Yarbrough
The consequences of deep wound infections before, during, and after coronary artery bypass grafting have prompted research to clarify risk factors and explore preventive measures to keep infection rates at an irreducible minimum. An analysis of 42 studies in which investigators used multivariate logistic regression analysis revealed that diabetes mellitus and obesity are by far the chief preoperative risk factors. A 4-point preoperative scoring system based on a patient's body mass index and the presence or absence of diabetes is one practical way to determine the risk of mediastinitis, and other risk-estimate methods are being refined...
2013: Texas Heart Institute Journal
R K Moorthy, H Sarkar, V Rajshekhar
OBJECTIVE: To audit the efficacy of a conservative prophylactic antibiotic policy in patients undergoing non-trauma cranial surgery. MATERIALS AND METHODS: Prospectively collected infection data in consecutive patients who underwent non-trauma cranial surgeries in one neurosurgical unit between 1 January 2003 and 31 December 2011 were reviewed. Depending on the surgery performed, a one-day course of intravenous chloramphenicol or a single dose of ceftriaxone was used as the prophylactic antibiotic therapy...
August 2013: British Journal of Neurosurgery
Ru Shing Ng, Chee Ping Chong
Surgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP), which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on several factors, including selection of appropriate antibiotic, timing of administration, dosage, duration of prophylaxis and route of administration...
2012: Australasian Medical Journal
Abubaker Ibrahim Elbur, Mirghani Abd El Rahman Yousif, Ahmed Sayed Ahmed Elsayed, Manar Elsheikh Abdel-Rahman
BACKGROUND: Antibiotic prophylaxis is effective at reducing the risk of postoperative infection for nearly all types of surgery. Objective To audit the use of prophylactic antibiotics for elective surgery. SETTING: Khartoum Teaching Hospital, Sudan, a 1,000 bed tertiary level hospital. METHOD: A prospective study was conducted over a 9 month period; patients admitted for elective surgery were included consecutively. MAIN OUTCOME MEASURE: The use and administration of prophylactic antibiotics for elective surgery...
February 2013: International Journal of Clinical Pharmacy
Rashid Alrahbi, Ruth Easton, Cino Bendinelli, Natalie Enninghorst, Krisztian Sisak, Zsolt J Balogh
INTRODUCTION:   Intercostal catheters (ICC) are the standard management of chest trauma, but are associated with complications in up to 30%. The aim of this study was to evaluate errors in technique during ICC insertion to characterize the potential benefit of improved training programmes. METHODS:   Prospective audit of all ICC in trauma patients at a level 1 trauma centre for over 12 months. Exclusions were pigtail catheters and ICC inserted during thoracic surgery...
June 2012: ANZ Journal of Surgery
Y Ding, M Lin, H Liu, W Zhang, L Wang, Y Li
BACKGROUND: Endophthalmitis after cataract surgery is an uncommon but devastating complication. Prophylactic intracameral injection of cefuroxime 1 mg at the end of surgery decreases the incidence five-fold. The visual outcome can be good (53% of cases having a visual acuity [VA] of better than 20/40) if treatment is initiated rapidly and follows the Endophthalmitis Vitrectomy Study (EVS) guidelines; but even with the best treatment, some patients end up with a poor visual outcome. Previous studies on postoperative endophthalmitis mainly focus on the cases performed in metropolitan tertiary hospitals; however, little information is available on the cases performed in local hospitals in rural areas...
October 2011: Infection
S M McHugh, M A Corrigan, B D Dimitrov, S Cowman, S Tierney, A D K Hill, H Humphreys
Surgical patients are at particular risk of healthcare-associated infection (HCAI) due to the presence of a surgical site leading to surgical site infection (SSI), and because of the need for intravascular access resulting in catheter-related bloodstream infection (CRBSI). A two-year initiative commenced with an initial audit of surgical practice; this was used to inform the development of a targeted educational initiative by surgeons specifically for surgical trainees. Parameters assessed during the initial audit and a further audit after the educational initiative were related to intra- and postoperative aspects of the prevention of SSIs, as well as care of peripheral venous catheters (PVCs) in surgical patients...
August 2011: Journal of Hospital Infection
G Morris-Stiff, J D'Souza, S Raman, S Paulvannan, M H Lewis
INTRODUCTION: The aims of this study were to audit results of a 10-year experience of surgery for acute limb ischaemia (ALI) in terms of limb salvage and mortality rates, and to compare results with a historical published series from our unit. PATIENTS AND METHODS: All emergency operations performed during the period 1993-2003 were identified from theatre registers and patient notes reviewed to determine indications for, and outcome of, surgery. Data were compared to a similar cohort who underwent surgery from 1980 to 1990...
November 2009: Annals of the Royal College of Surgeons of England
Nigel J Henderson, Michael Fancourt, William Gilkison, Stephen Kyle, Damien Mosquera
BACKGROUND: Skin grafts are a common method of closing skin defects. The literature comparing methods of graft application and subsequent outcomes is poor, but reports indicate a graft failure rate between 2 and 30%. The aim of this study was to audit our current skin graft practice. METHODS: Data were collected prospectively on all skin grafts performed by the general surgical department between 1st December 2005 and 1st December 2006. A standardized proforma on each patient included data on age, gender, graft indication, application method, comorbidities, length of stay, and graft outcomes including graft take at 1, 2 and 6 weeks post-operatively...
May 2009: ANZ Journal of Surgery
Satyamaanasa Polubothu, Sylvia Harrison, Andrew Clement, Haytham Kubba
OBJECTIVE: Published data on the role of antibiotics after open airway reconstruction surgery in children is lacking. We reviewed adherence to our own departmental antibiotic protocol to determine its adequacy and effectiveness. METHODS: We reviewed the records of all children undergoing open airway reconstruction surgery 2003-2007 in our unit which is based in a tertiary referral children's hospital. RESULTS: 36 children underwent surgery, of whom 32 were given appropriate antibiotic prophylaxis...
August 2009: International Journal of Pediatric Otorhinolaryngology
Greg J Knepil, Richard A Loukota
Data regarding the use of prophylactic antibiotics and infection rate following surgery for fractures of the zygomatic bone is scarce. Therefore an audit of the use and outcomes of antibiotic prophylaxis for surgery of fractures of the zygoma was undertaken. Following audit approval, four maxillofacial surgery units in the Yorkshire Region gathered prospective data for 134 patients undergoing surgery for fractures of the zygoma. Data was collected on four groups of patients undergoing surgery for fractures of the zygomatic bone: uncomplicated reductions of the zygomatic arch, reductions of the zygomatic complex without mini-plate fixation, reductions of the zygomatic complex using mini-plate fixation but excluding zygomatico-maxillary buttress, and fixation of the zygomatic complex with miniplates including the zygomatico-maxillary buttress...
March 2010: Journal of Cranio-maxillo-facial Surgery
S Malavaud, E Bonnet, D Vigouroux, J Mounet, B Suc
OBJECTIVE: To evaluate compliance with clinical guidelines on prophylactic antibiotic usage in gastro-intestinal surgery. MATERIAL AND METHODS: The medical charts of one hundred consecutive patients undergoing surgery in the last 6 months of 2006 were analysed as to determine whether the use of prophylactic antibiotics was indicated. Compliance with the prophylactic antibiotic guidelines of the Toulouse teaching hospitals and the Société Française d'Anesthésie et de Réanimation (SFAR) was examined; cases were analyzed by the criteria of the Haute Autorité en Santé for indication, type of antibiotic, time of administration, and duration of treatment...
November 2008: Journal de Chirurgie
S Malavaud, E Bonnet, F Atallah, R El Farsaoui, J Roze, M Mazerolles, P Massip, P Rischmann, P Plante, B Malavaud
OBJECTIVE: To evaluate compliance with clinical practice guidelines concerning prophylactic antibiotics in urological surgery. MATERIAL AND METHODS: Thirty per cent of the medical charts for the first 288 patients operated in 2005 and requiring prophylactic antibiotics were selected at random. On this sample of 84 patients, compliance with the CHU de Toulouse (Toulouse teaching hospital) and société française d'anesthésie et de réanimation (SFAR) (French Society of Anaesthesia and Intensive Care), prophylactic antibiotic guidelines were investigated according to the method recommended by the Centre de coordination de da lutte dontre des infections nosocomiales (CCLIN) Ouest (Nosocomial Infection Control Coordination Centre) which analyses the indication, type of antibiotic, time of administration and duration of treatment...
June 2008: Progrès en Urologie
Andrew D Rosenberg, Daniel Wambold, Linede Kraemer, Maureen Begley-Keyes, Scott L Zuckerman, Neeraj Singh, Max M Cohen, Michele V Bennett
BACKGROUND: Delivery of intravenous antibiotic prophylaxis within one hour prior to surgical incision is considered important in helping to decrease the incidence of surgical site infections, but methods to ensure compliance have not been established. METHODS: All patients at our institution are subjected to a surgical "time-out" protocol to prevent wrong-site surgery. During a seven-week period, all patients undergoing spine surgery, total hip arthroplasty, or total knee arthroplasty had another safety initiative, that of ensuring that prophylactic intravenous antibiotics were administered at least one hour prior to incision, "piggybacked" onto our existing time-out verification checklist...
February 2008: Journal of Bone and Joint Surgery. American Volume
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