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https://www.readbyqxmd.com/read/29473540/-prevention-of-postoperative-infections-patient-safety-subordinated-to-antibiotic-stewardship
#1
M J M Bonten, J Kluytmans
A new Dutch guideline for surgical antimicrobial prophylaxis recommends preoperative treatment with mupirocin and chlorhexidine showers only in patients identified as nasal carriers of Staphylococcus aureus. Yet, preoperative screening and treatment may not be achieved in many patients, because of the infrastructural complexity of all procedures this requires. We are therefore pleading for a universal treatment approach, which is more cost-effective and precludes carriers from being missed, while monitoring the occurrence of S...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29344102/should-preoperative-showering-or-cleansing-with-chlorhexidine-gluconate-chg-be-part-of-the-surgical-care-bundle-to-prevent-surgical-site-infection
#2
Charles E Edmiston, David Leaper
Showering preoperatively with chlorhexidine gluconate is an issue that continues to promote debate; however, many studies demonstrate evidence of surgical site infection risk reduction. Methodological issues have been present in many of the studies used to compile guidelines and there has been a lack of standardisation of processes for application of the active agents in papers pre-2009. This review and commentary paper highlights the potential for enhancing compliance with this low-risk and low-cost intervention and provides some guidance for enhancing implementation of preoperative showering with both chlorhexidine in solution and impregnated wipes...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28690206/combination-of-oral-antibiotics-and-mechanical-bowel-preparation-reduces-surgical-site-infection-in-colorectal-surgery
#3
Kerri A Ohman, Leping Wan, Tracey Guthrie, Bonnie Johnston, Jennifer A Leinicke, Sean C Glasgow, Steven R Hunt, Matthew G Mutch, Paul E Wise, Matthew L Silviera
BACKGROUND: Surgical site infections (SSI) are a common complication after colorectal surgery. An infection prevention bundle (IPB) was implemented to improve outcomes. STUDY DESIGN: A standardized IPB that included the administration of oral antibiotics with a mechanical bowel preparation, preoperative shower with chlorhexidine, hair removal and skin preparation in holding, antibiotic wound irrigation, and a "clean-closure" protocol was implemented in January 2013...
October 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28341500/effect-of-2-chlorhexidine-gluconate-impregnated-cloth-on-surgical-site-infections-in-vascular-surgery
#4
John Bak, Jason Le, Toshio Takayama, Angela Gibson, Sara Zerbel, Nasia Safdar, Jon S Matsumura
BACKGROUND: Surgical site infections (SSIs) are a significant burden to patients and health care systems. This retrospective study evaluates the observed rates of SSI after our institution implemented chlorhexidine gluconate-impregnated (CHG) cloth as a preoperative antiseptic preparation in elective vascular surgery. METHODS: Between March 2011 and January 2012, we reviewed 250 patients who underwent elective vascular surgery who used the CHG cloth preoperatively...
August 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28263778/evaluation-of-the-bundle-zero-surgical-site-infection-to-prevent-surgical-site-infection-in-vascular-surgery
#5
María Fernández-Prada, Carmen Martínez-Ortega, Livia Revuelta-Mariño, Ángeles Menéndez-Herrero, Juan F Navarro-Gracia
BACKGROUND: To compare the incidence of surgical site infections (SSIs) before and after the implementation of a bundle of care called "Zero Surgical Site Infection." Secondary goals included estimating measures of association and their potential impact, determining care management indicators in vascular surgery, and evaluating the level of compliance with the bundle. METHODS: This is a prospective observational study with a historic control group. The bundle included (1) removal of body hair with clippers; (2) preoperative showering with chlorhexidine soap; (3) preparation of the surgical field with alcoholic chlorhexidine 2%; (4) adequacy of antimicrobial prophylaxis; (5) intraoperative and (6) postoperative glycemic and central temperature control...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28052784/reducing-the-rate-of-surgical-site-infections-after-breast-surgery-with-the-use-of-larger-volumes-of-4-chlorhexidine-gluconate-solution-as-preoperative-antiseptic-showering
#6
Jon Persichino, Hayley Lee, Made Sutjita, Karla Talavera, Glenn San-Agustin, Silvia Gnass
No abstract text is available yet for this article.
January 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27387479/methicillin-resistant-and-methicillin-sensitive-staphylococcus-aureus-screening-and-decolonization-to-reduce-surgical-site-infection-in-elective-total-joint-arthroplasty
#7
Scott M Sporer, Thea Rogers, Linda Abella
BACKGROUND: Deep infection after elective total joint arthroplasty remains a devastating complication. Preoperative nasal swab screening for Staphylococcus aureus colonization and subsequent treatment of colonized patients is one proposed method to identify at-risk patients and decrease surgical site infections (SSIs). The purpose of this study was to determine whether a preoperative staphylococcus screening and treatment program would decrease the incidence of SSI in elective joint arthroplasty patients...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27159744/using-bundled-interventions-to-reduce-surgical-site-infection-after-major-gynecologic-cancer-surgery
#8
Megan P Johnson, Sharon J Kim, Carrie L Langstraat, Sneha Jain, Elizabeth B Habermann, Jean E Wentink, Pamela L Grubbs, Sharon A Nehring, Amy L Weaver, Michaela E McGree, Robert R Cima, Sean C Dowdy, Jamie N Bakkum-Gamez
OBJECTIVE: To investigate whether implementing a bundle, defined as a set of evidence-based practices performed collectively, can reduce 30-day surgical site infections. METHODS: Baseline surgical site infection rates were determined retrospectively for cases of open uterine cancer, ovarian cancer without bowel resection, and ovarian cancer with bowel resection between January 1, 2010, and December 31, 2012, at an academic center. A perioperative bundle was prospectively implemented during the intervention period (August 1, 2013, to September 30, 2014)...
June 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26836053/is-staphylococcal-screening-and-suppression-an-effective-interventional-strategy-for-reduction-of-surgical-site-infection
#9
REVIEW
Charles E Edmiston, Nathan A Ledeboer, Blake W Buchan, Maureen Spencer, Gary R Seabrook, David Leaper
BACKGROUND: Staphylococcus aureus has been recognized as a major microbial pathogen for over 100 y, having the capacity to produce a variety of suppurative and toxigenic disease processes. Many of these infections are life-threatening, with particularly enhanced virulence in hospitalized patients with selective risk factors. Strains of methicillin-resistant Staphylococcus aureus (MRSA) have rapidly spread throughout the healthcare environment such that approximately 20% of S. aureus isolates recovered from surgical site infections are methicillin-resistant, (although this is now reducing following national screening and suppression programs and high impact interventions)...
April 2016: Surgical Infections
https://www.readbyqxmd.com/read/26308490/evidence-for-a-standardized-preadmission-showering-regimen-to-achieve-maximal-antiseptic-skin-surface-concentrations-of-chlorhexidine-gluconate-4-in-surgical-patients
#10
RANDOMIZED CONTROLLED TRIAL
Charles E Edmiston, Cheong J Lee, Candace J Krepel, Maureen Spencer, David Leaper, Kellie R Brown, Brian D Lewis, Peter J Rossi, Michael J Malinowski, Gary R Seabrook
IMPORTANCE: To reduce the amount of skin surface bacteria for patients undergoing elective surgery, selective health care facilities have instituted a preadmission antiseptic skin cleansing protocol using chlorhexidine gluconate. A Cochrane Collaborative review suggests that existing data do not justify preoperative skin cleansing as a strategy to reduce surgical site infection. OBJECTIVES: To develop and evaluate the efficacy of a standardized preadmission showering protocol that optimizes skin surface concentrations of chlorhexidine gluconate and to compare the findings with the design and methods of published studies on preoperative skin preparation...
November 2015: JAMA Surgery
https://www.readbyqxmd.com/read/26308068/chlorhexidine-gluconate-4-showers-and-surgical-site-infection-reduction
#11
COMMENT
Zeinab M Alawadi, Lillian S Kao
No abstract text is available yet for this article.
November 2015: JAMA Surgery
https://www.readbyqxmd.com/read/25927093/preoperative-bathing-or-showering-with-skin-antiseptics-to-prevent-surgical-site-infection
#12
REVIEW
Joan Webster, Sonya Osborne
BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection. OBJECTIVES: To review the evidence for preoperative bathing or showering with antiseptics for preventing hospital-acquired (nosocomial) surgical site infections...
February 20, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25695511/preoperative-bathing-or-showering-with-skin-antiseptics-to-prevent-surgical-site-infection
#13
Joan Webster, Sonya Osborne
BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after invasive (surgical) procedures. Preoperative bathing or showering with an antiseptic skin wash product is a well-accepted procedure for reducing skin bacteria (microflora). It is less clear whether reducing skin microflora leads to a lower incidence of surgical site infection. OBJECTIVES: To review the evidence for preoperative bathing or showering with antiseptics for preventing hospital-acquired (nosocomial) surgical site infections...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25692267/evidence-update-on-prevention-of-surgical-site-infection
#14
REVIEW
David Leaper, Karen Ousey
PURPOSE OF REVIEW: Surgical site infection (SSI) is a common healthcare-associated infection and complicates up to 10-20% of operations with considerable strain on healthcare resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and perioperative glycaemic control to reduce SSIs, this review has considered new research and systematic reviews, and whether their findings should be included in guidelines. RECENT FINDINGS: The efficacy of preoperative bathing/showering, antibiotic prophylaxis for clean surgery and perioperative oxygen supplementation to reduce the risk of SSI is still in doubt...
April 2015: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/25539752/-what-s-new-in-instrumental-dermatology
#15
REVIEW
J-M Amici
This "What's new in instrumental dermatology" focuses on cutaneous oncologic surgery, base on a review of the 2012-2014 literature. First, the ability of dermatologists to make a good "oncologic reading of tumors" is the key of radical surgical treatment. Advantages and disadvantages of the biopsy are discussed. Then, the second message is the management of anticoagulants, that should not be interrupted for skin surgery. Despite recommendations, this practice is not followed in 40% of cases; this point is critical because bleeding complications are minor compared to potential morbidity of thrombotic events when stopping these medications...
December 2014: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/25442124/-what-is-the-scientific-basis-of-our-surgical-beliefs
#16
REVIEW
M Gorj, M Revol
The purpose of the study is to assess the validity of surgical beliefs and their application in the operating room… An exhaustive revue of literature was performed using PubMed and the Cochrane Library. We found over 400 articles, and chose to select the 135 most pertinent ones. Antiseptic hand washing and the use of sterile gloves are the main elements of SSI prevention. In this field, use of hydroalcoholic solutions and chlorhexidine seem to be the more efficient. Regarding the surgical gown, the use of masks and surgical hands contamination...
February 2015: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/25322531/preoperative-skin-antiseptics-for-preventing-surgical-site-infections-what-to-do
#17
Paule Poulin, Kelly Chapman, Lynda McGahan, Lea Austen, Trevor Schuler
BACKGROUND: Safe and effective patient preoperative skin antisepsis is recommended to prevent surgical site infections (SSIs), reduce patient morbidity, and reduce systemic costs. However, there is lack of consensus among best practice recommendations regarding the optimal skin antiseptic solution and method of application. METHODS: In 2010 and 2011 the health technology appraisal committee of the Surgery Operational Clinical Network (SOCN), of Alberta Health Services (AHS), conducted an environmental scan to determine the current preoperative skin antisepsis in Alberta, reviewed key publications and existing guidelines, and requested a systematic review from the Canadian Agency for Drugs and Technologies in Health (CADTH)...
September 2014: ORNAC Journal
https://www.readbyqxmd.com/read/25134645/weekly-chlorhexidine-douche-does-it-reduce-healthcare-associated-bloodstream-infections
#18
Derya Seyman, Nefise Oztoprak, Hande Berk, Filiz Kizilates, Mestan Emek
BACKGROUND: Daily chlorhexidine (CHG) bathing has been used as a precaution to reduce the rate of healthcare-associated bloodstream infections (HA-BSI). The application frequency of CHG bathing remains unclear, this procedure has been implemented daily by this time. The aim of this study was to determine the efficacy of weekly whole-body douche with CHG shower gel on rates of HA-BSI. METHODS: We conducted a prospective intervention trial in medical, surgical, and anesthesiology intensive care units (ICUs) in a tertiary teaching hospital from June 2011 to November 2012...
October 2014: Scandinavian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/24880956/empowering-the-surgical-patient-a-randomized-prospective-analysis-of-an-innovative-strategy-for-improving-patient-compliance-with-preadmission-showering-protocol
#19
RANDOMIZED CONTROLLED TRIAL
Charles E Edmiston, Candace J Krepel, Sarah E Edmiston, Maureen Spencer, Cheong Lee, Kellie R Brown, Brian D Lewis, Peter J Rossi, Michael Malinowski, Gary Seabrook
BACKGROUND: Surgical site infections (SSIs) are responsible for significant morbidity, mortality, and excess use of health care resources. The preadmission antiseptic shower is accepted as an effective strategy for reducing the risk for SSIs. The study analyzes the benefit of an innovative electronic patient alert system (EAS) for enhancing compliance with a preadmission showering protocol with 4% chlorhexidine gluconate (CHG). STUDY DESIGN: After providing informed consent, 80 volunteers were randomized to 4 CHG showering groups...
August 2014: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/24773797/care-bundle-to-prevent-methicillin-resistant-staphylococcus-aureus-sternal-wound-infection-after-off-pump-coronary-artery-bypass
#20
Chen-Yen Chien, Cheng-Hsin Lin, Ron-Bin Hsu
Methicillin-resistant Staphylococcus aureus (MRSA) sternal wound infection (SWI) after cardiac surgery is endemic in our hospital. An infection control care bundle with preoperative chlorhexidine showering and povidone iodine paint before bathing was introduced in 2006. From 2001 to 2012, 23 (2.3%) of 1,010 patients undergoing off-pump coronary artery bypass had SWIs. SWI significantly decreased after 2006 (1.4% vs 3.4%, respectively; P = .03). Care bundle was more protective against MRSA infection (2.3% vs 0...
May 2014: American Journal of Infection Control
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