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Surgical site infections

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https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#1
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28323799/a-prospective-randomized-trial-to-assess-oral-versus-intravenous-antibiotics-for-the-treatment-of-postoperative-wound-infection-after-extremity-fractures-poviv-study
#2
William T Obremskey, Andrew H Schmidt, Robert V OʼToole, Jennifer DeSanto, Saam Morshed, Paul Tornetta, Clinton K Murray, Clifford B Jones, Daniel O Scharfstein, Tara J Taylor, Anthony R Carlini, Renan C Castillo
Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#3
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#4
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323795/assessment-of-severe-extremity-wound-bioburden-at-the-time-of-definitive-wound-closure-or-coverage-correlation-with-subsequent-postclosure-deep-wound-infection-bioburden-study
#5
Michael J Bosse, Clinton K Murray, Anthony R Carlini, Reza Firoozabadi, Theodore Manson, Daniel O Scharfstein, Joseph C Wenke, Mary Zadnik, Renan C Castillo
Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#6
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#7
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28315721/current-outcomes-and-predictors-of-treatment-failure-in-patients-with-surgical-site-infection-after-elective-colorectal-surgery-a-multicentre-prospective-cohort-study
#8
Aina Gomila, Josep Ma Badia, Jordi Carratalà, Xavier Serra-Aracil, Evelyn Shaw, Vicens Diaz-Brito, Antoni Castro, Elena Espejo, Carmen Nicolás, Marta Piriz, Montserrat Brugués, Josefina Obradors, Ana Lérida, Jordi Cuquet, Enric Limón, Francesc Gudiol, Miquel Pujol
OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS: Of 3,701 patients, 669 (18.1%) developed SSI; 336 (9...
March 15, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28315515/tailored-corneo-conjunctival-autografting-in-primary-and-secondary-pterygium-surgery
#9
Mahmoud M Genidy, Ahmed A Abdelghany, Jorge L Alio
PURPOSE: To describe the outcomes of a novel technique for pterygium removal: tailored corneo-conjunctival autograft, which offers the advantages of better postoperative cosmetic outcomes and recurrence prevention. METHODS: This retrospective interventional noncomparative study included 420 eyes in 370 patients (ages 25-60 years) (127 women, 243 men). We divided the patients into 2 groups. The first group included 348 primary pterygium; the second group included 72 recurrent pterygium...
February 28, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28314089/electrosurgery-reduces-blood-loss-and-immediate-postoperative-inflammation-compared-to-cold-instruments-for-midline-celiotomy-in-dogs-a-randomized-controlled-trial
#10
Lee B Meakin, Jo C Murrell, Ivan C P Doran, Toby G Knowles, Michael S Tivers, Guillaume P A Chanoit
OBJECTIVES: To compare the use of an electrosurgical device with traditional cold instruments (scalpel and scissors) for midline celiotomy incision. STUDY DESIGN: Prospective randomized controlled clinical trial. SAMPLE POPULATION: One hundred and twenty client-owned dogs undergoing abdominal surgery. METHODS: Dogs were prospectively recruited and randomized to receive electroincision or cold instrument incision. For cold incision, surgeons used basic surgical instruments including scalpel and scissors...
March 17, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#11
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28303656/incidence-and-risks-for-surgical-site-infection-after-adult-tibial-plateau-fractures-treated-by-orif-a-prospective-multicentre-study
#12
Yanbin Zhu, Song Liu, Xiaolin Zhang, Wei Chen, Yingze Zhang
Tibial plateau fractures are difficult to treat and more likely complicated by subsequent surgical site infection (SSI). There is limited information about its characteristics and related risk factors for SSI. This study was designed as a prospective and multicentre one to address this issue. From July to 15 November in 2014, 235 patients with tibial plateau fractures were treated by open reduction and internal fixation (ORIF) and followed up with complete data. Twelve patients (5·1%, 12/235) developed SSI, with 2·1% for deep SSI and 3·0% for superficial SSI...
March 16, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28303341/epidemiology-and-risk-factors-associated-with-surgical-site-infection-after-different-types-of-hepatobiliary-and-pancreatic-surgery
#13
Keita Morikane
PURPOSE: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database. METHODS: Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance...
March 16, 2017: Surgery Today
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#14
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28302449/is-laparoscopic-appendectomy-feasible-for-complicated-appendicitis-a-systematic-review-and-meta-analysis
#15
REVIEW
Man-Cheng Yu, Yao-Jun Feng, Wei Wang, Wei Fan, Hong-Tao Cheng, Juan Xu
BACKGROUND: laparoscopic appendectomy(LA) has proved to be a safe alternative to open appendectomy(OA) in uncomplicated appendicitis; however, the feasibility of LA for complicated appendicitis(CA) has not been conclusively determined. OBJECTIVES: To assess the feasibility and safety of LA for CA through a systematic review and meta-analysis. METHODS: A literature search in PubMed, Embase, Cochrane Library, and web of Science was performed for eligible studies published from the inception of the databases to January 2016...
March 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28302305/absolute-or-relative-stability-in-minimal-invasive-plate-osteosynthesis-of-simple-distal-meta-or-diaphyseal-tibia-fractures
#16
R Wenger, F Oehme, J Winkler, S M Perren, R Babst, F J P Beeres
INTRODUCTION: Minimal invasive plate osteosynthesis in simple distal meta or diaphyseal tibia fractures can be applied using absolute (lag screw and neutralisation plate; LSN) or relative stability (bridge plate; BP). The primary aim of the study was to compare time to radiological union and time to full weight bearing in the two groups (LSN vs. BP). Reduction was performed either percutaneously or by a minimally open approach (mini open). Secondary aim was to analyse the number of complications between both groups...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28301615/topical-approaches-to-improve-surgical-outcomes-and-wound-healing-a-review-of-efficacy-and-safety
#17
Kristin Totoraitis, Joel L Cohen, Adam Friedman
<p>Surgical procedures are an important piece of a dermatologist's daily practice. Therefore, the optimization of post-surgical wound healing is an area of utmost importance and interest. Although low risk, one notable barrier to proper wound healing is surgical site infection.</p> <p>In an attempt to mitigate this risk and improve surgical outcomes, multiple topical products continue to be used both pre- and postprocedure. Traditionally, this includes both topical antibiotics and antiseptics...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28301471/genomic-confirmation-of-vancomycin-resistant-enterococcus-transmission-from-deceased-donor-to-liver-transplant-recipient
#18
Ali Bashir, Oliver Attie, Mitchell Sullivan, Robert Sebra, Kavindra V Singh, Deena Altman, Theodore Pak, Jayeeta Dutta, Kieran Chacko, Elizabeth Webster, Martha Lewis, Camille Hamula, Kristin W Delli Carpini, Barbara E Murray, Andrew Kasarskis, Harm van Bakel, Shirish Huprikar
In a liver transplant recipient with vancomycin-resistant Enterococcus (VRE) surgical site and bloodstream infection, a combination of pulsed-field gel electrophoresis, multilocus sequence typing, and whole genome sequencing identified that donor and recipient VRE isolates were highly similar when compared to time-matched hospital isolates. Comparison of de novo assembled isolate genomes was highly suggestive of transplant transmission rather than hospital-acquired transmission and also identified subtle internal rearrangements between donor and recipient missed by other genomic approaches...
2017: PloS One
https://www.readbyqxmd.com/read/28301395/increased-anatomic-severity-in-appendicitis-is-associated-with-outcomes-in-a-south-african-population
#19
Matthew C Hernandez, Victor Y Kong, Johnathon M Aho, John L Bruce, Stephanie F Polites, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Severity of emergency general surgery diseases (EGS) has not been standardized until recently. The American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system for EGS diseases to facilitate communication and quality comparisons between providers and hospitals. Previous work has demonstrated validity of the system for appendicitis in the United States. In order to demonstrate generalizability, we aim to externally validate this grading system in South African patients with appendicitis...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28299273/guidelines-for-patient-specific-jawline-definition-with-titanium-implants-in-esthetic-deformity-and-malformation-surgery
#20
Maurice Yves Mommaerts
CONTEXT: Asymmetry and unfavorable esthetics of the jawline have become possible to correct in three dimensions using computer aided design and computer aided manufacturing. AIMS: The aim of this study was to provide esthetic, technical, and operative guidelines for mandibular angle and border augmentation using patient-specific titanium implants made by selective laser melting. SETTINGS AND DESIGN: University hospital - prospective registry...
July 2016: Annals of Maxillofacial Surgery
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