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https://www.readbyqxmd.com/read/28724387/risk-factors-for-acute-surgical-site-infections-after-lumbar-surgery-a-retrospective-study
#1
Qi Lai, Quanwei Song, Runsheng Guo, Haidi Bi, Xuqiang Liu, Xiaolong Yu, Jianghao Zhu, Min Dai, Bin Zhang
BACKGROUND: Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. METHODS: We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit...
July 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28723736/timing-of-preoperative-antibiotic-prophylaxis-in-54-552-patients-and-the-risk-of-surgical-site-infection-a-systematic-review-and-meta-analysis
#2
Stijn Willem de Jonge, Sarah L Gans, Jasper J Atema, Joseph S Solomkin, Patchen E Dellinger, Marja A Boermeester
The aim of the study was to assess the effect of timing of preoperative surgical antibiotic prophylaxis (SAP) on surgical site infection (SSI) and compare the different timing intervals.The benefit of routine use of SAP prior to surgery has long been recognized. However, the optimal timing has not been defined. For the purpose of developing recommendations for the World Health Organization guideline for SSI prevention, a systematic review and meta-analysis of all relevant evidence was conducted.Major medical databases were searched from 1990 to 2016...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28717532/retrograde-intrarenal-surgery-for-renal-stones-part-1
#3
REVIEW
Ben Van Cleynenbreugel, Özcan Kılıç, Murat Akand
The main aim in the treatment of renal stones is to clearance of the stones completely with the least morbidity. Parallel to the improvements in technology during recent years, new flexible ureterorenoscopes and effective lithotripters such as holmium laser have been developed, thus retrograde intrarenal surgery (RIRS) has become an efficient and safe option in the management of urinary system stone disease with a gradually increasing popularity. Therewithal, innovations in auxiliary equipment such as guide-wires, ureteral access sheath and stone baskets have made this procedure more effective...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28709667/routine-use-of-topical-bacitracin-to-prevent-sternal-wound-infections-after-cardiac-surgery
#4
Joshua L Chan, Andrada C Diaconescu, Keith A Horvath
BACKGROUND: The development of sternal wound infections remains a serious complication after cardiac surgery. A number of studies have assessed the use of topical antibiotics placed on the sternal edges. We evaluated the routine use of bacitracin ointment applied over the sternotomy skin incision as a prophylactic measure against sternal wound infections. METHODS: A retrospective review of all coronary artery bypass graft and valve surgery cases performed at a single institution between 2006 and 2015 was performed (n = 1,495)...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707170/effectiveness-and-risk-of-biliary-drainage-prior-to-pancreatoduodenectomy-review-of-current-status
#5
REVIEW
Alban Zarzavadjian Le Bian, David Fuks, Raffaele Dalla Valle, Manuela Cesaretti, Vincenzo Violi, Renato Costi
Preoperative biliary drainage (PBD) prior to pancreatoduodenectomy (PD) has gained popularity as bridge management to resolve jaundice, but its role is being challenged as it is thought to increase morbidity. To clarify the current recommendations for PBD prior to PD, we reviewed the literature, including all relevant articles published in English up until December, 2015. There is increasing evidence that PBD causes bile infection, which is related to the morbidity of infectious complications. Results of transhepatic drainage are poorer than those of endoscopic stenting, especially in an oncologic setting, although it is still unclear whether metallic stents are superior to nasobiliary drainage...
July 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/28702149/postoperative-antibiotic-therapy-after-appendectomy-in-patients-with-non-perforated-appendicitis
#6
Seyed-Mohammadreza Sadraei-Moosavi, Novin Nikhbakhsh, Ali-Asghar Darzi
BACKGROUND: Appendectomy intra-abdominal is the most frequently performed emergency surgery. This study was conducted to determine the role of postoperative antibiotics in reducing surgical site infections (SSIs) and abscess formation after open appendectomy. METHODS: In the Department of Surgery, Shahid Beheshti Hospital, Babol, Iran, from October 2013 to October 2014 one hundred and fifty two patients, who underwent appendectomy for nonperforated appendicitis (NPA) and fulfilled the selection criteria, were randomized into two groups...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#7
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#8
Yang Liu, Ming Feng, Yong Yao, Kan Deng, Xinjie Bao, Xiaohai Liu, Renzhi Wang
RATIONALE: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection. PATIENT CONCERNS AND DIAGNOSIS: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28697103/chlorhexidine-alcohol-compared-with-povidone-iodine-for-preoperative-topical-antisepsis-for-abdominal-hysterectomy
#9
Shitanshu Uppal, Ali Bazzi, R Kevin Reynolds, John Harris, Mark D Pearlman, Darrell A Campbell, Daniel M Morgan
OBJECTIVE: To compare preoperative chlorhexidine-alcohol topical antiseptic agent with povidone-iodine in patients undergoing abdominal hysterectomy for benign indications. METHODS: A retrospective cohort study of patients undergoing abdominal hysterectomy from July 2012 to February 2015 in the Michigan Surgical Quality Collaborative was performed. The primary exposure was the use of chlorhexidine-alcohol or povidone-iodine. The primary outcome was surgical site infection within 30 days...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28695238/predictive-risk-factors-for-systemic-inflammatory-response-syndrome-following-ureteroscopic-laser-lithotripsy
#10
Yusuke Uchida, Ryoji Takazawa, Sachi Kitayama, Toshihiko Tsujii
The objective of this study was to investigate risk factors for the development of systemic inflammatory response syndrome following ureteroscopic laser lithotripsy. We retrospectively collected data of 469 patients who underwent ureteroscopic laser lithotripsy at our single institution from February 2008 to June 2016. Details for the patient, the stone, and the surgical factors that potentially contributed to postoperative infection were extracted. Using a logistic regression model, we analyzed how the clinical factors affected the incidence of systemic inflammatory response syndrome...
July 10, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#11
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#12
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28690206/combination-of-oral-antibiotics-and-mechanical-bowel-preparation-reduces-surgical-site-infection-in-colorectal-surgery
#13
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...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28689542/-treatment-of-simple-subcutaneous-abscesses
#14
Nina Hardgrib, Klaus Kjær Petersen
Simple subcutaneous abscesses are common, and we have examined the literature concerning the ideal treatment of subcutaneous abscesses. We recommend radical debridement with removal of all pus, the abscess wall and any necrosis. If primary suture is chosen, preoperative antibiotics should be administered, and the cavity should be closed without dead space. Antibiotics should not routinely be given, but always be considered in immunocompromised patients or patients with septicaemia. Routine examination of the microbiology has no influence on the treatment and is not recommended...
July 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28673871/rectal-shaving-using-plasma-energy-in-deep-infiltrating-endometriosis-of-the-rectum-four-years-of-experience
#15
Noémie Marty, Salma Touleimat, Salwa Moatassim-Drissa, Jenny Claude Millochau, Aurélie Vallee, Emanuela Stochino Loi, Eulalie Desnyder, Horace Roman
STUDY OBJECTIVE: To evaluate postoperative complications, digestive function and fertility outcomes in patients managed by rectal shaving using plasma energy in deep infiltrating endometriosis of the rectum. DESIGN: A single center retrospective cohort study using data prospectively recorded, including patients managed from December 2012 to December 2016. DESIGN CLASSIFICATION: Canadian Task Force classification II-2. SETTINGS: Department of Gynecology and Obstetrics of Rouen University Hospital (France)...
June 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28671888/complications-after-total-skin-sparing-mastectomy-and-expander-implant-reconstruction-effects-of-radiation-therapy-on-the-stages-of-reconstruction
#16
Anne Warren Peled, Marie Sears, Frederick Wang, Robert D Foster, Michael Alvarado, Jasmine Wong, Cheryl A Ewing, Hani Sbitany, Laura J Esserman, Barbara Fowble
BACKGROUND: Many patients undergoing total-skin sparing mastectomy (TSSM) and 2-staged expander-implant (TE-I) reconstruction require postmastectomy radiation therapy (PMRT). Additionally, many patients undergoing TSSM for recurrent cancer have a history of lumpectomy and radiation therapy (XRT). Few studies have looked at the impact of XRT on the stages of TE-I reconstruction. METHODS: Patients undergoing TSSM and immediate TE-I reconstruction between 2006 and 2013 were identified from a prospectively maintained database...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28669540/successful-management-of-primary-atrophic-rhinitis-by-turbinate-reconstruction-using-autologous-costal-cartilage
#17
Marn Joon Park, Yong Ju Jang
Initial management of primary atrophic rhinitis is conservative, with nasal ointments, saline irrigation, and antibiotics prescribed to relieve symptoms. However, in cases that show no improvement, a surgical approach is considered. Recently, many studies have reported successful surgical outcomes using various nasal implants. However, no study has reported implantation of autologous costal cartilage in PAR patients. We report here the case of a 63-year-old woman diagnosed with PAR that was intractable to medical therapy...
June 29, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#18
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28652756/noncontact-plating-technique-in-an-open-fracture
#19
Ümit Tuhanioğlu, Hasan Ulaş Oğur, Hakan Çiçek, Fırat Seyfettinoğlu, Osman Çiloğlu, Ahmet Kapukaya
AIM: In comparison with closed fractures, open fractures have an increased risk of infection, there are soft tissue-related problems, and difficulties are experienced in union. The aim of this study was to evaluate and discuss the results of osteosynthesis applied with a noncontact plate in Gustilo-Anderson Type 2, 3a, and 3b fractures. METHOD: The study included 23 patients applied with debridement + noncontact plate osteosynthesis + soft tissue procedures in a single session for the treatment of an open fracture...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28647716/bilateral-recurrent-pyosalpinx-in-a-sexually-inactive-12-year-old-girl-secondary-to-rare-variant-of-mullerian-duct-anomaly
#20
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
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