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https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#1
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#2
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28105080/current-practice-of-antibiotic-prophylaxis-for-surgical-fixation-of-closed-long-bone-fractures-a-survey-of-297-members-of-the-orthopaedic-trauma-association
#3
Itai Gans, Amit Jain, Norachart Sirisreetreerux, Elliott R Haut, Erik A Hasenboehler
BACKGROUND: The risk of postoperative surgical site infection after long bone fracture fixation can be decreased with appropriate antibiotic use. However, there is no agreement on the superiority of a single- or multiple-dose perioperative regimen of antibiotic prophylaxis. The purpose of this study is to determine the following: 1) What are the current practice patterns of orthopaedic trauma surgeons in using perioperative antibiotics for closed long bone fractures? 2) What is the current knowledge of published antibiotic prophylaxis guidelines among orthopaedic trauma surgeons? 3) Are orthopaedic surgeons willing to change their current practices? METHODS: A questionnaire was distributed via email between September and December 2015 to 955 Orthopaedic Trauma Association members, of whom 297 (31%) responded...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28104282/-incidence-of-bacteria-from-cultures-of-bile-and-gallbladder-wall-of-laparoscopic-cholecystectomy-patients-in-the-university-hospital-dr-jos%C3%A3-eleuterio-gonz%C3%A3-lez
#4
Rubén Cueto-Ramos, Marco Hernández-Guedea, Edelmiro Pérez-Rodríguez, Francisco Reyna-Sepúlveda, Gerardo Muñoz-Maldonado
BACKGROUND: Through experience it has been accepted that bile in normal conditions remains sterile. Bactibilia is a common finding in individuals at high risk or with complicated cholecystolithiasis, however few data prevails about the prevalence of bactibilia in patients operated on for uncomplicated laparoscopic cholecystectomy. There is s common usage of preoperative and postoperative antibiotics in the different patients without the existence of any actual bacteriologic and epidemiologic evidence...
January 16, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28101041/endophthalmitis-following-27-gauge-pars-plana-vitrectomy-for-vitreous-floaters
#5
Zhong Lin, Rong Han Wu, Nived Moonasar
PURPOSE: To report a case of Staphylococcus epidermidis endophthalmitis following 27-gauge pars plana vitrectomy for symptomatic vitreous floaters. METHODS: The clinical course and imaging findings, including fundus optomap, and spectral domain optical coherence tomography of a 24-year-old male patient were documented. RESULTS: The patient, with a preoperative best-corrected visual acuity (BCVA) of 1.0, developed endophthalmitis following 27-gauge pars plana vitrectomy for symptomatic vitreous floaters...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28091841/transumbilical-abdominal-incision-for-laparoscopic-colorectal-surgery-does-not-increase-the-risk-of-postoperative-surgical-site-infection
#6
Mizunori Yaegashi, Koki Otsuka, Toshimoto Kimura, Masanori Hakozaki, Megumu Kamishima, Tomoki Hatanaka, Kei Sato, Hitoshi Fujii, Teppei Matsuo, Akira Sasaki
PURPOSE: Besides antibiotic prophylaxis, antiseptic skin preparation is an important measure to prevent surgical site infection (SSI). No reports have detailed the relationship between SSI and umbilical microflora following laparoscopic colorectal cancer with a transumbilical longitudinal incision. METHODS: Risk factors and the rate of SSI were investigated in 453 patients who underwent laparoscopic colorectal resection over a 3-year period. Microbiological samples were collected from the umbilicus and SSI areas...
January 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28087166/future-surgery-after-revision-shoulder-arthroplasty-the-impact-of-unexpected-positive-cultures
#7
Eric M Padegimas, Cassandra Lawrence, Alexa C Narzikul, Benjamin M Zmistowski, Joseph A Abboud, Gerald R Williams, Surena Namdari
BACKGROUND: The clinical implications and treatment of unexpected positive cultures (UPCs) in revision shoulder arthroplasty are not well defined. The purpose of this study was to describe results of patients with and without UPCs after revision shoulder arthroplasty. METHODS: A single institutional database was used to retrospectively identify all revision shoulder arthroplasties performed between January 1, 2011, and December 31, 2013. Patients with preoperative suspicion of infection were excluded...
January 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28081579/predicting-full-enteral-feeding-in-the-postoperative-period-in-infants-with-congenital-diaphragmatic-hernia
#8
Carlos Zozaya, Miryam Triana, Rosario Madero, Steven Abrams, Leopoldo Martinez, Maria Virginia Amesty, Miguel Sáenz de Pipaón
Introduction The objective of the study is to examine the factors associated with time to achieve full enteral feeding after repair of congenital diaphragmatic hernia. Materials and Methods Demographic, clinical, and therapeutic data were retrospectively assessed, and uni- and multivariate Cox regression were performed to examine factors predictive of achieving full enteral feeding that was defined as time to achieve120 mL/kg/d after surgical repair. Results Of 78 infants, 66 underwent intervention before hospital discharge...
January 12, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28067086/-prospective-randomized-study-regarding-the-effect-of-the-preoperative-antibiotic-and-chlorhexidine-rinse-on-wound-healing-after-mandibular-third-molar-surgery
#9
István Kaposvári, Kinga Körmöczi, Zsuzsa Beáta László, Ferenc Oberna, Ferenc Horváth, Árpád Joób-Fancsaly
INTRODUCTION AND AIM: The study compares the antibiotic prophylaxis combined with postoperative antibiotic therapy to preoperative chlorhexidine rinse combined with postoperative antibiotic therapy in preventing complications after surgical removal of a mandibular third molar. METHOD: 71 healthy patients in four groups were enrolled in the study: I. prophylactic dose of 2000 mg of amoxicillin clavulanate, continued with amoxicillin clavulanate postoperatively; II...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28065350/preoperative-urine-culture-results-correlate-poorly-with-bacteriology-of-urologic-prosthetic-device-infections
#10
Nicholas L Kavoussi, Jordan A Siegel, Boyd R Viers, Travis J Pagliara, Matthias D Hofer, Billy H Cordon, Nabeel Shakir, Jeremy M Scott, Allen F Morey
INTRODUCTION: Although preoperative negative urine culture results and treatment of urinary tract infections are generally advised before artificial urinary sphincter (AUS) and penile prosthesis (PP) surgery to prevent device infection, limited evidence exists to support this practice. AIM: To evaluate the relation between preoperative urine culture results and the bacteriology of prosthetic device infections. METHODS: Men undergoing AUS and/or PP placement at a tertiary referral center from 2007 through 2015 were analyzed...
January 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28060753/clostridium-difficile-colonization-in-preoperative-colorectal-cancer-patients
#11
Yi Zheng, Yun Luo, Yinxiang Lv, Chen Huang, Qinsong Sheng, Peng Zhao, Julian Ye, Weiqin Jiang, Lulu Liu, Xiaojun Song, Zhou Tong, Wenbin Chen, Jianjiang Lin, Yi-Wei Tang, Dazhi Jin, Weijia Fang
The entire process of Clostridium difficile colonization to infection develops in large intestine. However, the real colonization pattern of C. difficile in preoperative colorectal cancer patients has not been studied. In this study, 33 C. difficile strains (16.1%) were isolated from stool samples of 205 preoperative colorectal cancer patients. C. difficile colonization rates in lymph node metastasis patients (22.3%) were significantly higher than lymph node negative patients (10.8%) (OR=2.314, 95%CI=1.023-5...
January 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28059918/quality-improvement-initiatives-in-colorectal-surgery-value-of-physician-feedback
#12
Joshua A Waters, Todd Francone, Peter W Marcello, Patricia L Roberts, David J Schoetz, Thomas E Read, Caitlin Stafford, Rocco Ricciardi
BACKGROUND: The impact of process improvement through surgeon feedback on outcomes is unclear. OBJECTIVE: We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. DESIGN: This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. SETTING: This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28040397/should-preoperative-antibiotics-be-tailored-according-to-patient-s-comorbidities-and-susceptibility-to-organisms
#13
Timothy L Tan, Miguel M Gomez, Michael M Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Preoperative antibiotic prophylaxis remains one of the most important strategies for preventing periprosthetic joint infection (PJI). Current guidelines recommend giving universal antibiotic prophylaxis to all total joint arthroplasty patients regardless of their medical conditions or immune status; however, no studies have evaluated the individualizing of antibiotics. The aims of this study were (1) to determine if comorbidities influence the organism profile of PJIs, and (2) to investigate if the efficacy of two different perioperative antibiotics (cefazolin or vancomycin) for preventing PJI is affected by patient's comorbidities...
November 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28031515/percutaneous-radiofrequency-ablation-for-osteoid-osteoma-under-guidance-of-threedimensional-fluoroscopy
#14
Yavuz Arıkan, Umut Yavuz, Osman Lapcin, Sami Sökücü, Bilge Özkan, Yavuz Kabukçuoğlu
PURPOSE: To evaluate the outcome of percutaneous radiofrequency ablation under guidance of 3-dimensional fluoroscopy in 17 patients with osteoid osteoma. METHODS: Records of 11 male and 6 female consecutive patients aged 4 to 28 (mean, 13.8) years who underwent radiofrequency ablation under guidance of 3-dimensional fluoroscopy for osteoid osteoma and were followed up for a mean of 15.8 (range, 12-28) months were reviewed. All patients had been treated with analgesics but failed to achieve lasting pain relief...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28027655/removal-of-hardware-after-syndesmotic-screw-fixation
#15
Kempland C Walley, Kurt J Hofmann, Brian T Velasco, John Y Kwon
BACKGROUND: While trans-syndesmotic fixation with metal screws is considered the gold standard in treating syndesmotic injuries, controversy exists regarding the need and timing of postoperative screw removal. Formal recommendations have not been well established in the literature and clinical practice is highly variable in this regard. The purpose of this systematic review is to critically examine the most recent literature regarding syndesmotic screw removal in order to provide surgeons an evidence-based approach to management of these injuries...
December 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28012533/a-review-of-acute-postoperative-sialadenitis-in-children
#16
Michael T Yim, Yi-Chun C Liu, Julina Ongkasuwan
OBJECTIVE: Acute postoperative sialadenitis is a previously described rare entity that has occurred following general anesthesia and has also been associated with prolonged neurosurgical procedures. We aim to better characterize this entity while performing a literature review regarding potential etiologies, diagnosis, airway management and treatment options. METHODS: A retrospective chart review was performed at a pediatric tertiary care center from 2000 to 2014...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28002367/single-stage-revision-is-effective-for-failed-shoulder-arthroplasty-with-positive-cultures-for-propionibacterium
#17
Jason E Hsu, Jacob D Gorbaty, Ian J Whitney, Frederick A Matsen
BACKGROUND: Revision shoulder arthroplasties are often culture-positive for Propionibacterium. This study tests the hypothesis that the functional outcomes of revising Propionibacterium culture-positive failed arthroplasties with a single-stage revision and immediate antibiotic therapy are not inferior to the clinical outcomes of revising failed shoulder arthroplasties that are not culture-positive. METHODS: Fifty-five shoulders without obvious clinical evidence of infection had a single-stage revision arthroplasty...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27996097/prevention-of-cardiac-implantable-electronic-device-infections-single-operator-technique-with-use-of-povidone-iodine-double-gloving-meticulous-aseptic-antiseptic-measures-and-antibiotic-prophylaxis
#18
Antonis S Manolis, Helen Melita
BACKGROUND: Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. METHODS: A meticulous search for and treatment of active, occult or smoldering infection was undertaken preoperatively...
December 20, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27989071/broad-range-16s-rdna-pcr-on-heart-valves-in-infective-endocarditis
#19
Manica Müller Premru, Tatjana Lejko Zupanc, Tomislav Klokočovnik, Eva Ruzić Sabljić, Tjaša Cerar
BACKGROUND: Infective endocarditis (IE) is diagnosed by blood and/or resected valve cultivation and echocardiographic findings, as defined by the Duke criteria. Unfortunately, cultures may be negative due to prior antibiotic therapy or fastidious or slow-growing microorganisms. The study aim was to investigate the value of the broad-range polymerase chain reaction (PCR) in addition to blood and valve culture for the detection of causative microorganisms. METHODS: Between February 2012 and March 2015, valve samples from 36 patients undergoing cardiac surgery were analyzed; of these patients, 26 had a preoperative diagnosis of IE and 10 served as controls...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27987067/prophylactic-antibiotic-treatment-following-laparoscopic-robot-assisted-radical-prostatectomy-for-the-prevention-of-catheter-associated-urinary-tract-infections-did-the-aua-guidelines-make-a-difference
#20
Miki Haifler, Yoram Mor, Zohar Dotan, Jacob Ramon, Dorit E Zilberman
We sought to evaluate the effectiveness of the American Urological Association (AUA) antibiotic prophylaxis guidelines in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). Our prospective registry database was reviewed for all RALP cases. The following variables were evaluated: age, associated comorbidities, body mass index (BMI), total operative time, length of stay (LOS), prostate weight, pathological grade and stage. Until 11/2011, RALP patients were treated with antibiotics administered in the operating room and continued until urethral catheter removal...
December 16, 2016: Journal of Robotic Surgery
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