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https://www.readbyqxmd.com/read/29443839/how-common-and-how-serious-is-clostridium-difficile-colitis-after-geriatric-hip-fracture-findings-from-the-nsqip-dataset
#1
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29443762/incidence-and-risk-factors-for-surgical-site-infection-after-open-reduction-and-internal-fixation-of-ankle-fracture-a-retrospective-multicenter-study
#2
Yaning Sun, Huijuan Wang, Yuchao Tang, Haitao Zhao, Shiji Qin, Lihui Xu, Zhiyong Xia, Fengqi Zhang
Information on surgical site infection (SSI) after surgical treatment of ankle fracture is limited and remains controversial. The purpose of the present study was to determine the incidence and risk factors for SSI after open reduction and internal fixation (ORIF) of ankle fracture. Patients who underwent ORIF for ankle fracture at 3 centers between January 2015 and December 2016 were included. The potential risk factors for SSI included demographic variables, including age, sex, body mass index (BMI), hypertension, diabetes mellitus, heart disease, smoking, and excessive alcohol intake; blood test variables including preoperative white blood cell count, neutrophil count, red blood cell count, hemoglobin, total protein, albumin and globulin; injury- and surgery-related variables, including duration of operation (minutes), intraoperative blood loss, surgeon level, fracture site, accompanied dislocation, use of a drainage tube, and antibiotic use...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29437061/mid-term-follow-up-of-patients-with-hindfoot-arthrodesis-with-retrograde-compression-intramedullary-nail-in-charcot-neuroarthropathy-of-the-hindfoot
#3
M Chraim, S Krenn, H M Alrabai, H-J Trnka, P Bock
AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29432267/effectiveness-of-preoperative-antibiotics-in-preventing-surgical-site-infection-after-common-soft-tissue-procedures-of-the-hand
#4
Kevin Li, Tanmaya D Sambare, Sam Y Jiang, Emily J Shearer, Nathan P Douglass, Robin N Kamal
BACKGROUND: Antibiotic prophylaxis is a common but controversial practice for clean soft tissue procedures of the hand, such as carpal tunnel release or trigger finger release. Previous studies report no substantial reduction in the risk of surgical site infection (SSI) after antibiotic prophylaxis, yet are limited in power by low sample sizes and low overall rates of postoperative infection. QUESTIONS/PURPOSES: Is there evidence that antibiotic prophylaxis decreases the risk of SSI after soft tissue hand surgery when using propensity score matching to control for potential confounding variables such as demographics, procedure type, medication use, existing comorbidities, and postoperative events? METHODS: This retrospective analysis used the Truven Health MarketScan databases, large, multistate commercial insurance claims databases corresponding to inpatient and outpatient services and outpatient drug claims made between January 2007 and December 2014...
February 8, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29428098/pathophysiological-consequences-of-obstructive-jaundice-and-perioperative-management
#5
REVIEW
Efstathios T Pavlidis, Theodoros E Pavlidis
BACKGROUND: Obstructive jaundice is a common problem in daily clinical practice. Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management. DATA SOURCES: A PubMed was searched for relevant articles published up to August 2016. The effect of obstructive jaundice on proinflammatory cytokines, coagulation status, hemodynamics and organ functions were evaluated. RESULTS: The effects of obstructive jaundice included biliary tree, the hepatic cell and liver function as well as systemic complications...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29422473/comparison-of-preoperative-and-perioperative-antibiotic-prophylaxis-regimen-in-compound-facial-fractures
#6
Veeranjaneyalu Mamthashri, Bokka Praveen Reddy
AIMS AND OBJECTIVES: Intraoperative antibiotics may be effective in elective surgery; there may be an advantage to starting antibiotics preoperatively when there is already an infective focus, such as compound facial fractures. The purpose of this study is to compare preoperative and intraoperative antibiotic prophylaxis in compound facial fractures. MATERIALS AND METHODS: This is a prospective study conducted over a period of 2 years on 50 patients, who underwent open reduction and rigid internal fixation...
February 1, 2018: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/29420412/suture-compared-with-staple-closure-of-skin-incision-for-high-order-cesarean-deliveries
#7
Nathan S Fox, Stephanie Melka, James Miller, Samuel Bender, Michael Silverstein, Daniel H Saltzman, Andrei Rebarber
OBJECTIVE: To compare wound complication rates in tertiary or higher-order cesarean delivery based on wound closure technique. METHODS: We performed a retrospective cohort study of all tertiary or higher-order cesarean deliveries performed by one group practice in a large academic medical center from 2005 to 2017. We excluded patients with a vertical skin incision. Although the study was not randomized, wound closure type was relatively uniform in this practice and based on time period: before 2011, the preferred closure was staple closure; after 2011, subcuticular suture closure was preferred...
February 5, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29417782/-posterior-debridement-interbody-fusion-internal-fixation-for-treatment-of-lumbar-discitis
#8
Lin Chen, Jun Cheng, Bo Li, Fang-Biao Zhan, You Zhang, Shi-Long Feng
OBJECTIVE: To evaluate the clinical effects of posterior debridement, interbody fusion with internal fixation in the treatment of lumbar discitis. METHODS: The clinical data of 13 patients with lumbar discitis treated from January 2005 to June 2012 was retrospectively analyzed. There were 9 males and 4 females, aged from 31 to 68 years old with an average of 56 years old. There were 2 cases on L3, 4, 4 cases on L4, 5, and 7 cases on L5S1. Two cases complicated with diabetes, 4 cases with hypertension, and 1 case with obsolete pulmonary tuberculosis...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417775/-mechanical-complications-with-self-made-antibiotic-loaded-cement-articulating-spacers-in-the-treatment-of-the-infected-hip-replacement
#9
Yin-Qiao Du, Yong-Gang Zhou, Li-Bo Hao, Wen-Ming Wu, Hai-Yang Ma, Chong Zheng, Shang Piao, Zhi-Sen Gao, Jing-Yang Sun, Sen Wang
OBJECTIVE: To study the complications and efficacy of self-made, antibiotic-loaded cement articulating spacers in the treatment of the infected hip replacement. METHODS: Between January 2006 and July 2016, 265 patients (266 hips) received a self-made, antibiotic-loaded cement articulating spacer as part of a two-stage protocol. Among those patients, there were 143 males(144 hips) and 122 females(122 hips). The cement articulating spacers with vancomycin and two Steinman pins were made by a self-made mold system...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417348/perioperative-management-of-external-fixation-in-staged-protocols-an-international-survey
#10
Sandro Hodel, Björn-Christian Link, Reto Babst, W H Mallee, Philippe Posso, Frank J P Beeres
INTRODUCTION: Despite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities. MATERIALS AND METHODS: A 26-question survey was sent to 170 members of the Traumaplatform...
February 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29416462/an-observational-study-of-perioperative-antibiotic-prophylaxis-use-at-a-major-quaternary-care-and-referral-hospital-in-saudi-arabia
#11
Yasser Younis A Tolba, Ahmed Osama El-Kabbani, NorAldeen Suhail Al-Kayyali
Context: The use of perioperative antimicrobial prophylaxis has been consistently considered an effective means of reducing the risk of surgical site infections. However, inappropriate use of surgical antibiotic prophylaxis is associated with complications such as reduced treatment efficacy, development of antibiotic resistance, and increased health-care costs. Aims: The aim of this study is to investigate the adherence to international/national guidelines regarding the use of surgical antibiotic prophylaxis in the perioperative period...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406579/intraoperative-interventions-for-preventing-surgical-site-infection-an-overview-of-cochrane-reviews
#12
REVIEW
Zhenmi Liu, Jo C Dumville, Gill Norman, Maggie J Westby, Jane Blazeby, Emma McFarlane, Nicky J Welton, Louise O'Connor, Julie Cawthorne, Ryan P George, Emma J Crosbie, Amber D Rithalia, Hung-Yuan Cheng
BACKGROUND: Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro-organisms into incisions; and optimising the patient's own bodily functions to promote best recovery...
February 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#13
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29398330/perioperative-antibiotics-for-clean-hand-surgery-a-national-study
#14
Shepard P Johnson, Lin Zhong, Kevin C Chung, Jennifer F Waljee
PURPOSE: Given that surgical site infections remain a common performance metric in assessing the quality of health care, we hypothesized that prophylactic antibiotics are overutilized in soft tissue hand surgery when antimicrobials are not indicated. METHODS: We studied insurance claims from the Truven MarketScan Databases to identify patients who underwent 1 of 5 outpatient hand surgery procedures: open or endoscopic carpal tunnel release, trigger finger release, de Quervain release, and wrist ganglion excision between 2009 and 2015 (n = 305,946)...
February 2, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29398033/preoperative-biliary-colonization-infection-caused-by-multidrug-resistant-mdr-pathogens-in-patients-undergoing-major-hepatectomy-with-extrahepatic-bile-duct-resection
#15
Gen Sugawara, Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Junpei Yamaguchi, Takashi Mizuno, Tetsuya Yagi, Masato Nagino
BACKGROUND: The aim of this study was to review the surgical outcomes of patients who underwent major hepatectomy with extrahepatic bile duct resection after preoperative biliary drainage with a particular focus on the impact of preoperative biliary colonization/infection caused by multidrug-resistant pathogens. METHODS: Medical records of patients who underwent hepatobiliary resection after preoperative external biliary drainage between 2001 and 2015 were reviewed retrospectively...
February 1, 2018: Surgery
https://www.readbyqxmd.com/read/29394675/-a-case-of-locally-advanced-rectal-cancer-with-abscess-and-rectovesical-fistula-curatively-resected-following-preoperative-chemotherapy
#16
Tatsuya Matsumoto, Masayoshi Nakanishi, Mahito Miyamae, Koji Takao, Tomohiko Fukunaga, Eigo Otsuji
A 63-year-old man with bloody stools, anal incompetence, and feeling of fatigue was diagnosed as having a RAS mutanttype rectal cancer with abscess and rectovesical fistula. Computed tomography revealed that the tumor had invaded the seminal vesicle, prostate, and bladder and formed an abscess. In addition, his general condition was poor. Thus, we evaluated the lesion as unresectable. His nutritional status improved, and the infection was controlled after colostomy. Then, we performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin(FOLFOX)plus bevacizumab...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29392046/relation-of-actinomyces-with-tonsillar-hypertrophy-and-antibiotic-use
#17
Leyla Kansu
Objective: This study aimed to investigate the incidence of Actinomyces in tonsillar tissues of patients undergoing tonsillectomy and to determine the association among tonsillar volume, preoperative antibiotic use, and presence of Actinomyces in tonsil tissues. Methods: In this study, 142 patients who underwent tonsillectomy in last four years were included. Of the total patients, 97 (66.9%) were children and 47 (33.1%) were adults. The patients' age, sex, preoperative antibiotic use, tonsillar volume, and presence of actinomyces in tonsillar tissues were recorded...
March 2017: Turkish Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29391117/efficacy-of-negative-pressure-wound-treatment-in-preventing-surgical-site-infections-after-whipple-procedures
#18
Ryan Gupta, Geoffrey C Darby, David K Imagawa
Surgical site infections (SSIs) occur at an average rate of 21.1 per cent after Whipple procedures per NSQIP data. In the setting of adherence to standard National Surgery Quality Improvement Program (NSQIP) Hepatopancreatobiliary recommendations including wound protector use and glove change before closing, this study seeks to evaluate the efficacy of using negative pressure wound treatment (NPWT) over closed incision sites after a Whipple procedure to prevent SSI formation. We retrospectively examined consecutive patients from January 2014 to July 2016 who met criteria of completing Whipple procedures with full primary incision closure performed by a single surgeon at a single institution...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390536/osteoma-with-actinomycosis-in-a-nasal-cavity-a-case-report
#19
Jong Seung Kim, Sang Jae Noh, Soon Ho Ryu
RATIONALE: Osteoma with actinomycosis is a very rare disease in the nasal cavity. PATIENT CONCERNS: We report a case of a 17-year-old female student who presented with nasal obstruction and rhinorrhea for 6 months. DIAGNOSES: The preoperative finding was osteoma covered with yellowish polypoid material. INTERVENTIONS: We performed endoscopic sinus surgery, which included excision of the tumor and medication with oral penicillin for 8 weeks...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29387347/the-efficacy-of-ampicillin-compared-with-ceftriaxone-on-preventing-cesarean-surgical-site-infections-an-observational-prospective-cohort-study
#20
Srisuda Assawapalanggool, Nongyao Kasatpibal, Supatra Sirichotiyakul, Rajin Arora, Watcharin Suntornlimsiri, Anucha Apisarnthanarak
Background: Cesarean surgical site infections (SSIs) can be prevented by proper preoperative antibiotic prophylaxis. Differences in antibiotic selection in clinical practice exist according to obstetricians' preferences despite clear guidelines on preoperative antibiotic prophylaxis. This study aimed to compare the efficacy of ampicillin and ceftriaxone in preventing cesarean SSIs. Methods: The observational prospective cohort study was conducted at a tertiary hospital in Thailand from 1 January 2007 to 31 December 2012...
2018: Antimicrobial Resistance and Infection Control
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