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https://www.readbyqxmd.com/read/29679951/surgical-site-infection-rate-after-hemilaminectomy-and-laminectomy-in-dogs-without-perioperative-antibiotic-therapy
#1
Barbara A R Dyall, Hugo G Schmökel
OBJECTIVE:  The aim of this study was to retrospectively review the surgical site infection (SSI) rate in dogs undergoing laminectomies without perioperative antibiotics, and compare those data with the expected infection rate for clean surgical wounds in dogs undergoing similar procedures. METHODS:  This was a retrospective single-centre study composed of dogs that underwent hemilaminectomies or laminectomies for thoracolumbar disc herniation or lumbosacral disease during a 2-year period (during 2015 and 2016)...
April 21, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29675898/implementation-of-the-who-surgical-safety-checklist-at-a-teaching-hospital-in-india-and-evaluation-of-the-effects-on-perioperative-complications
#2
Raghavendra Shankar
BACKGROUND: The WHO Surgical Safety Checklist was developed to help operating teams reduce the occurrence of patient harm. The Checklist is a simple, practical tool that any surgical team in the world can use to ensure that the preoperative, intraoperative, and postoperative steps that have been shown to benefit patients are undertaken in a timely and efficient way. METHODS: This study was carried out at Rajarajeswari Medical College Hospital, Bangalore, India, to study the effects of the WHO Surgical Safety Checklist on mortality and morbidity in surgical patients, to identify the potential problems in the long-term implementation of the same, and to document the complications in patients undergoing a major surgery during the study period...
April 20, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29671041/oropharyngeal-and-nasopharyngeal-decontamination-with-chlorhexidine-gluconate-in-lung-cancer-surgery-a-randomized-clinical-trial
#3
Xavier Benoit D'Journo, Pierre-Emmanuel Falcoz, Marco Alifano, Jean-Philippe Le Rochais, Thomas D'Annoville, Gilbert Massard, Jean Francois Regnard, Philippe Icard, Charles Marty-Ane, Delphine Trousse, Christophe Doddoli, Bastien Orsini, Sophie Edouard, Matthieu Million, Nathalie Lesavre, Anderson Loundou, Karine Baumstarck, Florence Peyron, Stephane Honoré, Stéphanie Dizier, Aude Charvet, Marc Leone, Didier Raoult, Laurent Papazian, Pascal Alexandre Thomas
PURPOSE: Respiratory complications are the leading causes of morbidity and mortality after lung cancer surgery. We hypothesized that oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate (CHG) would be an effective method to reduce these complications as reported in cardiac surgery. METHODS: In this multicenter parallel-group randomized double-blind placebo-controlled trial, we enrolled consecutive adults scheduled for anatomical pulmonary resection for lung cancer...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29665357/second-trimester-surgical-abortion-practices-in-the-united-states
#4
Katharine O White, Heidi E Jones, Jade Shorter, Wendy V Norman, Edith Guilbert, E Steve Lichtenberg, Maureen Paul
OBJECTIVE: To assess whether second-trimester surgical abortion practices of U.S. providers agree with evidence-based policy guidelines. STUDY DESIGN: We conducted a cross-sectional survey of abortion facilities in the U.S. identified via publicly available resources and professional networks from June through December 2013. RESULTS: Of 703 identified facilities, 383 (54%) participated including 172 clinicians providing second-trimester surgical abortions (D&Es)...
April 14, 2018: Contraception
https://www.readbyqxmd.com/read/29660396/analysis-of-clinical-management-of-infected-breast-implants-and-of-factors-associated-to-successful-breast-pocket-salvage-in-infections-occurring-after-breast-reconstruction
#5
Simonetta Franchelli, Marianna Pesce, Ilaria Baldelli, Anna Marchese, Pierluigi Santi, Andrea De Maria
OBJECTIVES: Considerable efforts have been devoted so far to improve salvage procedures of infected breast implants in absence of defined guidelines or validated clinical protocols. Within a cohort of prospectively recruited patients who underwent breast reconstruction, we performed a retrospective review of proven implant infections in order to describe factors contributing to management success. METHODS: We collected data in 1293 consecutive patients who underwent two stage (expander+ prosthesis) breast reconstruction with at least 12 months of follow-up...
April 13, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#6
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#7
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29628572/impact-of-targeted-preoperative-optimization-on-clinical-outcome-in-emergency-abdominal-surgeries-a-prospective-randomized-trial
#8
Ashish Sethi, Miltan Debbarma, Neeraj Narang, Anudeep Saxena, Mamta Mahobia, Gaurav Singh Tomar
Background: Perforation peritonitis continues to be one of the most common surgical emergencies that need a surgical intervention most of the times. Anesthesiologists are invariably involved in managing such cases efficiently in perioperative period. Aims: The assessment and evaluation of Acute Physiology and Chronic Health Evaluation II (APACHE II) score at presentation and 24 h after goal-directed optimization, administration of empirical broad-spectrum antibiotics, and definitive source control postoperatively...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627175/multivariate-analysis-of-risk-factors-for-nuss-bar-infections-a-single-center-study
#9
Robert J Obermeyer, Nina S Cohen, Sheema Gaffar, Robert E Kelly, M Ann Kuhn, Frazier W Frantz, Margaret M McGuire, James F Paulson
BACKGROUND/PURPOSE: Our previously published data suggested several risk factors for infection after the Nuss procedure. We aimed to further elucidate these findings. METHODS: An IRB-approved (14-03-WC-0034), single institution, retrospective review was performed to evaluate the incidence of postoperative Nuss bar infections associated with seven variables. These were subjected to bivariate and multivariable analyses. A broad definition of infection was used including cellulitis, superficial infection with drainage, or deep infection occurring at any time postoperatively...
March 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29624147/risk-factors-for-surgical-site-infection-after-intracranial-electroencephalography-monitoring-for-epilepsy-in-the-pediatric-population
#10
Ying Meng, Mathew R Voisin, Suganth Suppiah, Zamir Merali, Ali Moghaddamjou, Naif M Alotaibi, Arbelle Manicat-Emo, Shelly Weiss, Cristina Go, Blathnaid McCoy, Elizabeth J Donner, James T Rutka
OBJECTIVE Intracranial electroencephalography (iEEG) monitoring is an important method of identifying the seizure focus in patients with medically refractory epilepsy. While previous studies have demonstrated low rates of surgical complications, reported rates of surgical site infection (SSI) are highly variable. To date, no studies have specifically evaluated the patient or operative risk factors contributing to SSI. The goals of this study were to examine the rate of SSI after iEEG monitoring for epilepsy workup in pediatric patients and to determine the variables that might contribute to the development of SSI...
April 6, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29609860/prophylaxis-of-surgical-site-infection-in-adult-spine-surgery-a-systematic-review
#11
REVIEW
Reina Yao, Terence Tan, Jin Wee Tee, John Street
INTRODUCTION: Surgical site infection (SSI) remains a significant source of morbidity in spine surgery, with reported rates varying from 0.7 to 16%. OBJECTIVE: To systematically review and evaluate the evidence for strategies for prophylaxis of SSI in adult spine surgery in the last twenty years. METHODS: Two independent systematic searches were conducted, at two international spine centers, encompassing PubMed, ClinicalTrials.gov, Cochrane Database, EBSCO Medline, ScienceDirect, Ovid Medline, EMBASE (Ovid), and MEDLINE...
March 30, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29605354/trends-in-the-management-of-secondary-post-tonsillectomy-hemorrhage-in-children
#12
Christine M Clark, Jane R Schubart, Michele M Carr
OBJECTIVE: To define current practices in management of secondary post-tonsillectomy hemorrhage (PTH) in children by pediatric and general otolaryngologists. INTRODUCTION: Bleeding after tonsillectomy is common. Our goal was to describe management methods across the U.S. METHODS: Questions regarding perioperative management and treatment in response to three hypothetical cases featuring secondary post-tonsillectomy bleeding were posed via REDCap survey...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29582099/-paths-to-the-professional-and-responsible-use-of-antibiotics
#13
REVIEW
Marianne Abele-Horn, Ellen Pantke, Tim Eckmanns
Germany's position on prescribing antibiotics is among the lower third in Europe. There are some countries that prescribe remarkably fewer antibiotics. In Germany, the number of out-patient antibiotic prescriptions is too high for patients with low-grade infections and non-bacterial infections. Often, broad-spectrum antibiotics are prescribed instead of narrow-spectrum antibiotics. For in-patients, perioperative prophylaxis is given for too long.In this article, different ways to reduce antibiotic prescriptions are introduced...
March 26, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29574175/developing-process-maps-as-a-tool-for-a-surgical-infection-prevention-quality-improvement-initiative-in-resource-constrained-settings
#14
Jared A Forrester, Luca A Koritsanszky, Demisew Amenu, Alex B Haynes, William R Berry, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical infections cause substantial morbidity and mortality in low-and middle-income countries (LMICs). To improve adherence to critical perioperative infection prevention standards, we developed Clean Cut, a checklist-based quality improvement program to improve compliance with best practices. We hypothesized that process mapping infection prevention activities can help clinicians identify strategies for improving surgical safety. STUDY DESIGN: We introduced Clean Cut at a tertiary hospital in Ethiopia...
March 21, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29570150/cost-effectiveness-research-in-anesthesiology
#15
Bijan J Teja, Tori N Sutherland, Sheila R Barnett, Daniel S Talmor
Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions. We excluded interventions related to critical care or pediatric anesthesiology, and articles on interventions not normally ordered or performed by anesthesiologists...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29560408/postoperative-prophylactic-antibiotics-in-total-joint-arthroplasty
#16
Adolph J Yates
The Center for Disease Control and Prevention recently released their 2017 Guideline for the Prevention of Surgical Site Infection. One of their recommendations is the ordering of a single dose of preoperative prophylactic antibiotics with no subsequent postoperative dosing; this recommendation includes perioperative antibiotics for patients undergoing total joint arthroplasty. At this time, the American Association of Hip and Knee Surgeons (AAHKS) does not agree with this recommendation vis-a-vis total joint arthroplasty because it contradicts current international standards of care with limited evidence and study...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29558373/antibiotic-prophylaxis-with-cefuroxime-influence-of-duration-on-infection-rate-with-staphylococcus-aureus-in-a-contaminated-open-fracture-model
#17
Jan Puetzler, Willem-Jan Metsemakers, Daniel Arens, Stephan Zeiter, Richard Kuehl, Michael J Raschke, Robert Geoff Richards, Thomas Fintan Moriarty
OBJECTIVES: The optimal duration of perioperative antibiotic prophylaxis (PAP) for open fractures remains controversial because of heterogeneous or unclear guidelines and highly variable prophylactic regimens in clinical practice. We aimed at testing different PAP durations under controlled conditions in a contaminated rabbit fracture model. METHODS: A complete humeral osteotomy in 18 rabbits was fixed with a 7-hole locking compression plate and inoculated with Staphylococcus aureus...
April 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29556747/-the-role-of-infection-prevention-in-the-control-of-antimicrobial-resistance-any-avoided-infection-contributes-to-the-reduction-of-antibiotic-use
#18
REVIEW
Martin Mielke
Clinically relevant infections are the primary indication for the use of antimicrobial agents in human medicine. Consequently, the prevention of infections is the fundament of all measures to rationally reduce the use of antibiotics. A prevented infection must not be treated. For the prevention of several community-acquired infections, vaccines are available. In addition, several infections may be prevented on the basis of knowledge and responsible behavior. However, the prevention of nosocomial infections depends mainly on the responsibility of third parties in the context of medical procedures...
March 19, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29555547/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#19
Cheisson Gaëlle, Jacqueminet Sophie, Cosson Emmanuel, Ichai Carole, Leguerrier Anne-Marie, Nicolescu-Catargi Bogdan, Ouattara Alexandre, Tauveron Igor, Valensi Paul, Benhamou Dan
Perioperative hyperglycaemia (>1.80g/L or 10 mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/l but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous administration of insulin therapy via an electronic syringe (IVES) in type-1 diabetes (T1D) and type-2 diabetes (T2D) patients if required or in cases of stress hyperglycaemia...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29555498/preoperative-anemia-is-associated-with-failure-of-open-debridement-polyethylene-exchange-in-acute-and-acute-hematogenous-prosthetic-joint-infection
#20
Richard D Swenson, James A Butterfield, Timothy J Irwin, John J Zurlo, Charles M Davis
BACKGROUND: Acute and acute hematogenous prosthetic joint infections (PJIs) are often treated with open debridement and polyethylene exchange (ODPE) in an effort to save the prosthesis, decrease morbidity, and reduce costs. However, failure of ODPE may compromise a subsequent 2-stage treatment. The purpose of this study is to identify patient factors that impact the success of ODPE for acute and acute hematogenous PJIs. METHODS: A retrospective review examined comorbidities, preoperative laboratory values, and patient history for patients with successful and failed ODPE treatment for acute perioperative or acute hematogenous periprosthetic hip or knee joint infections...
February 1, 2018: Journal of Arthroplasty
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