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Perioperative antibiotics

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https://www.readbyqxmd.com/read/28437812/infection-rate-in-1033-elective-neurosurgical-procedures-at-a-university-hospital-in-south-china
#1
Hongwei Zhu, Xiyao Liu, Zhanxiang Wang
Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors. Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28421546/electronic-medical-record-interventions-and-recurrent-perioperative-antibiotic-administration-a-before-and-after-study
#2
Alexander Hincker, Arbi Ben Abdallah, Michael Avidan, Penka Candelario, Daniel Helsten
PURPOSE: Perioperative antibiotics decrease rates of surgical-site infections. Numerous interventions have improved administration of the first antibiotic dose; however, failures in the administration of subsequent doses frequently occur. We hypothesized that modifications to the electronic medical record (EMR) would improve the administration of the second antibiotic dose and that such improvements would be sustained over time. METHODS: This historical cohort before-and-after study of multipronged alerts in the EMR analyzed 1,348 operations on adult patients...
April 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#3
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28410711/failure-modes-and-effects-analysis-of-bilateral-same-day-cataract-surgery
#4
Neal H Shorstein, Carol Lucido, James Carolan, Liyan Liu, Geraldine Slean, Lisa J Herrinton
PURPOSE: To systematically analyze potential process failures related to bilateral same-day cataract surgery toward the goal of improving patient safety. SETTING: Twenty-one Kaiser Permanente surgery centers, Northern California, USA. DESIGN: Retrospective cohort study. METHODS: Quality experts performed a Failure Modes and Effects Analysis (FMEA) that included an evaluation of sterile processing, pharmaceuticals, perioperative clinic and surgical center visits, and biometry...
March 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28402472/direct-sternal-administration-of-vancomycin-and-gentamicin-during-closure-prevents-wound-infection%C3%A2
#5
Martin Andreas, Moritz Muckenhuber, Doris Hutschala, Alfred Kocher, Florian Thalhammer, Paul Vogt, Tatjana Fleck, Guenther Laufer
OBJECTIVES: Deep sternal wound infection is still a major complication in patients undergoing cardiac surgery. We previously identified mammary artery harvesting as a risk factor for decreased antibiotic tissue penetration. In addition, other risk factors including diabetes may inhibit sufficient tissue penetration of perioperative antibiotic prophylaxis. A novel closure protocol applying 2 topical antibiotics and further recommendations for sternal wiring was introduced at our department to decrease the incidence of sternal wound infections...
April 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28401341/vancomycin-prophylaxis-for-total-joint-arthroplasty-incorrectly-dosed-and-has-a-higher-rate-of-periprosthetic-infection-than-cefazolin
#6
Michael M Kheir, Timothy L Tan, Ibrahim Azboy, Dean D Tan, Javad Parvizi
BACKGROUND: In total joint arthroplasty (TJA), vancomycin is used as perioperative antibiotic prophylaxis in patients with penicillin allergy or in patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Although vancomycin dosing should be weight-based (15 mg/kg), not all surgeons are aware of this; a fixed 1-g dose is instead frequently administered. QUESTIONS/PURPOSES: (1) Is there a difference in the risk of periprosthetic joint infection (PJI) in patients receiving vancomycin or cefazolin prophylaxis after primary TJA? (2) What proportion of patients is adequately dosed with vancomycin? (3) Compared with actual fixed dosing, does weight-based dosing result in a greater proportion of patients staying above the recommended 15-mg/L level at the beginning and end of surgery? (4) Are patients overdosed with vancomycin at greater risk of developing nephrotoxicity and acute kidney injury? METHODS: A single-institution, retrospective study was performed on 1828 patients undergoing primary TJAs who received vancomycin prophylaxis between 2008 and 2014...
April 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28390069/antimicrobial-agents-for-preventing-peritonitis-in-peritoneal-dialysis-patients
#7
REVIEW
Denise Campbell, David W Mudge, Jonathan C Craig, David W Johnson, Allison Tong, Giovanni Fm Strippoli
BACKGROUND: Peritoneal dialysis (PD) is an important therapy for patients with end-stage kidney disease and is used in more than 200,000 such patients globally. However, its value is often limited by the development of infections such as peritonitis and exit-site and tunnel infections. Multiple strategies have been developed to reduce the risk of peritonitis including antibiotics, topical disinfectants to the exit site and antifungal agents. However, the effectiveness of these strategies has been variable and are based on a small number of randomised controlled trials (RCTs)...
April 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28388304/laparoscopic-ureteroureterostomy-with-an-intraoperative-retrograde-ureteroscopy-assisted-technique-for-distal-ureteral-injury-secondary-to-gynecological-surgery-a-retrospective-comparison-with-laparoscopic-ureteroneocystostomy
#8
Zhaohui Wang, Zhi Chen, Yao He, Bingsheng Li, Zhiqiang Wen, Xiang Chen
OBJECTIVES: The aim of this study was to compare the operative and postoperative outcomes of laparoscopic ureteroureterostomy (LAP-UU) using a retrograde ureteroscopy-assisted technique with laparoscopic ureteroneocystostomy (LAP-UNC) in treating ureteral injury after gynecological surgery. MATERIALS AND METHODS: The study analyzed 60 ureteral injury repairs performed between May 2010 and February 2016 in patients who underwent either LAP-UU using the retrograde ureteroscopy-assisted technique (n = 26) or LAP-UNC (n = 34)...
April 7, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28386783/postoperative-leukocyte-changes-in-facial-fracture-patients-a-randomized-prospective-study-with-short-term-dexamethasone
#9
Johanna Snäll, Jyrki Törnwall, Anna Liisa Suominen, Hanna Thorén
PURPOSE: We investigated leukocyte changes in facial fracture patients undergoing surgery. Of specific interest was the effect of perioperative dexamethasone on leukocyte changes. METHODS: Facial fracture patients were randomized to receive perioperatively a total dose of 30 mg of dexamethasone, whereas patients in the control group received no glucocorticoid. All patients received antibiotics until postoperative days 7-10. Leukocyte count was measured on postoperative days 1 and 2...
April 6, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28377245/postoperative-non-pathological-fever-after-spinal-surgery-incidence-and-risk-factor-analysis
#10
Junghan Seo, Jin Hoon Park, Eun Hee Song, Young-Seok Lee, Sang Ku Jung, Sang Ryong Jeon, Seung Chul Rhim, Sung Woo Roh
BACKGROUND: Although there are many postoperative febrile causes, surgical site infection has always been considered as one of the major causes, but it should be excluded; we encountered many patients who showed delayed postoperative fever that was not related to wound infection after spinal surgery. We aimed to determine the incidence of delayed postoperative fever and its characteristics after spinal surgery, and to analyze the causal factors. METHODS: A total of 250 patients who underwent any type of spinal surgery were analyzed...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28372915/creation-of-an-online-wiki-improves-post-operative-surgical-protocol-adherence-in-arthroplasty-patients
#11
Eric F Swart, Daniel J Miller, Thomas R Hickernell, Kevin J Bozic, Jeffrey A Geller, William B Macaulay
BACKGROUND: Perioperative care pathways are tools used in high-volume clinical settings to standardize care, reduce variability, and improve outcomes. However, the mechanism by which the information is transmitted to other caregivers is often inconsistent and error-prone. At our institution, we developed an online, user-editable ("wiki") database to communicate post-operative protocols. The purpose of this study is to evaluate the hypothesis that implementation of the wiki would improve protocol adherence and reduce unintentional deviations inpatient care...
March 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28371248/randomized-controlled-trial-of-perioperative-antimicrobial-therapy-based-on-the-results-of-preoperative-bile-cultures-in-patients-undergoing-biliary-reconstruction
#12
Kunishige Okamura, Kimitaka Tanaka, Takumi Miura, Yoshitsugu Nakanishi, Takehiro Noji, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: The high frequency of surgical site infections (SSIs) after hepato-pancreato-biliary (HPB) surgery is a problem that needs to be addressed. This prospective, randomized, controlled study examined whether perioperative prophylactic use of antibiotics based on preoperative bile culture results in HPB surgery could decrease SSI. METHODS: Participants comprised 126 patients who underwent HPB (bile duct, gallbladder, ampullary, or pancreatic) cancer surgery with biliary reconstruction at Hokkaido University Hospital between August 2008 and March 2013 (UMIN Clinical Trial Registry #00001278)...
March 29, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28370003/clinical-outcomes-following-inpatient-penicillin-allergy-testing-a-systematic-review-and-meta-analysis
#13
REVIEW
Keith A Sacco, Allan Bates, Tara J Brigham, J Saadi-Imam, M Caroline Burton
BACKGROUND: A documented penicillin allergy is associated with increased morbidity including length of hospital stay and an increased incidence of resistant infections attributed to use of broader-spectrum antibiotics. The aim of the systematic review was to identify whether inpatient penicillin allergy testing affected clinical outcomes during hospitalization. METHODS: We performed an electronic search of Ovid Medline/PubMed, Embase, Web of Science, Scopus and the Cochrane Library over the past 20 years...
March 29, 2017: Allergy
https://www.readbyqxmd.com/read/28341500/effect-of-2-chlorhexidine-gluconate-impregnated-cloth-on-surgical-site-infections-in-vascular-surgery
#14
John Bak, Jason Le, Toshio Takayama, Angela Gibson, Sara Zerbel, Nasia Safdar, Jon S Matsumura
BACKGROUND: Surgical site infections (SSIs) are a significant burden to patients and health care systems. This retrospective study evaluates the observed rates of SSI after our institution implemented chlorhexidine gluconate-impregnated (CHG) cloth as a preoperative antiseptic preparation in elective vascular surgery. METHODS: Between March 2011 and January 2012, we reviewed 250 patients who underwent elective vascular surgery who used the CHG cloth preoperatively...
March 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341492/understanding-antibiotic-decision-making-in-surgery-a-qualitative-analysis
#15
E Charani, C Tarrant, K Moorthy, N Sevdalis, L Brennan, A H Holmes
OBJECTIVE: To investigate the characteristics and culture of antibiotic decision making in the surgical specialty. METHODS: A qualitative study including ethnographic observation and face to face interviews with participants from six surgical teams at a teaching hospital in London was conducted. Over a three month period: 1) thirty ward rounds (WRs) (100 hours) were observed, 2) face-to-face follow up interviews took place with thirteen key informants, 3) multidisciplinary meetings on the management of surgical patients and daily practice on wards were observed...
March 21, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28338306/implantation-of-a-biodegradable-rectum-balloon-implant-tips-tricks-and-pitfalls
#16
Ben G L Vanneste, Kees van De Beek, Ludy Lutgens, Philippe Lambin
INTRODUCTION: A rectum balloon implant (RBI) is a new device to spare rectal structures during prostate cancer radiotherapy. The theoretical advantages of a RBI are to reduce the high radiation dose to the anterior rectum wall, the possibility of a post-implant correction, and their predetermined shape with consequent predictable position. OBJECTIVE: To describe, step-by-step, our mini-invasive technique for hands-free transperineal implantation of a RBI before start of radiotherapy treatment...
March 24, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28334545/-conservative-treatment-of-late-aortic-graft-infection
#17
Peter Baľa, Kamil Zeman, Renata Kološová, Ivo Pavlas, Dušan Kučera
Aortic graft infection is one of the most serious complications of aortovascular surgery. Diagnosis is based on clini-cal and radiologic findings. The emphasis is put on early diagnosis and its impact on prognosis of patients. The management should be individualized. The gold standard is surgical treatment with complete excision of the infected foreign material with debridement of the surrounding tissue and repair of vascular continuity by extra-anatomic bypass or in situ bypass with autologous femoral vein or cryopreserved arterial allografts...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28321988/a-quality-improvement-initiative-to-optimize-dosing-of-surgical-antimicrobial-prophylaxis
#18
Thomas J Caruso, Ellen Wang, Hayden T Schwenk, David Scheinker, Calida Yeverino, Mary Tweedy, Manjit Maheru, Paul J Sharek
BACKGROUND: The risk of surgical site infections is reduced with appropriate timing and dosing of preoperative antimicrobials. Based on evolving national guidelines, we increased the preoperative dose of cefazolin from 25 to 30 mg·kg(-1) . This quality improvement project describes an improvement initiative to develop standard work processes to ensure appropriate dosing. AIMS: The primary aim was to deliver cefazolin 30 mg·kg(-1) to at least 90% of indicated patients...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#19
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28317676/effect-of-the-administration-period-of-perioperative-topical-levofloxacin-on-normal-conjunctival-bacterial-flora
#20
Ryohei Nejima, Kimiya Shimizu, Takashi Ono, Yukari Noguchi, Akiko Yagi, Takuya Iwasaki, Nobuyuki Shoji, Kazunori Miyata
PURPOSE: To assess the long-term and short-term effects of post-cataract surgery antibiotic therapy on the drug-resistance profile of normal conjunctival bacterial flora. SETTING: Miyata Eye Hospital, Miyazaki, Japan. DESIGN: Randomized prospective clinical trial. METHODS: Patients aged 20 years or older who had cataract surgery between May and September 2015 were given levofloxacin 1.5% ophthalmic solution for 3 days preoperatively...
January 2017: Journal of Cataract and Refractive Surgery
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