scholarly journals Outcomes and Predictors of Incisional Surgical Site Infection in Stoma Reversal

JAMA Surgery ◽  
2013 ◽  
Vol 148 (2) ◽  
pp. 183 ◽  
Author(s):  
Mike K. Liang ◽  
Linda T. Li ◽  
Andres Avellaneda ◽  
Jennifer M. Moffett ◽  
Stephanie C. Hicks ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Site Infection ◽  
Stoma Reversal ◽  
Incisional Surgical Site Infection

scholarly journals Variation in the Type and Frequency of Postoperative Invasive Staphylococcus aureus Infections According to Type of Surgical Procedure

2010 ◽  
Vol 31 (7) ◽  
pp. 701-709 ◽  
Author(s):  
Deverick J. Anderson ◽  
Jean Marie Arduino ◽  
Shelby D. Reed ◽  
Daniel J. Sexton ◽  
Keith S. Kaye ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Bloodstream Infection ◽  
Surgical Procedures ◽  
Tertiary Care ◽  
Orthopedic Procedures ◽  
Neurosurgical Procedures ◽  
Site Infection ◽  
Incisional Surgical Site Infection ◽  
Epidemiological Characteristics

Objective.To determine the epidemiological characteristics of postoperative invasive Staphylococcus aureus infection following 4 types of major surgical procedures.Design.Retrospective cohort study.Setting.Eleven hospitals (9 community hospitals and 2 tertiary care hospitals) in North Carolina and Virginia.Patients.Adults undergoing orthopedic, neurosurgical, cardiothoracic, and plastic surgical procedures.Methods.We used previously validated, prospectively collected surgical surveillance data for surgical site infection and microbiological data for bloodstream infection. The study period was 2003 through 2006. We defined invasive S. aureus infection as either nonsuperficial incisional surgical site infection or bloodstream infection. Nonparametric bootstrapping was used to generate 95% confidence intervals (CIs). P values were generated using the Pearson x2 test, Student t test, or Wilcoxon rank-sum test, as appropriate.Results.In total, 81,267 patients underwent 96,455 procedures during the study period. The overall incidence of invasive S. aureus infection was 0.47 infections per 100 procedures (95% CI, 0.43–0.52); 227 (51%) of 446 infections were due to methicillin-resistant S. aureus. Invasive S. aureus infection was more common after cardiothoracic procedures (incidence, 0.79 infections per 100 procedures [95% CI, 0.62–0.97]) than after orthopedic procedures (0.37 infections per 100 procedures [95% CI, 0.32–0.42]), neurosurgical procedures (0.62 infections per 100 procedures [95% CI, 0.53–0.72]), or plastic surgical procedures (0.32 infections per 100 procedures [95% CI, 0.17¬0.47]) (P < .001). Similarly, S. aureus bloodstream infection was most common after cardiothoracic procedures (incidence, 0.57 infections per 100 procedures [95% CI, 0.43–0.72]; P < .001, compared with other procedure types), comprising almost three-quarters of the invasive S. aureus infections after these procedures. The highest rate of surgical site infection was observed after neurosurgical procedures (incidence, 0.50 infections per 100 procedures [95% CI, 0.42–0.59]; P < .001, compared with other procedure types), comprising 80% of invasive S. aureus infections after these procedures.Conclusion.The frequency and type of postoperative invasive S. aureus infection varied significantly across procedure types. The highest risk procedures, such as cardiothoracic procedures, should be targeted for ongoing preventative interventions.

scholarly journals The safety of preoperative amino acid (Elental®) loading in colon cancer surgery: Prospective cohort study.

2017 ◽  
Author(s):  
Jun Watanabe ◽  
Mitsuyoshi Ota ◽  
Yusuke Suwa ◽  
Shinsuke Suzuki ◽  
Hirokazu Suwa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Colon Cancer ◽  
Amino Acid ◽  
Surgical Site Infection ◽  
Bowel Movement ◽  
Cancer Surgery ◽  
Site Infection ◽  
Incisional Surgical Site Infection ◽  
Colon Cancer Surgery ◽  
Induction Of Anaesthesia

Abstract Objective: The aim of this prospective study was to evaluate the safety of preoperative amino acid plus CHO drink (Elental®) loading in colon cancer surgery. Summary of Background Data: Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate drinks 2 hours before surgery. Methods: We prospectively enrolled consecutive patients with a preoperative diagnosis of colon cancer who underwent surgery. The patients received 600 ml of Elental® the night before surgery and 300 ml of Elental® 3 h prior to induction of anaesthesia. Primary endpoint was the safety of preoperative amino acid (Elental®) loading in colon cancer surgery. Safety measurement was anastomotic leakage and aspiration pneumonia. Secondary endpoints were incidence rate of incisional surgical site infection, recovery of bowel movement, length of hospital stay, postoperative nutritional status and insulin resistance. Results: A total of 80 consecutive patients were enrolled in this study from February 2013 to January 2014. The incidence of anastomotic leakage was 3 cases (3.8%) and there were no aspiration pneumonia. The incidence of incisional surgical site infection was 2 cases (2.5%). The median time of first flatus, defecation after surgery and postoperative hospital stay was 1 day, 2 days and 6 days. The insulin resistance recovered to a preoperative level after 3 days after surgery. Conclusion: The preoperative amino acid plus CHO drink (Elental®) loading 3h prior to induction of anaesthesia in colon cancer surgery is safe and incisional surgical site infection rate and recovery of bowel movement and insulin resistance are feasible.

scholarly journals Negative pressure wound therapy in the treatment of surgical site infection in cardiac surgery

2020 ◽  
Vol 73 (5) ◽  
Author(s):  
Mayra de Castro Oliveira ◽  
Alessandra Yuri Takehana de Andrade ◽  
Ruth Natalia Teresa Turrini ◽  
Vanessa de Brito Poveda
Keyword(s):  
Cardiac Surgery ◽  
Surgical Site Infection ◽  
Negative Pressure ◽  
Medical Records ◽  
Negative Pressure Wound Therapy ◽  
Myocardial Revascularization ◽  
Site Infection ◽  
Wound Therapy ◽  
Convenience Sample ◽  
Incisional Surgical Site Infection

ABSTRACT Objectives: to describe the relationship between epidemiological and clinical characteristics of postoperative cardiac surgery patients undergoing negative pressure wound therapy for the treatment of surgical site infection. Methods: an observational, cross-sectional analytical study including a convenience sample consisting of medical records of patients undergoing sternal cardiac surgery with surgical site infection diagnosed in medical records treated by negative pressure wound therapy. Results: medical records of 117 patients, mainly submitted to myocardial revascularization surgery and with deep incisional surgical site infection (88; 75.2%). Negative pressure wound therapy was used on mean for 16 (±9.5) days/patient; 1.7% had complications associated with therapy and 53.8% had discomfort, especially pain (93.6%). The duration of therapy was related to the severity of SSI (p=0.010) and the number of exchanges performed (p=0.045). Conclusions: negative pressure wound therapy has few complications, but with discomfort to patients.

scholarly journals Subcutaneous Fat Thickness and the Risk of Superficial Incisional Surgical Site Infection Following Open Appendectomy

2021 ◽  
Vol 23 (1) ◽  
pp. 1-5
Author(s):  
Subash Rai ◽  
P Poudel ◽  
A Chalise ◽  
M Nepal ◽  
M Shrestha
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Subcutaneous Fat ◽  
Site Infection ◽  
Female Population ◽  
Wound Site ◽  
Incisional Surgical Site Infection ◽  
Subcutaneous Fat Thickness ◽  
Fat Thickness

Obesity is a known risk factor for surgical site infection (SSI). Recent studies have demonstrated that fat burden at the incisional site rather than body mass index (BMI) is a more precise and sensitive measure to predict the risk of SSI. The purpose of the study was to evaluate the correlation between subcutaneous fat thickness (SCFT) at the level of Mc Burney’s point and the occurrence of superficial incisional SSI among the patients undergoing open appendectomy. A total of 120 patients who underwent open appendectomy were included in the study. SCFT was measured preoperatively with ultrasonography (USG). The occurrence of superficial incisional SSI was evaluated in relation to SCFT. Previously identified well established risk factors for the development of SSI were also considered by the study. Statistical analysis was performed using SPSS version 17. Overall, superficial incisional SSI was observed in 27 (22.5%) participants. Mean SCFT at the level of Mc Burney’s point among male and female population was 2.26 cm ± 0.74 (SD) and 2.02 cm ± 0.83 (SD) respectively. Patients with superficial incisional SSI had a mean fat thickness of 2.80 cm and those without SSI had mean fat thickness of 1.97 cm. The difference in SCFT was statistically significant (p=.001). More interestingly, the area under the ROC curve was more for SCFT, in comparison to BMI among the patients who developed superficial incisional SSI (81% vs. 73%). Furthermore, we analysed the occurrence of superficial incisional SSI with SCFT cut off at 2.80 cm, which was statistically significant. As majority of the study population were young adults, risk factors like smoking, diabetes mellitus and nutritional status failed to demonstrate significant correlation with post appendectomy wound site complications. The study demonstrated that the thickness of subcutaneous fat at the site of inci sion is a good predictor of superficial incisional SSI following open appendectomy and the risk of superficial wound site infection increases as the thickness of subcutaneous fat at the site of incision increases.

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