scholarly journals Septoplasty with and without additional sinonasal surgery: postoperative sequelae and the use of prophylactic antibiotics

2021 ◽  
Author(s):  
Ida Kotisalmi ◽  
Maija Hytönen ◽  
Antti A. Mäkitie ◽  
Markus Lilja
Keyword(s):  
Infection Rate ◽  
Postoperative Infection ◽  
Patient Characteristics ◽  
Neck Surgery ◽  
Prophylactic Antibiotics ◽  
University Hospital ◽  
Postoperative Infections ◽  
Prophylactic Measure ◽  
Prophylaxis Group

Abstract Purpose One of the most common complications after septoplasty is a postoperative infection. We investigated the number of postoperative infections and unplanned postoperative visits (UPV) in septoplasties with and without additional nasal surgery at our institution and evaluated the role of antibiotic prophylaxis. Methods We collected data of all consecutive 302 septoplasty or septocolumelloplasty patients operated during the year 2018 at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record sociodemographic patient characteristics and clinical parameters regarding surgery and follow-up. Results Altogether 239 patients (79.1%) received pre- and/or postoperative prophylactic antibiotics and within this group 3.3% developed a postoperative infection. The infection rate in the non-prophylaxis group of 63 patients was 12.7% (p = 0.007). When all patients who received postoperative antibiotics were excluded, we found that the infection rate in the preoperative prophylaxis group was 3.8%, as opposed to an infection rate of 12.7% in the non-prophylaxis group (p = 0.013). When evaluating septoplasty with additional sinonasal surgery (n = 115) the rate of postoperative infection was 3.3% in the prophylaxis group and 16.7% in the non-prophylaxis group (p = 0.034). These results show a statistically significant stand-alone effect of preoperative prophylactic antibiotics in preventing postoperative infection in septoplasty, especially regarding additional sinonasal surgery. Conclusion The use of preoperative antibiotics as a prophylactic measure diminished statistically significantly the rate of infections and UPVs in septoplasty when all postoperative infections, superficial and mild ones included, were taken into account.

Aseptically Processed Allograft Implantation: A Safe Strategy for Knee Ligament Reconstructions

2021 ◽  
Author(s):  
Chilan B.G. Leite ◽  
João M.N. Montechi ◽  
Gilberto L. Camanho ◽  
Riccardo G. Gobbi ◽  
Fabio J. Angelini
Keyword(s):  
Infection Rate ◽  
Disease Transmission ◽  
Postoperative Infection ◽  
Cruciate Ligament ◽  
High Energy ◽  
Postoperative Infections ◽  
Knee Ligament ◽  
The Mean ◽  
Bone Plug ◽  
Postoperative Infection Rate

AbstractPostoperative infections after allograft implantation is a major concern in knee ligament reconstructions considering the theoretical risk of disease transmission and its potential severity. Here, we aimed to evaluate the postoperative infection rate after knee ligament reconstructions using aseptically processed allografts, and provide an overview of the allografts use in an academic tertiary hospital. A retrospective study was performed evaluating patients who underwent knee ligament reconstructions using aseptically processed allografts, including primary and revision surgeries, from 2005 to 2018. Demographic data, including the type of knee injury and trauma energy, and postoperative data were collected focusing on postoperative infections. Regarding these infected cases, further analyses were performed considering the presenting signs and symptoms, the isolated microorganism identified in culture, the time between graft implantation and diagnosis of infection (defined as acute, subacute, and late), and the need for graft removal. A total of 180 cases of ligament reconstructions were included. The mean follow-up was 8.2 (range: 2.1–15.6) years and the mean age at surgery was 34.1 (± 11.1) years. A total of 262 allografts were implanted in those 180 cases, 93 (35.5%) as bone plug allografts and 169 (64.5%) as soft tissue allografts. Common surgical indications included multiligament reconstruction (57.2%) and primary anterior cruciate ligament (ACL) reconstruction (15%). Seven cases (3.9%) presented postoperative infections. Knee pain (100%) and swelling (100%) were the most prevalent symptoms. Two cases (28.6%) presented sinus tract. Allografts were removed in two cases, the same cases that presented draining sinus (p = 0.04). High-energy trauma was the only statistically associated factor for infection (p = 0.04). No significant association between infection and the type of allograft (p > 0.99) or sex (p = 0.35) were observed. Four cases (57.1%) had monomicrobial staphylococcal infections. Based on that, the allograft-related infection rate was 1.7% (the remaining three infected cases). Nonirradiated, aseptically processed allografts have a low postoperative infection rate in knee ligament reconstructions, being a safe alternative for surgeries that require additional source, increased variety, and quantity of grafts.

Infection Rate in 1033 Elective Neurosurgical Procedures at a University Hospital in South China

2017 ◽  
Vol 78 (05) ◽  
pp. 467-471 ◽  
Author(s):  
Hongwei Zhu ◽  
Xiyao Liu ◽  
Zhanxiang Wang
Keyword(s):  
Risk Factors ◽  
Foreign Body ◽  
Antibiotic Prophylaxis ◽  
Infection Rate ◽  
South China ◽  
Postoperative Infection ◽  
University Hospital ◽  
Csf Leak ◽  
Neurosurgical Procedures ◽  
Foreign Body Implantation

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. Results A total of 33 patients (40 cases) experienced postoperative infection representing 3.19% of the study population. Twenty cases were incision infections (1.94%), and 20 were cranial/spinal infections (1.94%) including 15 intracranial infections and 5 intraspinal infections. The 2.4-fold greater incidence of postoperative infection in 2008 to 2010 was compared with that in 2011 to 2014 with perioperative antibiotic prophylaxis (p <0.01). The neurosurgical procedure associated with the highest rate of infection was cranioplasty (6.85%); the lowest rate of infection was associated with functional neurosurgery (1.08%). The most common offending organism was Staphylococcus aureus (27.5%). Foreign body implantation, operative time > 4 hours, and cerebrospinal fluid (CSF) leak (13 infections in 158 patients; p <0.001) were risk factors for infections (p <0.05). Conclusion The neurosurgical infection rate is usually low with perioperative antibiotic prophylaxis even in developing countries. Less foreign body implantation, shorter operative times, and controlling CSF leak could reduce infection rates.

scholarly journals Surgical Outcome and Complications of Nasal Septal Perforation Repair with Temporal Fascia and Periosteal Grafts

2015 ◽  
Vol 8 ◽  
pp. CMENT.S23230 ◽  
Author(s):  
Paula Virkkula ◽  
Antti a. Mäkitie ◽  
Seija i. Vento
Keyword(s):  
Postoperative Infection ◽  
Donor Site ◽  
Neck Surgery ◽  
University Hospital ◽  
Septal Perforation ◽  
Temporal Fascia ◽  
Nasal Septal Perforation ◽  
Main Technique ◽  
Advancement Flaps

Aims Surgical treatment of nasal septal perforation remains a challenging field of rhinology. A large variety of techniques and grafts with promising results have been introduced for perforation repair. However, the use of fascia or fascia with periosteum has not been previously evaluated for a large sample of patients. Methods During the years 2007–2014, 105 operations were performed and 98 patients were treated for nasal septal perforation at the Department of Otorhinolaryngology–-Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland. We performed a retrospective review of closure rates and complications. Follow-up time ranged from 1 to 62 months. Results Bleeding was the most common early complication (9%), followed by postoperative infection (5%) in the whole series. Our main technique, bipedicled advancement flaps with fascia or fascia and periosteum, was performed for 81 patients. We obtained successful closure in 78% of these patients with this operative technique and the rate increased to 86% during the last 3 years of the study period. Conclusions Perforation repair with temporal fascia or fascia with periosteum requiring only one donor site seems to be a reliable option for nasal septal perforation repair.

Declining Mortality From Pulmonary Embolism In Surgical Patients

1981 ◽  
Author(s):  
S E Dismuke
Keyword(s):  
Pulmonary Embolism ◽  
Cause Of Death ◽  
Patient Characteristics ◽  
University Hospital ◽  
Surgical Patients ◽  
Pulmonary Vasculature ◽  
Competing Causes ◽  
Prophylactic Anticoagulation ◽  
Death Cases

The frequency and clinical characteristics of autopsied surgical patients dying with pulmonary embolism (PE) were studied at a University hospital from 1966-1976. During this period a standard autopsy protocol was in use. All patients in whom PE occluded the equivalent of at least one lobar artery were studied. Information collected in all adult deaths confirmed the year to year similarity of patient characteristics and likelihood of autopsy. In order to assess the role of PE in a patient’s death, cases were grouped separately by 2 criteria: 1) according to size of PE (3 groups: greater than 2/3 of pulmonary vasculature occluded, 1/2 - 2/3 occluded, less than 1/2 occluded); 2) weighing competing causes of death by having 3 physicians (randomly selected from a pool of 25) judge the likelihood of death after 1 month had PE been prevented (classifying them as primary PE death, contributory PE death, and death from competing causes). Sixty percent (900/1489) of surgical deaths were autopsied and 7.7% (69) had large emboli. The percentage of deaths from PE, using either criteria, has declined significantly (p<0.01) over time (1966-71 vs 1972-76): 10.5% to 4.5% for all cases studied and 5.5% to 2.1% in those where PE was the primary or a contributory cause of death. PE was the primary or a contributory cause of death in 3.9% (34 cases) of these autopsies. The clinical diagnosis of PE was considered in only 17% (6) of these cases but 63% (22) had no symptoms suggestive of PE prior to death. An infiltrate or effusion, however, was present in 60% (21) of cases and 80% (28) had 2 or more major risk factors for PE. In contrast to previous studies, this study demonstrates an impressive decline in surgical deaths from PE from 1966-1976 despite no routine use of prophylactic anticoagulation.

scholarly journals Role of Hum Test in Diagnosis of Hearing Loss

2020 ◽  
Vol 4 (3) ◽  
pp. 782-785
Author(s):  
Ashish Dhakal ◽  
Bikash Lal Shrestha ◽  
Sameer Karmacharya ◽  
Aakash Pradhan
Keyword(s):  
Hearing Loss ◽  
Gold Standard ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: The Hum Test is used by some otolaryngologists as an alternative to the Weber Test to detect the presence and type of acute hearing change; however, its use has not yet been formally validated. Objective: To compare the diagnostic performance of Hum test with Weber test to detect hearing loss taking pure tone audiometry as the gold standard. Methodology: A prospective, cross-sectional study was conducted in the department of Otorhinolaryngology and Head and Neck surgery, Dhulikhel Hospital- Kathmandu University Hospital, from June 2018 to February 2019. Total of 257 patients were enrolled in the study and were subjected to 3 tests: Weber test, Hum test, and pure tone audiometry. Results: When examining patients with hearing loss, sensitivity of Hum test and weber test were 60.3% and 93.8 % respectively. In patients with CHL, sensitivity of Hum test was 55.7% while Weber test was 94.8%. In SNHL, it was 74.6% for Hum test and 90.5% for Weber test. Likewise, according to laterality of disease, sensitivity of Hum test was 58.6% for unilateral hearing loss and 65.2% for bilateral hearing loss. For Weber test it was 96.3% for unilateral and 86.4% for bilateral disease. Conclusion: Hum test is not as sensitive as Weber test in diagnosis of hearing loss both for conductive and sensorineural hearing loss.

scholarly journals Incidence, preventability, and causality of adverse drug reactions at a university hospital emergency department

2020 ◽  
Author(s):  
Mirjam Kauppila ◽  
Janne T. Backman ◽  
Mikko Niemi ◽  
Outi Lapatto-Reiniluoto
Keyword(s):  
Emergency Room ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Age Group ◽  
Emergency Room Visits ◽  
Hospital Emergency ◽  
Pharmacogenetic Testing ◽  
Severe Infections

Abstract Purpose To investigate the characteristics of ADRs in patients admitting at the emergency room of a tertiary hospital. Methods We collected the patient records of 1600 emergency room visits of a university hospital in 2018. The patient files were studied retrospectively and all possible ADRs were identified and registered. Patient characteristics, drugs associated with ADRs, causality, severity, preventability, and the role of pharmacogenetics were assessed. Results There were 125 cases with ADRs, resulting in a 7.8% overall incidence among emergency visits. The incidence was greatest in visits among elderly patients, reaching 14% (men) to 19% (women) in the 80–89 years age group. The most common causative drugs were warfarin, acetylsalicylic acid (ASA), apixaban, and docetaxel, and the most common ADRs were bleedings and neutropenia and/or severe infections. Only two of the cases might have been prevented by pharmacogenetic testing, as advised in Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Conclusion The same ATC classes, antithrombotics and cytostatics, were involved in ADRs causing university clinic hospitalizations as those identified previously in drug-related hospital fatalities. It seems difficult to prevent these events totally, as the treatments are vitally important and their risk-benefit-relationships have been considered thoroughly, and as pharmacogenetic testing could have been useful in only few cases.

Efficacy of Cefazolin as a Prophylactic Antibiotic in Head and Neck Surgery

1978 ◽  
Vol 86 (4_suppl) ◽  
pp. ORL-568-ORL-572 ◽  
Author(s):  
Michael B. Seagle ◽  
Larry E. Duberstein ◽  
Charles W. Cross ◽  
John L. Fletcher ◽  
Azhar Q. Mustafa
Keyword(s):  
Head And Neck ◽  
Surgical Procedures ◽  
Postoperative Infection ◽  
Postoperative Morbidity ◽  
Prophylactic Antibiotic ◽  
Neck Surgery ◽  
Prophylactic Antibiotics ◽  
Head And Neck Surgery ◽  
Short Term ◽  
Perioperative Antibiotics

The rationale for use of perioperative short-term prophylactic antibiotics in prevention of postoperative infection in major head and neck surgery was reviewed. Cefazolin and placebo were compared in 50 patients and results showed that short-term perioperative cefazolin was a useful adjunct in reduction of postoperative infection. Findings suggest perioperative antibiotics may be safely and effectively used to reduce postoperative morbidity from infection after surgical procedures involving skin and mucosa of the upper aero-digestive tract.

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