scholarly journals Diagnosing Surgical Site Infection Using Wound Photography: A Scenario-Based Study

2017 ◽  
Vol 224 (1) ◽  
pp. 8-15.e1 ◽  
Author(s):  
Patrick C. Sanger ◽  
Vlad V. Simianu ◽  
Cameron E. Gaskill ◽  
Cheryl A.L. Armstrong ◽  
Andrea L. Hartzler ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Site Infection ◽  
Wound Photography

Wound photography for evaluation of surgical site infection and wound healing after lower limb trauma

2021 ◽  
Vol 103-B (12) ◽  
pp. 1802-1808
Author(s):  
Julie Bruce ◽  
Ruth Knight ◽  
Nick Parsons ◽  
Ria Betteridge ◽  
Amy Verdon ◽  
...  
Keyword(s):  
Wound Healing ◽  
Surgical Site Infection ◽  
Clinical Assessment ◽  
Lower Limb ◽  
Open Fracture ◽  
Alternative Methods ◽  
Site Infection ◽  
Limb Fracture ◽  
Wound Photography ◽  
Level Of Agreement

Aims Deep surgical site infection (SSI) is common after lower limb fracture. We compared the diagnosis of deep SSI using alternative methods of data collection and examined the agreement of clinical photography and in-person clinical assessment by the Centers for Disease Control and Prevention (CDC) criteria after lower limb fracture surgery. Methods Data from two large, UK-based multicentre randomized controlled major trauma trials investigating SSI and wound healing after surgical repair of open lower limb fractures that could not be primarily closed (UK WOLLF), and surgical incisions for fractures that were primarily closed (UK WHiST), were examined. Trial interventions were standard wound care management and negative pressure wound therapy after initial surgical debridement. Wound outcomes were collected from 30 days to six weeks. We compared the level of agreement between wound photography and clinical assessment of CDC-defined SSI. We are also assessed the level of agreement between blinded independent assessors of the photographs. Results Rates of CDC-defined deep SSI were 7.6% (35/460) after open fracture and 6.3% (95/1519) after closed incisional repair. Photographs were obtained for 77% and 73% of WOLLF and WHiST cohorts respectively (all participants n = 1,478). Agreement between photographic-SSI and CDC-SSI was fair for open fracture wounds (83%; k = 0.27 (95% confidence interval (CI) 0.14 to 0.42)) and for closed incisional wounds (88%; k = 0.29 (95% CI 0.20 to 0.37)) although the rate of photographically detected deep SSIs was twice as high as CDC-SSI (12% vs 6%). Agreement between different assessors for photographic-SSI (WOLLF 88%, k = 0.63 (95% CI 0.52 to 0.72); WHiST 89%; k = 0.61 (95% CI 0.54 to 0.69)); and wound healing was good (WOLLF 90%; k = 0.80 (95% CI 0.73 to 0.86); WHiST 87%; k = 0.57 (95% CI 0.50 to 0.64)). Conclusion Although wound photography was feasible within the research context and inter-rater assessor agreement substantial, digital photographs used in isolation overestimated deep SSI rates, when compared to CDC criteria. Wound photography should not replace clinical assessment in pragmatic trials but may be useful for screening purposes where surgical infection outcomes are paramount. Cite this article: Bone Joint J 2021;103-B(12):1802–1808.

Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh
Keyword(s):  
Surgical Site Infection ◽  
Multiple Drug Resistance ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Site Infection ◽  
Retrospective Case ◽  
Acinetobacter Baumanii ◽  
Health Care Centre ◽  
North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship  b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

USE OF AN ELECTRONIC DATA WAREHOUSE TO ENHANCE CARDIAC SURGICAL SITE SURVEILLANCE AT A LARGE CANADIAN CENTRE

2008 ◽  
Vol 31 (4) ◽  
pp. 21 ◽  
Author(s):  
G W Rose ◽  
V R Roth ◽  
K N Suh ◽  
M Taljaard ◽  
C Van Walraven ◽  
...  
Keyword(s):  
Infection Control ◽  
Surgical Site Infection ◽  
Data Warehouse ◽  
Stepwise Logistic Regression ◽  
Site Infection ◽  
Electronic Data ◽  
Trigger Mechanism ◽  
Trigger Tool ◽  
Infection Surveillance ◽  
Trigger Mechanisms

Background/Purpose: Surgical site infection surveillance to determineincidence is a key infection control activity. Case detection is labour-intensive, therefore most infection control programs use manual or simple electronic mechanisms to “trigger” chart review. However, such “trigger” mechanisms are also labour-intensive, and often of poor specificity. Our objective is to develop a complex trigger mechanism using data from an electronic data warehouse, to improve specificity of surveillance of surgical site infection compared to current trigger mechanisms. Methods: We will derive an electronic trigger tool for cardiac surgical site infection surveillance using a nested case-control design, among a cohort of all patients undergoing coronary artery bypass grafting, cardiac valve repairor replacement, or heart transplant at the University of Ottawa Heart Institute, from July 1 2004 to June 30 2007. We will perform a systematic literature review to identify potential trigger factors to include in the model, then construct the trigger tool by backwards stepwise logistic regression. The best-fit model will be used to calculate the probability of surgical site infection. We will select the threshold probability to use in surveillance by visual inspection of receiver-operator-characteristic curves. The accuracy of this electronic trigger mechanism will be compared to pre-existing manual and simple electronic mechanisms using relative true positive ratios and relative false positive ratios. Results/Conclusions: We have selected 200 cases of surgical site infection and 541 controls from among 3744 procedures performed during the study period. As of the date ofthis abstract we are still undertaking the systematic review.

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