scholarly journals Surgical-site infection after abdominal wall closure with triclosan-impregnated polydioxanone sutures: Results of a randomized clinical pathway facilitated trial (NCT00998907)

Surgery ◽  
2013 ◽  
Vol 154 (3) ◽  
pp. 589-595 ◽  
Author(s):  
Christoph Justinger ◽  
Jan Erik Slotta ◽  
Sebastian Ningel ◽  
Stefan Gräber ◽  
Otto Kollmar ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Clinical Pathway ◽  
Site Infection ◽  
Abdominal Wall Closure

scholarly journals A prospective study in peritonitis patients to compare the impact of subcutaneous negative suction closure, conventional primary closure of skin and subcutaneous tissue and open skin technique following laparotomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3293
Author(s):  
Mano Zac Mathews ◽  
Sriram Gopalakrishnaiah Subramanyam ◽  
Nivedita Mitta
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Suction Drain ◽  
Group A ◽  
Group B ◽  
Negative Suction

Background: Abdominal wall closure in the presence of sepsis presents a challenge to the surgeon. The objective of this study is to determine the advantages and disadvantages of each method to individualise the techniques based on patient profile about surgical site infection, duration of hospitalisation and morbidity.Methods: A prospective comparative study was conducted among 102 operated patients of peritonitis in the Department of General Surgery at St John’s Medical College and Hospital. The patients were divided into three groups, group A, group B and group C. In group A, skin and subcutaneous tissue was closed after draining the subcutaneous space by a negative-suction drain. In group B, the patient’s skin and subcutaneous tissues were closed primarily with continuous sutures without negative suction drain. In group C, the laparotomy wound was closed and the skin was left open. And the outcome compared in the form of wound infection, hospital stay and morbidity. Patients on immunosuppressive therapy and paediatric patients were excluded. Demographic and clinical variables were recorded at the time of admission. SPSS version 18 was used for analysis.Results: The study showed male preponderance and the mean age was 43.2 years. Duodenal perforation was the commonest cause of peritonitis in this study (38.2%). Incidence of surgical site infection was less in Group A (20.6%) compared to group B (52.9%) and group C (29.4%). Duration of hospital stay was also less in Group A patients (9.3±3.6 days) compared to other two groups. 37 patients who were included in the study were diabetic, out of which 25 patients (67.6%) developed surgical site infection.Conclusions: It can be concluded from this study that abdominal wall closure using a sub cutaneous negative suction drain in peritonitis cases reduces the incidence of surgical site infection, duration of hospital stays, subsequent surgeries related to wound dehiscence and its associated morbidity.  

scholarly journals Searching for the safest abdominal closure technique after emergency laparotomy for Hinchey III and IV peritonitis

2017 ◽  
Vol 4 (8) ◽  
pp. 2534
Author(s):  
Nicolo Tamini ◽  
Marco Cereda ◽  
Giulia Capelli ◽  
Alessandro Giani ◽  
Luca Gianotti
Keyword(s):  
Incisional Hernia ◽  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Data Retrieval ◽  
Fascial Closure ◽  
Skin Closure ◽  
Absorbable Suture ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Midline Laparotomy

Background: The optimal strategy for abdominal wall closure has been an ongoing issue of debate and convincing evidence is still lacking. The INLINE systematic review and meta-analysis published on annals of surgery 2010 suggested that a running suture with a slowly absorbable suture material was the gold standard technique for abdominal wall closure after elective surgery, while there’s no general agreement in the emergency setting.Methods: Retrospective study regarding patients who underwent emergency surgery for a generalized peritonitis due to colonic perforation from 2002 to 2014 at San Gerardo hospital (Monza, Italy). Particularly study analyzed differences between continuous suture (Maxon loop, Covidien ©) and interrupted suture (Safil, B. Braun ©) for fascial closure and between metallic clips and second intention healing for incision management. After completion of data retrieval, 110 patients were included in the statistical analysis.Results: Incisional hernia rate was 15/101 (14.9%) and surgical site infection rate was 29/110 (26.4%). No significant statistical differences were found between incidence of incisional hernia and surgical site infection in the two groups, although there was a higher prevalence of incisional hernia in the running suture group (25% vs 11,7%). There was no difference between skin-stapler’s and second-intention’s wound closure groups in terms of surgical site infection and incisional hernia development.Conclusions: We consider reasonable to use an interrupted long time absorbable suture for fascial closure after emergency midline laparotomy for Hinchey III and IV peritonitis, at least in high-risk patients. Considering skin closure, suggestion is to perform a primary skin closure.

Effectiveness of triclosan-coated PDS Plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial

The Lancet ◽  
2014 ◽  
Vol 384 (9938) ◽  
pp. 142-152 ◽  
Author(s):  
Markus K Diener ◽  
Phillip Knebel ◽  
Meinhard Kieser ◽  
Philipp Schüler ◽  
Tobias S Schiergens ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Randomised Controlled

scholarly journals PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA PROFILAKSIS PADA SEKSIO SESAR SESUAI ALUR KLINIS RSUP DR SARDJITO DENGAN ANTIBIOTIKA DOSIS MULTIPEL TERHADAP KEJADIAN INFEKSI LUKA OPERASI

2016 ◽  
Vol 3 (2) ◽  
pp. 75
Author(s):  
Ardian Rahmansyah ◽  
Mohammad Hakimi ◽  
Rukmono Siswishanto
Keyword(s):  
Length Of Stay ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Clinical Pathway ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
Site Infection ◽  
Short Term

Background: Clinical pathway recommend the use of short-term prophylaxis antibiotics for cesarean section. Long-term antibiotics or multiple doses was found in clinical practice. There are differences in the mode of administration and the number of doses administered at sardjito hospital.Objective: To determine the effectiveness of short-term antibiotic prophylaxis in cesarean section appropriate to clinical pathway in the prevention of surgical site infection (ssi), the incidence of fever, dysuria events, length of stay.Method: The study used randomized clinical trial. The study subjects who underwent cesarean section and meet the inclusion and exclusion criteria in the period July 2013 to January 2014 divided into an intervention group (n = 52) who received ampicillin 2 gram pre and post-cesarean section, and a control group (n = 54) who received ampicillin 2 gram pre cesarean section and 1 gram every 8 hours for 6 times. Observed on days 3 and 10 post-cesarean section. The primary outcomes assessed were the incidence of surgical wound infection based on the criteria of surgical site infection from Centers for Disease Controland Prevention. Secondary outcomes assessed were the incidence of fever, dysuria events, length of stay. Homogeneity analysis were conducted on subject. Outcome analysis performed bivariate with t test and chi squared test.Results and Discussion : A total of 106 subjects can be analyzed. SSI events in the intervention group at day 3 was 3.8% (n = 52) and control group was 1.84% (n = 54) with p>0.05 RR 2.077 (95% CI 0.194 to 22.219). SSI on day 10 of 7.7% (n = 52) in the intervention group versus 9.3% (n = 54) in controls with p<0.05 RR 0.831 (CI 95%, 0.236 to 2.924). Fever events on day 3 by 5.8% in the intervention group versus 3.7% incontrols with p>0.05 RR 1.558 (95% CI 0.271 to 8.948) and on day 10 was 3.8% versus 3.7 % with p>0.05 RR 1.038 (95% CI 0.152 to 7.102). Dysuria not found on day 3 and but on 10 found 5.8% in the intervention group versus 11.1% with p>0.05 RR 0.519 (IK95% 0.137 to 1.968). Length of stay after cesarean section for 3.21 ± 0.412 days in the intervention group and 3.26 ± 0.442 days in the control group with p>0.05 (95% CI -0.213 - 0.117).Conclusion: There is no significant difference in the incidence of surgical wound infections, the incidence of fever, dysuria, length of stay between short-term prophylaxis antibiotics ampicillin appropriate to clinical pathway and long-term or multiple doses prophylaxis antibiotics. Short term antibiotics prophylaxis are more efficiently with the same effectiveness in preventing outcomes research.Keywords: prophylaxis antibiotics, ampicillin, short term regimen, long term regimen, cesarean section, surgical site infection. 

scholarly journals Short term outcome of midline laparotomies in view abdominalfascia closer

2021 ◽  
Vol 9 (1) ◽  
pp. 107
Author(s):  
Chinmay S. Gandhi ◽  
Dajiram G. Mote ◽  
Zahid Shivani ◽  
Kalan Kumar Sama
Keyword(s):  
Comparative Study ◽  
Surgical Site Infection ◽  
Abdominal Wall ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Site Infection ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

Background: This is a prospective non randomized observational comparative study for surgical site infections and surgical site occurrences after laparotomy fascia closer with two different techniques. Regular bite remains the standard of care in most hospitals. Laparotomies were done for elective and emergency cases.Methods: There were two techniques used to close abdominal wall fascia. The present study has evaluated small bite abdominal closer verses regular bite closer. Author and his team had used small bite fascia closer technique for all laparotomies, while other group of surgeons utilized regular bite fascia closer.Results: Out of 26 laparotomies in short bite closer, 8 had surgical site infections and surgical site occurrences, while 26 laparotomies in regular bite closer group had 15 patients with surgical site infections and surgical site occurrences. There is significant reduction in surgical site infection and surgical site occurrences observed in small bite abdominal closer group.Conclusions: It is recommended all laparotomies elective or emergent should be closed with small bite technique as it reduces surgical site infections and surgical site occurrences.

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