Deep postoperative wound infection after carpal tunnel release

1989 ◽  
Vol 14 (5) ◽  
pp. 869-873 ◽  
Author(s):  
Arlen D. Hanssen ◽  
Peter C. Amadio, ◽  
Stephen P. DeSilva ◽  
Duane M. Ilstrup
Author(s):  
Inayat Ali Khan

Background: It has been well documented that administering a prophylactic antibiotic brings down the rate of postoperative wound infection very strikingly in carpal tunnel release (CTR) surgery. Carpal tunnel syndrome (CTS) is definitely a compressive neuropathy of the upper limbs, which is both benign and frequent. The study objective was to determine the postoperative wound infection rate in carpal tunnel release surgery after having administered a single dose of a prophylactic antibiotic. Methods: This cross-sectional study was carried out at the department of Neurosurgery, Dammam Medical Complex-Saudi Arabia. The study was based on 122 patients who were operated for carpal tunnel release procedures at the centre. Pre-operatively all patients were subjected to nerve conduction studies (NCS) to document CTS as the definitive diagnosis. As a routine, every patient was administered intravenous loading dose of cefuroxime (1.5g) at least 1 hour prior to surgery. All patients were treated as day care cases and were discharged after a few hours of surgery. On discharge, no further antibiotics were administered. Their wounds were examined. Results: Superficial redness over the site of incision was noted in three of the patients and wound infection in two others. These two patients improved with oral antibiotics. Not a single patient needed re-exploration. Conclusion: The current study showed that this is an efficacious and a very safe protocol to follow. Assuming the fact that the incidence of surgical site infection (SSI) in CTR surgery is low, the results were not different when compared to the results from other centres.


2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
SUHAIL AMER

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad. Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repairelectively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results were assessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections in both groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.


2017 ◽  
Vol 4 (5) ◽  
pp. 1569
Author(s):  
Shobha S. Nisale ◽  
Meghraj Chawada ◽  
Ganesh K. Kharkate ◽  
Sudhir B. Deshmukh

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.


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