P226 Postoperative wound dealing and superficial surgical site infection in open radical prostatectomy

238 Background: Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is the most effective method for detecting lymph node metastases in patients with prostate cancer. The association between PLND during RP and morbidity, especially thromboembolic adverse events (AEs), remains unclear. We assessed the effect of PLND on 30−day postoperative AEs in patients undergoing RP using the American College of Surgeons’ National Surgical Quality Improvement Program database (NSQIP). Methods: A total of 21,895 men undergoing RP between 2006 and 2013 were classified into two groups according to surgical approach (MIS−RP vs. ORP) and whether PLND was performed. Multivariate logistic regression adjusting for approach and demographic features was performed to assess the impact of PLND for predicting two primary endpoints (overall complications and major complications defined as Clavien−Dindo ≥ 3) and for 17 types of complications. P−values were adjusted to maintain an experiment−wise p < 0.05. Results: MIS−RP and ORP was performed in 17,354 (79.3%) and 4,541 (20.7%) patients, respectively. PLND was performed in 7,579 (43.7%) and 3,597 (79.2%) patients in the MIS−RP and ORP groups, respectively. The overall postoperative complication rate was 8.7% (5.5% for MIS−RP and 21.0% for ORP). PLND was not associated with a higher risk of DVT (OR 0.99; p= 0.98) or PE (OR 1.02; p= 0.91). However, PLND was associated with a higher risk of superficial surgical site infection (OR 1.68; p = 0.013), organ space surgical site infection (OR 1.77; p = 0.02), and perioperative transfusion (OR 1.32; p = 0.002) regardless of surgical approach. PLND was not associated with overall or major AEs on multivariable analysis. ORP was associated with a significantly higher risk of overall (OR 4.64, p < 0.0001) and major (OR 1.6, p = 0.0004) AEs compared to MIS−RP. Conclusions: PLND during RP is associated with a significantly increased risk of certain types of AEs within the 30−day post−operative period. However, there appears to be no significant association between PLND and thromboembolic AEs.

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AN UPDATED GUIDELINES ON POST-OPERATIVE WOUND MANAGEMENT

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i11.2274 ◽

2021 ◽

Vol 5 (11) ◽

Author(s):

Sangita Santosh Nimbalkar ◽

Manish R. Malani

Keyword(s):

Surgical Site Infection ◽

Surgical Procedure ◽

Wound Management ◽

Site Infection ◽

Nice Guidelines ◽

Postoperative Wound ◽

Post Surgery ◽

Operative Care ◽

Study Results ◽

Group 1

Introduction: management and prevention of wounds after a surgical procedure, are important and debatable topics. Optimal adoption of guidelines for proper prevention and management of post-surgical wounds must be carried out by any surgeon or institute. Postoperative wound care is done by cleaning and dressing the wounds after the surgical procedure, preventing them from getting contaminated with the external surfaces or the microorganisms on the patient’s body. Surgical Site Infection (SSI) is the infection associated with healthcare in which the infection occurs in the wound after an invasive surgical procedure. A minimum of 5% of the patients who undergo surgical procedures will develop surgical site infections. This study draws the attention of the clinicians to a proper set of guidelines for post-operative care to minimize post-operative complications. Materials and Methods: this study is a Retrospective Cohort design. The study was considered 92 patients who had various types of surgery from during the period of 10 months. The patients who had intra-abdominal surgery are only included. The study divided 92 patients into 2 groups. In each group, 46 patients were assigned based on following NICE guidelines on postoperative wound management. Patients, for whom the NICE guidelines were followed properly at every aspect, were assigned to the first group (Group 1). Otherwise, the patients were assigned to the second group (Group 2). The study adopted a list comprising of NICE guidelines which are applicable to this study. The study assessment was done by observing the appearance of Surgical Site Infection among the patients, 3 to 7 days post-surgery. Results: it as found that 91.30% of the Group 1 patients showed significant improvement in terms of resolution while only 13.04% of the patients in improved significant without any surgical site infection (SSI). Conclusion: the study results show that the patients who were given post-operative care according to NICE guidelines had much lesser Surgical Site Infection (SSI) as compared to those who were not given post-operative care according to NICE guidelines. Keywords: surgical site infection, postoperative care, nice guidelines, wound management

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Prophylaxis of surgical site infection

Kazan medical journal ◽

10.17816/kmj2020-852 ◽

2020 ◽

Vol 101 (6) ◽

pp. 852-858

Author(s):

A G Izmaylov ◽

S V Dobrokvashin ◽

D E Volkov ◽

L E Nikitina ◽

D I Tereshenkov ◽

...

Keyword(s):

Postoperative Complications ◽

Surgical Site Infection ◽

Infectious Complications ◽

Wound Complications ◽

Contamination Rate ◽

Site Infection ◽

Surgical Interventions ◽

Postoperative Wound ◽

Clean Contaminated

The article provides a literature review of the methods for the prevention of local infectious complications preoperative, intraoperative and postoperative. The analysis of the literature is devoted to the methods of prevention of postoperative purulent inflammatory wound complications. The review of scientific medical literature is based on the analysis of this problem. The article presents risk factors that contribute to the development of postoperative wound complications. Classification of surgical wounds was adopted to determine the risk of developing a surgical site infection (SSI), which distinguishes 4 classes: clean, conditionally clean, contaminated and dirty. The presented classification is based on the postoperative assessment of the wound bacterial contamination rate. The ClavienDindo classification of postoperative complications is the most relevant. This classification presents the tactics of the surgeon, depending on the class. The results of various studies indicate that antibiotic prophylaxis in the preoperative period reduces the development of local complications. The description of prevention methods focuses on intraoperative methods (devices for bringing together the edges of the wound, devices for treating wounds, surgical needles, suture material) and various types of antiseptics, which can reduce tissue damage during surgical interventions, reduce microbial contamination and the number of wound postoperative complications. Intraoperative instrumental methods allow less pronounced trauma to the wound during its processing and suturing. The postoperative method for diagnosing wound complications is an ultrasound method, which determines various formations in a postoperative wound.

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