scholarly journals Wound infections after surgery in a modern operating suite: clinical, bacteriological and epidemiological findings

1979 ◽  
Vol 83 (1) ◽  
pp. 41-58 ◽  
Author(s):  
Stellan Bengtsson ◽  
Anna Hambraeus ◽  
Gunnar Laurell
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Wound Infection Rate ◽  
Wound Infections ◽  
Staph Aureus ◽  
Air Contamination ◽  
Operating Theatres ◽  
A Prospective Study ◽  
Operating Suite ◽  
Operative Wound

SUMMARYA prospective study of 2983 operations in general and orthopaedic surgery during 3 years performed in four operating theatres in a modern operating suite was carried out in order to evaluate the importance of airborne infection. Weekly nose-and-throat samples were taken from the surgical staff and pre-operative samples were taken from the nose, throat, skin and perineum of the patients. The air contamination was followed by using settle plates, which showed low mean counts of total bacteria of between 9 and 15 c.f.u./m2/min, with mean counts of Staph. aureus of between 0.03 and 0.06 c.f.u./m2/min. No correlation was found between the total number of bacteria and the incidence of post-operative infections or between the amount of Staph. aureus in the air and post-operative Staph. aureus infections. It was concluded that further increases in ventilation could, at best, only marginally affect the incidence of post-operative infection.The post-operative wound-infection rate was 9.0%. In various types of surgery, the infection rates varied from 5.3% in clean operations to 47.6% in dirty surgery. About one third of the infections were classified as moderate or severe.Adverse patient factors, such as immunodeficiency, steroid treatment, intensive care, etc., increased the rate to 15.0%; in ‘normal’ patients it was 3.8%.Among the bacteria isolated, gram-negative bacilli (31% of wounds), often together with other bacteria, and Staph. aureus (28%) predominated, but in 25% no specimens were taken.Of 76 post-operative Staph. aureus infections, 32 were caused by the patients' own strains, and of the remaining 44 infections, 22, or 8% of all infections, could be traced to strains present in the air and/or the respiratory tracts of staff during the operation.The length of pre-operative hospital stay had no influence on the carrier rate of Staph. aureus in patients. The incidence of post-operative wound infection was significantly higher in patients carrying Staph. aureus and was even higher if these bacteria were found on the skin.Patients with wound infections stayed, on an average, 15 days longer than patients without infections. In serious infections the increase in duration of stay was > 20 days. Although infections were commoner in older patients, the average additional hospital stay of infected patients did not increase with age. If the post-operative infections studied in a concurrent retrospective study are taken into account more than 12 000 bed-days were due to post-surgical wound infections in the period studied or, in other words, some 12 beds (corresponding to 5.5% of the total) were always occupied by infected patients.

scholarly journals Simultaneous surgery for primary and nodes in carcinoma penis: a rural tertiary medical centre experience and results

2017 ◽  
Vol 4 (10) ◽  
pp. 3466
Author(s):  
Senthil Kumar A. C. ◽  
Rajesh S.
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Retrospective Analysis ◽  
Wound Infection Rate ◽  
Medical Centre ◽  
Previous Therapy ◽  
Simultaneous Surgery ◽  
Simultaneous Procedure ◽  
The Mean ◽  
Carcinoma Penis

Background: Historically surgery for nodes in carcinoma penis was done as staged procedure due to fear of higher morbidity and longer hospital stay. However, in view of the established safety of the simultaneous procedure, very few centres do simultaneous surgery for nodes and primary in cancer penis.Methods: A retrospective analysis of all the simultaneous surgeries for nodes and primary for carcinoma penis done at our hospital, during the period April 2015 to March 2017 were done and various parameters were calculated and compared with historical standards of various series.Results: The various parameters namely wound morbidity, hospital stay and complications were analysed and compared with historical standards. A total of 15 patients during the above mentioned were found to be suitable for the analysis after having excluded patients who had previous therapy and inoperable tumours. The mean follows up period was 12 months (ranging from 8 to 20 months). The mean hospital stay was 15 days (range from 12 days to 25 days). The skin margin necrosis rate was 6.67%, wound infection rate was 6.67% and there were no perioperative deaths. The same was compared with historical standards.Conclusions: Simultaneous surgery for primary and nodes in carcinoma penis is safe and the standard results are reproducible in a rural tertiary medical centre like ours.

scholarly journals Distribution and Determinant of Post-Operative Wound Infection among Patients underwent Routine Abdominal Surgery

2019 ◽  
Vol 6 (1) ◽  
pp. 16-21
Author(s):  
Md Mafiur Rahman ◽  
SM Shafiul Azam Chaudhury ◽  
Md Atiqul Islam ◽  
Mohammad Khurshidul Alam ◽  
ABM Mir Mubinul Islam ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Wound Infection ◽  
Infection Rate ◽  
Wound Infection Rate ◽  
Operation Theatre ◽  
Medical College ◽  
Abdominal Operations ◽  
Contaminated Wound ◽  
Clean Contaminated ◽  
Operative Wound

Background: Post-operative wound infection may occur after routine abdominal surgery. Objective: The purpose of the present study was to see the distribution and determinants of post-operative wound infection among the patients underwent routine abdominal surgery. Methodology: This non-randomized clinical trial was conducted in the different surgical units of the Department of Surgery at Sir Sallimullah Medical College & Mitford Hospital, Dhaka, Bangladesh during January 2001 to December 2002 for a period of two (02) years. In the operation theatre, after anaesthesia skin was cleaned with Povidone iodine USP 5% w/w or Spirit (70% methylated spirit in water) or Chlorhexidine. During post-operative period dressing were left undisturbed unless it was felt necessary. Unusual pain in and around the wound was considered to be an indication of infection. A swab was taken from any discharge and was sent for bacteriological examination. Result: In this study, 50 patients were admitted as routine cases and undergone routine abdominal operations in general operation theatre. Out of 50 patients undergone routine abdominal surgery, 5 developed wound infection post operatively. Overall infection rate was 10.0%. In routine abdominal operations, infection was 9.09% in upper midline or extended midline incision, 33.33% in lower midline, 6.25% right subcostal/Kocher's. In routine abdominal operations, the rate of infection in clean contaminated wound was 11.11%, contaminated wound was 33.33%. Wound infection rate was 20.0% cases in patients with malnutrition, 14.28% cases in obesity and 16.66% cases in diabetes mellitus. Conclusion: In conclusion post-operative wound infection is common in routine surgical operation. Bangladesh Journal of Infectious Diseases, June 2019;6(1):16-21

scholarly journals Plastic wound protectors in laparoscopic colorectal surgery

2019 ◽  
Vol 6 (5) ◽  
pp. 1824
Author(s):  
Ayodeji Odofin
Keyword(s):  
Colorectal Surgery ◽  
Wound Infection ◽  
Literature Search ◽  
Critical Appraisal ◽  
Laparoscopic Colorectal Surgery ◽  
Port Site ◽  
Systematic Literature Search ◽  
Wound Infections ◽  
Port Site Metastasis ◽  
Operative Wound

Plastic wound protectors are used in colorectal surgery to reduce incidence of post-operative wound infection and port site metastasis. The aim of this study is to determine if this practice has research currency based on the available literature. A systematic literature search enabled critical appraisal of retrieved studies. Six studies focusing on the topic of interest were retrieved and rigorously analysed. Analysis of these studies revealed adequate support for this practice especially in reducing incidence of post-operative wound infections. Plastic wound protectors serve as a useful tool in preventing post-operative wound infections, but there is paucity of evidence to support its role in preventing port site metastasis. 

scholarly journals Comparative Study between Topical Heparin and Nebulised Heparin in the Management of Thermal Burn Patients in a Tertiary Care Hospital, Tirupati

2021 ◽  
Vol 8 (21) ◽  
pp. 1685-1690
Author(s):  
Srikanth Reddy Challapalli ◽  
Venkata Prakash Gandikota ◽  
Archana Chilakala ◽  
Yaswanth Kumar Gaddam
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Infection Rate ◽  
Pain Medication ◽  
Wound Infection Rate ◽  
Care Hospital ◽  
Burn Patients ◽  
Thermal Burn ◽  
Secondary Procedures ◽  
Topical Heparin

BACKGROUND Burn treatment is complex and involves many components. Topical solutions that contain antiseptic, antibiotic, and growth factor properties are effectively used in superficial burns. Heparin satisfies all the parameters. Routes of heparin administration described are subcutaneous, topical, intravenous, and inhalation. In this study, the need was felt to evaluate the efficacy of various heparin routes such as topical against nebulised heparin. METHODS 100 consecutive thermal burn patients were studied prospectively under two groups i.e., topical heparin (T group) and nebulised heparin (N group). Hospital stay, final scar outcome, wound infection rate, secondary procedures, pain medication, dressings and antibiotics required were compared. RESULTS It was found that the T patients complained of less pain and received less pain medication, fewer dressings and antibiotics compared to N group. Significantly less IV fluids were infused to T group 36 vs 64 litres compared to N group (P < 0.01). T group had fewer secondary procedures 6 vs 14 compared to N group. The number of days in hospital for T was significantly less (over all P < 0.0001). 14 patients (28 %) in the topical group were discharged from the hospital in 10 days or less compared with 8 patients (16 %) in the nebulised group (P < 0.001, S). 38 out of the 50 H patients (76 %) were discharged in less than 3 weeks compared with 22 nebulised group patients (32 %) (P < 0.001, S). CONCLUSIONS Usage of Heparin is safe, needs no monitoring by bleeding time (BT), clotting time (CT), or partial thromboplastin time (PTT). The final scar outcome with parameters such as scar itchiness, texture, the wound infection rate, secondary procedures like a skin graft, post-burn contractures release were fewer in burn patients treated with topical heparin. KEYWORDS Topical Heparin, Nebulised Heparin, Hospital Stay, Scar Outcome, Secondary Procedures, Pain

Caesarean section wound infections and antibiotic use: a retrospective case-series in a tertiary referral hospital in The Gambia

2017 ◽  
Vol 48 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Alex Aulakh ◽  
Patrick Idoko ◽  
Suzanne T Anderson ◽  
Wendy Graham
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Infection Rate ◽  
Wound Infection Rate ◽  
The Gambia ◽  
Referral Hospital ◽  
Wound Infections ◽  
Preoperative Antibiotic Prophylaxis

Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics. The wound infection rate found is likely to be an underestimate owing to loss to follow-up. The adherence to international guidelines regarding preoperative antibiotic prophylaxis needs to be improved.

scholarly journals Wound Infections from Taiwan Cobra (Naja atra) Bites: Determining Bacteriology, Antibiotic Susceptibility, and the Use of Antibiotics-A Cobra BITE Study

Toxins ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 183
Author(s):  
Heng Yeh ◽  
Shi-Ying Gao ◽  
Chih-Chuan Lin
Keyword(s):  
Wound Infection ◽  
Secondary Infection ◽  
Characteristic Curve ◽  
Wound Infection Rate ◽  
Emergency Department Visits ◽  
Wound Infections ◽  
Neutrophil Lymphocyte Ratio ◽  
Freeze Dried ◽  
Clinical Tools ◽  
Naja Atra

(1) Background: Wound necrosis and secondary infection are common complications after Naja atra bites. Clinical tools to evaluate the infection risk after Taiwan cobra bites are lacking. (2) Methods: Patients who had undergone treatment with freeze-dried neurotoxic antivenin within the Chang Gung Memorial Hospital’s emergency departments spanning January 2001 through May 2017 were enrolled. Patients with wound infection lacking tissue necrosis were included in developing our Cobra BITE score utilizing univariate and multiple logistic regression, as patients with wound necrosis require antibiotics for infection treatment. Wound infection bacteriology was investigated, too. (3) Results: 8,295,497 emergency department visits occurred in the span of this study, with 195 of those patients being diagnosed as having cobra bites. Of these patients, 23 had wound necrosis, and 30 had wound infection, resulting in a wound infection rate of 27.2% (53/195). Enterococcus faecalis and Morganella morganii were the main bacteria identified in the culture report regardless of whether patients’ wounds had necrosis. As per our Cobra BITE score, the three factors predicting secondary wound infection after cobra bites are hospital admission, a white blood cell count (in 103/µL) × by neutrophil-lymphocyte ratio value of ≥114.23, and the use of antivenin medication. The area under the receiver operating characteristic curve for the Cobra BITE score system was 0.88; ideal sensitivity and specificity were 0.89 and 0.76. (4) Conclusion: This scoring system enables the assessment of wound infections after N. atra bites, and it could be modified and improved in the future for other Naja spp. bites.

Effect of deep wound infection following lumbar arthrodesis for degenerative disc disease on long-term outcome: a prospective study

2011 ◽  
Vol 15 (4) ◽  
pp. 399-403 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Orlando Righesso ◽  
Vincent C. Traynelis ◽  
Alisson Roberto Teles ◽  
Pedro Guarise da Silva
Keyword(s):  
Prospective Study ◽  
Wound Infection ◽  
Degenerative Disc Disease ◽  
Wound Infections ◽  
Disc Disease ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Lumbar Arthrodesis ◽  
A Prospective Study

Object Deep wound infections are one of the most common and serious complications of spinal surgery. The impact of such infections on long-term outcomes is not well understood. The purpose of this study was to evaluate the functional status and satisfaction in patients who suffered a deep wound infection after undergoing lumbar arthrodesis for symptomatic degenerative disc disease. Methods The authors conducted a prospective study in 13 patients with a clinical and radiological diagnosis of symptomatic degenerative lumbar stenosis and instability; after undergoing decompression and instrumentation-augmented arthrodesis, the patients suffered a deep wound infection (infection group). A 3:1 (39-patient) matched cohort was selected for comparison (control group). All surgeries were performed during the same period and by a single surgeon. The postoperative infections were all treated in a similar manner and the instrumentation was not removed. Both groups were followed up and assessed with validated outcome instruments: Numerical Rating Scale of pain, Oswestry Disability Index, 36-Item Short Form Health Survey, Beck Depression Inventory, and Hospital Anxiety and Depression Scale. Patient satisfaction was also determined. Results The median follow-up duration was 22 months (range 6–108 months). The mean patient age was 62 ± 10 years, and 59.6% of the patients were female. There was no significant difference between the groups in pain, functional disability, quality of life, or depression and anxiety. However, 53.8% of the patients with infection were not satisfied with the procedure at the final evaluation, compared with 15.4% of the patients without a deep wound infection (p = 0.003). Conclusions Patients with successfully treated postoperative deep wound infections do not have a difference in functional outcome compared with patients who underwent an identical operation but did not suffer a complicating infection. Patients who suffered an infection were more likely to be unsatisfied with the procedure than patients who did not.

Acellular Dermal Allograft for Ventral Hernia Repair in the Compromised Surgical Field

2006 ◽  
Vol 72 (12) ◽  
pp. 1181-1188 ◽  
Author(s):  
Jose J. Diaz ◽  
Jeffrey Guy ◽  
Marshall B. Berkes ◽  
Oscar Guillamondegui ◽  
Richard S. Miller
Keyword(s):  
Hernia Repair ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Average Length ◽  
Wound Infection Rate ◽  
Multiple Organ ◽  
Wound Infections ◽  
Surgical Field ◽  
Clean Contaminated

A ventral hernia and a contaminated surgical field are a difficult surgical combination. We hypothesize that acellular human dermis (AHD) can be a suitable biological tissue alternative in the repair of a ventral hernia. The study involved a retrospective review of the use of AHD in the repair of ventral hernia from 2001–2004. Inclusion criteria included a ventral hernia repair in a clean-contaminated (CC) or contaminated-dirty (CD) surgical field. The primary outcome of the study was wound infection and mesh removal. Patients were stratified into CC and CD, and management of a wound infection [medically managed (MM) or surgically managed (SM)]. Seventy-five patients met the study criteria. The most common comorbidity was hypertension (45.3%). There was one death in the study (from multiple organ dysfunction syndrome). The overall wound infection rate was 33.3 per cent: 11 MM (14.7%) and 14 SM (18.7%). The average length of stay was 16.7 days (±20.8) with a mean follow-up of 275 (±209) days. Subgroup analysis: CC (n = 64) had 9 wound infections that were MM (14.1%) and 12 wound infections that were SM (18.8%); CD (n = 11) had 2 wound infections that were MM (18.2%) and 2 wound infections that were SM (18.2%). Five of 14 SM (35.7%) wound infections required removal of the mesh. Wound infection in the contaminated surgical field occurred 33.3 per cent of the time. Some (18.7%) of the cases required SM management, and 35.7 per cent of these required removal of the AHD.

scholarly journals Bacterial contamination in a modern operating suite, 2. Effect of a zoning system on contamination of floors and other surfaces

1978 ◽  
Vol 80 (1) ◽  
pp. 57-67 ◽  
Author(s):  
A. Hambraeus ◽  
S. Bengtsson ◽  
G. Laurell
Keyword(s):  
Staphylococcus Aureus ◽  
Bacterial Contamination ◽  
Central Area ◽  
Tween 80 ◽  
Egg Yolk ◽  
Operating Theatre ◽  
Staph Aureus ◽  
Colony Forming Units ◽  
Operating Theatres ◽  
Operating Suite

SUMMARYIn this investigation the bacterial contamination of surfaces such as walls and floors in a modern operating suite, together with surfaces of lamps in the operating theatres, and the clogs worn by staff, was studied. Counts of colony-forming units were made on impression plates containing blood-agar with Tween 80 for total bacterial counts, Baird Parker medium with egg yolk and tellurite for Staphylococcus aureus and trypticase peptone agar with neomycin and polymyxin for Clostridium spp.The areas examined were divided into the patients' route to the operating theatre, the staff's route, and the central area containing the operating rooms, anaesthetic rooms, and exit and scrub-up areas. In the patients' route counts of total organisms ranged from about 10 000 to 30 000/m2 for Staph. aureus the range was from 70 to 540/m2. In the staff's route the highest count was about 70000/m2 in the dressing area, and the numbers of Staph. aureus were about the same as along the patients' route. In the inner zone the counts were somewhat lower for both total organisms and Staph. aureus. Total counts on the floor from all areas of the inner zone were significantly higher just before the second operation than before the first operation on the same day. The total and Staph. aureus counts on walls, floors and lamps were the same after clean operations as after operations classified as ‘contaminated’ or ‘dirty’.

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