Actionable Risk Model for the Development of Surgical Site Infection after Emergency Surgery

Surgical site infection (SSI) is the second most normal irresistible inconvenience after urinary tract disease following cesarean section (CS). Surgical site infection after a cesarean area is related with expanded maternal horribleness, delayed emergency clinic remain and expanded clinical expenses. The hazard for creating SSI has noteworthily diminished over the three decades, fundamentally inferable from progress in cleanliness condition anti-infection prophylaxis, sterile methodology and other practice. Despite this decrease, the occurrence of surgical site infection is expected in the continuous rise in the incidence of cesarean delivery. A quantitative approach with descriptive study design was chosen to assess the risk factor of surgical site infection among mothers who underwent cesarean section at Saveetha Medical College Hospital. Sixty mothers who fulfil inclusive criteria were selected by purposive sampling technique. Sociodemographic variables were collected by semi-structured questionnaire, and the risk factors were assessed by surgical site assessment scale. The result of the study shows that 22(36.6%) of the mothers were obese, 34 (56.6%) were anaemia, 22 (36.6%) had hypertension, 7 (11.6%) had diabetes mellitus,37 (61.6%) were prolonged hospitalized, 9(15%) of study subject had previous surgery and 18 (30%) of study subject had emergency surgery. The surgical site assessment scale reveals that 31(51.6%) comes under the no-risk category,29(48.3 %) comes under the risk among preoperative mothers, and 22(36.6%) comes under no risk, 38 (63.3 %) comes under risk among post-operative mothers who underwent cesarean section. Thus the factors such as anaemia, hypertension, diabetes mellitus, prolonged hospital stay, previous surgery, and emergency surgery increase the risk for surgical site infection among mothers who underwent cesarean section.

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PREVALENCE OF SURGICAL SITE INFECTION ASSOCIATED RISK FACTORS IN A TERTIARY CARE HOSPITAL OF VEDANTA INSTITUTE OF MEDICAL SCIENCES

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i10.695 ◽

2019 ◽

Vol 3 (10) ◽

Author(s):

Dr. Amit Ramesh Churi

Keyword(s):

Surgical Site Infection ◽

Emergency Surgery ◽

Elective Surgery ◽

Prophylactic Antibiotics ◽

Surgical Patients ◽

Care Hospital ◽

Site Infection ◽

Deep Incision ◽

Surgery Group ◽

Wide Range

Introduction: Skin is generally colonised by a wide range of microorganisms that could cause infection. Surgical site infection (SSI) requires evidence of clinical signs and symptoms of infection rather than microbiological evidence alone. SSIs generally affect the superficial tissues, but some more serious infections affect the deeper tissues or other parts of the body manipulated during the surgical procedure.About 5% of patients posted for surgery develop surgical site infections (SSIs), which may cause much morbidity and may sometimes mortality. Treatment of SSIs imposes a substantial financial burden on the health care system. Patients who develop SSI are more likely to spend 60% more time in an Intensive care unit (ICU), they are 5 times as likely to be readmitted and their mortality rate is twice of non-infected patient. But to great surprise 40-60% of these infections are preventable. Material and Methods: A total of 500 patients who had undergone surgical procedure at the teaching hospitalwere studied prospectively. A total of 464(92.8%) elective surgical patients and 36(7.2%) emergency surgical patients were included in the study.Patient information gathered from the data chart, treatment chart and from ward rounds in the hospital. All patients were followed up from the time of admission until the time of discharge and 30 days postoperatively to inspect the incidence of SSI. Wound infection was diagnosed. SSI diagnosed was divided into three categories: Superficial incision SSI, Deep incision SSI and Organ/space SSI. SSI is considered if an infection occurred within 30 days after the operation, if no implant is left in place SSI was considered. Results: In the present study 500 patients were included of which 464(92.8%) were elective surgical patients and 36(7.2%) were emergency surgical patients. Total SSI cases were 41 (8.2%) of which 29 (70.7%) were identified in elective surgery cases and 12 (29.3%) were observed in emergency surgery superficial incision SSI was most prevalent 25 (61%) followed by deep incisional SSI 11(26.8%) and then by organ/space SSI 5(12.2%).Mean age in elective surgery group was 52.4±7.48 and in emergency surgery group was 56.2± 6.78. In elective surgery group there were 296 (63.8%) male and 168 (36.2%) female. In emergency group there were 29 (80.6%) male and 7 (19.4%) female. Prophylactic antibiotics were given to 404 (87.1%) in elective surgery group and 30 (83.3%) in emergency surgery group. SSI rate observed in elective surgery group was 29/464 (6.25%) while in emergency surgery group was 12/36 (33.33%).BMI (Body mass index) in elective surgery group was 28.7 ±2.45and in emergency surgery group was 27.6 ± 2.89. Conclusion: higher incidence of SSI with increasing age of the patient.it was observed that to prevent SSI prophylactic antibiotics should be initiated within one hour before surgical incision. Keywords: SSI, Surgery, Superficial incision SSI, Deep incision SSI, Organ/space SSI

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A Clinical Risk Model for Surgical Site Infection Following Pediatric Spine Deformity Surgery

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.21.00751 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Hiroko Matsumoto ◽

Elaine L. Larson ◽

Shay I. Warren ◽

Bradley T. Hammoor ◽

Lisa Bonsignore-Opp ◽

...

Keyword(s):

Surgical Site Infection ◽

Risk Model ◽

Spine Deformity ◽

Site Infection ◽

Pediatric Spine ◽

Clinical Risk

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Risk Factors for Methicillin-ResistantStaphylococcus aureusSurgical Site Infection

Infection Control and Hospital Epidemiology ◽

10.1086/590193 ◽

2008 ◽

Vol 29 (9) ◽

pp. 890-893 ◽

Cited By ~ 33

Author(s):

Stephan Harbarth ◽

Benedikt Huttner ◽

Pascal Gervaz ◽

Carolina Fankhauser ◽

Marie-Noelle Chraiti ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Surgical Site Infection ◽

Immunosuppressive Therapy ◽

Emergency Surgery ◽

Intervention Study ◽

Comorbid Condition ◽

Site Infection ◽

Factors Associated ◽

Surgical Duration

We prospectively evaluated 46 possible risk factors for methicillin-resistantStaphylococcus aureus(MRSA) surgical site infection (SSI) among patients with MRSA carriage in a large intervention study. Of 6,130 study patients, 68 (1.1%) developed MRSA SSI, which occurred a median of 14 days after surgery. Risk factors associated with MRSA SSI were receipt of emergency surgery, presence of comorbid condition, receipt of immunosuppressive therapy, receipt of contaminated surgery, and a surgical duration longer than the 75th percentile. MRSA carriage on admission did not predict MRSA SSI.

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The Safety and Efficiency of Surgery with Colonic Stents in Left-Sided Malignant Colonic Obstruction: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2014/407325 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 10

Author(s):

Xiang Zhao ◽

Bo Liu ◽

Ende Zhao ◽

Jiliang Wang ◽

Ming Cai ◽

...

Keyword(s):

Surgical Site Infection ◽

Emergency Surgery ◽

Primary Anastomosis ◽

Meta Analysis ◽

Colonic Obstruction ◽

Bridge To Surgery ◽

Site Infection ◽

Colonic Stenting ◽

Malignant Colonic Obstruction ◽

Colonic Stents

Objective.This meta-analysis is aimed at assessing the safety and efficiency of colonic self-expanding metallic stents (SEMS) used as a bridge to surgery in the management of left-sided malignant colonic obstruction (LMCO).Methods.A systematic search was conducted in PubMed, Web of Knowledge, OVID, Google Scholar, CNKI, and WANGFANG for relevant randomized trials comparing colonic stenting used as a bridge in semielective surgery versus emergency surgery from January 2001 to September 2013.Result.Five published studies were included in this systematic review, including 273 patients (140 male/133 female). 136 patients received semielective surgery after SEMS installation while 137 patients underwent emergency surgery without SEMS. SEMS intervention resulted in significantly lower overall colostomy rate (41.9% versus 56.2%,P=0.02), surgical site infection rate (10.2% versus 19.7%,P=0.03), and overall complication rate (29.2% versus 60.5%,P=0.05). There was no statistic difference for the rate of primary anastomosis, anastomotic leak and operation-related mortality between two groups.Conclusions.semielective surgery with SEMS as a bridge for proper patients of LMCO can lower the overall rate for colostomy, surgical site infection, and complications.

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