Meconium-Stained Amniotic Fluid is Associated With an Increased Risk of Post-Cesarean Surgical Site Infection [2OP]

Two main procedures are performed on patients suffering from colonic perforation, diverting colostomy and primary tissue repair. We investigated patient race, ethnicity, and socioeconomic status (SES) that predicted surgical outcomes after blunt or penetrating trauma. A retrospective analysis was performed using data from the National Trauma Data Bank for three years (2013–2015). We identified patients who presented with primary colonic injury and subsequent colon operation (n = 5431). Operations were grouped into three classes: colostomy, ileostomy, and nonostomy. Multiple linear and logistic regressions were performed to assess how race and insurance status are associated with the primary outcome of interest (ostomy formation) and secondary outcomes such as length of stay, time spent in ICU, and surgical site infection. Neither race/ethnicity nor insurance status proved to be reliable predictors for the formation of an ostomy. Patients who received either a colostomy or ileostomy were likely to have longer stays (OR [odds ratio]: 5.28; 95% CI [confidence interval]: 3.88–6.69) (OR: 11.24; 95% CI: 8.53–13.95), more time spent in ICU (2.73; 1.70–3.76) (7.98; 6.10–9.87), and increased risk for surgical site infection (1.32; 1.03–1.68) (2.54; 1.71–3.78). Race/ethnicity and SES were not reliable predictors for surgical decision-making on the formation of an ostomy after blunt and penetrating colonic injury. However, the severity of the injury as calculated by Injury Severity Score and the number of abdominal injuries were both associated with higher rates of colostomy and ileostomy. These data suggest that surgical decision-making is dependent on perioperative patient presentation and, not on race, ethnicity, or SES.

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Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

Infection Control and Hospital Epidemiology ◽

10.1086/590124 ◽

2008 ◽

Vol 29 (9) ◽

pp. 832-839 ◽

Cited By ~ 36

Author(s):

Deverick J. Anderson ◽

Luke F. Chen ◽

Kenneth E. Schmader ◽

Daniel J. Sexton ◽

Yong Choi ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Surgical Site Infection ◽

Functional Status ◽

Surgical Patients ◽

Control Group ◽

Site Infection ◽

Methicillin Resistant ◽

Increased Risk ◽

Duration Of Surgery ◽

Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

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Surgical Site Infection in a Tertiary Neonatal Surgery Centre

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1636916 ◽

2018 ◽

Vol 29 (03) ◽

pp. 260-265 ◽

Cited By ~ 6

Author(s):

Adiam Woldemicael ◽

Sarah Bradley ◽

Caroline Pardy ◽

Justin Richards ◽

Paolo Trerotoli ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Model ◽

Surgical Site Infection ◽

Hospital Stay ◽

Logistic Regression Model ◽

Length Of Hospital Stay ◽

Neonatal Surgery ◽

Site Infection ◽

Increased Risk

Introduction Surgical site infection (SSI) is a key performance indicator to assess the quality of surgical care. Incidence and risk factors for SSI in neonatal surgery are lacking in the literature. Aim To define the incidence of SSI and possible risk factors in a tertiary neonatal surgery centre. Materials and Methods This is a prospective cohort study of all the neonates who underwent abdominal and thoracic surgery between March 2012 and October 2016. The variables analyzed were gender, gestational age, birth weight, age at surgery, preoperative stay in neonatal intensive care unit, type of surgery, length of stay, and microorganisms isolated from the wounds. Statistical analysis was done with chi-square, Student's t- or Mann–Whitney U-tests. A logistic regression model was used to evaluate determinants of risk for SSI; variables were analyzed both with univariate and multivariate models. For the length of hospital stay, a logistic regression model was performed with independent variables. Results A total of 244 neonates underwent 319 surgical procedures. The overall incidence of SSIs was 43/319 (13.5%). The only statistical differences between neonates with and without SSI were preoperative stay (<4 days vs. ≥4 days, p < 0.01) and length of hospital stay (<30 days vs. ≥30 days, p < 0.01). A pre-operative stay longer than 4 days was associated with almost three times increased risk of SSI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.05–8.34, p = 0.0407). Gastrointestinal procedures were associated with more than ten times the risk of SSI compared with other procedures (OR 10.17, 95% CI 3.82–27.10, p < 0.0001). Gastroschisis closure and necrotizing enterocolitis (NEC) laparotomies had the highest incidence SSI (54% and 62%, respectively). The risk of longer length of hospital stay after SSI was more than three times higher (OR = 3.36, 95%CI 1.63–6.94, p = 0.001). Conclusion This is the first article benchmarking the incidence of SSI in neonatal surgery in the United Kingdom. A preoperative stay ≥4 days and gastrointestinal procedures were independent risk factors for SSI. More research is needed to develop strategies to reduce SSI in selected neonatal procedures.

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A forgotten risk factor for surgical site infection: Hypocholesterolemia

International Surgery Journal ◽

10.18203/2349-2902.isj20182758 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2482

Author(s):

Manjunath B. D. ◽

Harindranath H. R. ◽

Abdul Razak ◽

Mohammed Arafath Ali

Keyword(s):

Surgical Site Infection ◽

Minor Role ◽

P Value ◽

Site Infection ◽

Hernia Surgery ◽

Medical College ◽

Increased Risk ◽

Subcutaneous Tissues ◽

A Minor ◽

A Prospective Study

Background: Postoperative infection is one of the most common complications after any surgery. In the present study, surgical site infection (SSI) is described as; superficial (i.e., skin and subcutaneous tissues) and deep (i.e., fascia and muscles) infections occurring in the short term (i.e., 1-month) after surgery. The objective of this study was to detect various risk factors for SSI development.Methods: In this study, we prospectively enrolled 217 patients undergoing spinal surgery over an 8 months period. In a prospective study from January 2017 to August 2017, 217 patients who were admitted and operated for elective hernia surgery in hospitals attached to Bangalore Medical College and Research Institute, patients with immunodeficiency disorders and obstructed hernias were excluded.Results: Of 217 patients 35 (16.12%) patients developed SSI, multi-variant data analysis indicated that multiple factors correlated with an increased risk of SSI of which one of the important factor was hypocholesterolemia with 32.8% people developing SSI with p-value <0.01 along with Hypoalbuminemia and diabetes. Whereas other factors shuch as age had a minor role in increasing the incidence of SSI other factors such as smoking, alcoholism, gender, hypertension was found not to have much significant contribution in the development of SSI in the present study.Conclusions: Hypocholesterolemia is one on the forgotten factors which is usually brushed aside whose consideration can lead to significant decrease in this preventable complication especially in a malnourished population presenting in a government setup.

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EMERGENCY LAPAROTOMY;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.06.1215 ◽

2017 ◽

Vol 24 (06) ◽

pp. 808-811

Author(s):

Ch. Muhammad Atif Niaz ◽

Awais Talib ◽

Yasir Sultan ◽

Asim Shahzad Niazi

Keyword(s):

Surgical Site Infection ◽

Tertiary Care ◽

Primary Data ◽

Emergency Laparotomy ◽

Care Hospital ◽

Site Infection ◽

Increased Risk ◽

Deep Surgical Site Infection ◽

Male Patients ◽

Hospital Study

Objectives: Emergency laparotomy followed by placement of drain is acommon procedure in tertiary care hospitals but there are contradictory evidences regardingits association with deep surgical site infection. Thus current study was planned with anobjective to compare the frequency of deep surgical site infection among patients with andwithout postoperative drains after undergoing an emergency laparotomy at a tertiary carehospital. Data source: Primary data based on patients undergoing emergency laparotomy attertiary care hospital. Study design: Randomized control trial. Setting: Department of surgicalunit-III, Jinnah Hospital Lahore. Duration of study: Study was conducted from January 2016to December 2016. Subjects & methods: About 400 patients of 15-70 years undergoingemergency laparotomy were selected using non-probability consecutive sampling techniqueafter informed consent. Information regarding their demographic characteristics and studyvariable was recorded in a structured proforma. All the subjects were randomized into twogroups i.e. with and without post-operative drains using table of random number. Frequencyof deep surgical site infection was assessed on 7th post operative day and data was analyzedusing SPSS version 21.0. Result: The mean age of patients was 38.92 ± 6.246 years withabout 229(57.2%) male patients. The frequency of development of deep surgical site infectionin first postoperative week was 51(12.7%) overall, with 24(12%) patients in the group of postoperativedrains and 27(13.5%) patients without post-operative drains. The differences betweentwo groups were statistically insignificant. Moreover, it was not significantly related to the age,gender, duration of stay in the hospital and smoking. Conclusion: It can be concluded from thestudy that there is no significantly increased risk of deep surgical site wound infection with orwithout placement of drain. So it is reasonable and safe approach to place a drain in the woundfor the early detection of bleeding or leakage to decrease the morbidity and complication in thepatients.

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