Surgical site infection after trans urethral resection of the prostate (TURP): 2008–2013 French national SSI surveillance ISO-RAISIN

Objective: To describe surgical site infection (SSI) after transurethral resection of prostate (TURP) from the French national database. Methods: A national SSI surveillance system was implemented in 1999. Each year, the network included urology departments that included at least two months plus one month follow-up, or at least 100 consecutive targeted surgical procedures. A dataset of patients who underwent urology procedures during the six-year period 2008–2013 was made available. SSI diagnosis was made according to standardised CDC criteria. Descriptive analyses were performed using SAS software version 9.4. Results: A total of 12,897 TURPs were performed by 89 urology departments. The crude incidence SSI rate was 2.43 (95% confidence interval = 2.16–2.79). The mean delay for diagnosis was 11.9 ± 8.9 days. The treatment of the SSI required a new surgical intervention in 1.35%. In the multilevel multivariate analysis, ASA score and duration of follow-up were the only parameters correlated with the SSI rate. Conclusions: On more than 12,000 TURPs surveyed, the SSI rate was 2.43. ASA score and duration of follow-up were the only parameters correlated with the SSI rate.

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The vacuum-assisted closure (V.A.C®) system for surgical site infection with involved vascular grafts

Vascular ◽

10.1177/1708538114537488 ◽

2014 ◽

Vol 23 (2) ◽

pp. 144-150 ◽

Cited By ~ 8

Author(s):

Karaca Saziye ◽

Kalangos Afksendiyos

Keyword(s):

Surgical Site Infection ◽

Lower Limb ◽

Vascular Grafts ◽

Site Infection ◽

Secondary Intention ◽

Delayed Primary Closure ◽

The Mean ◽

Reoperation Rates ◽

Mean Time

Background In vascular surgery, surgical site infection is the most common postoperative morbidity, occurring in 5–10% of vascular patients. The optimal management of surgical site infection with involved lower limb vascular grafts remains controversial. We present our 6-year results of using the V.A.C.® system in surgical site infection with involved vascular grafts. Methods A retrospective 6-year review of patient who underwent a VAC® therapy for postoperative surgical site infection in lower limb with involved vascular grafts in our department between January 2006 and December 2011. V.A.C therapy was used in 40 patients. All patients underwent surgical wound revision with VAC® therapy and antibiotics. Results The mean time of use of the V.A.C. system was 14.2 days. After mean of 12 days in 34 of 40 patients, in whom the use of VAC® therapy resulted in delayed primary closure or healing by secondary intention. The mean postoperative follow-up time was 61.67 months, during which 3 patients died. Conclusion We showed that the V.A.C.® system is valuable for managing specifically surgical site infection with involved vascular grafts. Using the V.A.C.® system, reoperation rates are reduced; 85% of patients avoided graft replacement.

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HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.5.6 ◽

2016 ◽

pp. 39-43

Author(s):

Dinh Binh Tran ◽

Dinh Tan Tran

Keyword(s):

Surgical Site Infection ◽

Surgical Intervention ◽

University Hospital ◽

Hospital Infections ◽

Site Infection ◽

Cross Sectional ◽

Surgical Interventions ◽

Hospital Acquired Infections ◽

Tract Infections ◽

Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

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Cerebrospinal Fluid Shunt-Associated Surgical Site Infection With Three- Versus Twelve-Month Follow-Up in Canadian Hospitals

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.679 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s157-s157

Author(s):

Kelly Baekyung Choi ◽

John Conly ◽

Blanda Chow ◽

Joanne Embree ◽

Bonita Lee ◽

...

Keyword(s):

Surgical Site Infection ◽

Age Distribution ◽

Patient Characteristics ◽

Csf Shunt ◽

Surveillance Program ◽

Site Infection ◽

Infection Surveillance ◽

Surgical Manipulation ◽

National Systems

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None

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Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

Global Spine Journal ◽

10.1177/2192568220978225 ◽

2020 ◽

pp. 219256822097822

Author(s):

Muyi Wang ◽

Liang Xu ◽

Bo Yang ◽

Changzhi Du ◽

Zezhang Zhu ◽

...

Keyword(s):

Surgical Site Infection ◽

Spinal Deformity ◽

Recurrent Infection ◽

Implant Removal ◽

Site Infection ◽

Initial Surgery ◽

Spinal Deformity Surgery ◽

Solid Fusion ◽

Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

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Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90208-w ◽

1993 ◽

Vol 18 (1) ◽

pp. 115-118 ◽

Cited By ~ 16

Author(s):

J. STEVENSON ◽

I. W. R. ANDERSON

Keyword(s):

Emergency Department ◽

Complete Resolution ◽

Wound Care ◽

Duration Of Treatment ◽

Mean Delay ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

The Mean ◽

Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

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Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04078-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Weiwei Li ◽

Zheng Liu ◽

Xiao Xiao ◽

Zhenchao Xu ◽

Zhicheng Sun ◽

...

Keyword(s):

Blood Loss ◽

Surgical Intervention ◽

Spinal Tuberculosis ◽

Thoracic Spinal ◽

Cobb’S Angle ◽

Perioperative Complication ◽

The Mean ◽

Early Surgical Intervention ◽

Thoracic Spinal Tuberculosis

Abstract Background To explore the therapeutic effect of early surgical intervention for active thoracic spinal tuberculosis (TB) patients with paraparesis and paraplegia. Methods Data on 118 active thoracic spinal TB patients with paraparesis and paraplegia who had undergone surgery at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade and NASCIS score of neurological status rating, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects of surgery. Results The mean operating time was 194.2 minutes, and the mean blood loss was 871.2 ml. The perioperative complication rate was 5.9 %. The mean preoperative VAS score was 5.3, which significantly decreased to 3.2 after the operation and continued decreasing to 1.1 at follow up (P<0.05). All cases achieved an increase of at least one ASIA grade after operation. The rate of full neurological recovery for paraplegia (ASIA grade A and B) was 18.0 % and was significantly lower than the rate (100 %) for paraparesis (ASIA grade C and D) (P<0.05). On the NASCIS scale, the difference in the neurological improvement rate between paraplegia (22.2 % ± 14.1 % in sensation and 52.2 % ± 25.8 % in movement) and paraparesis (26.7 % ± 7.5 % in sensation and 59.4 % ± 7.3 % in movement) was remarkable (P<0.05). Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, respectively, which showed a significant increase after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm/h and 2.6 ± 0.82 mg/L, respectively, at final follow up (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, which significantly decreased to 6.5º after operation (P<0.05) while kyphotic correction was not lost during follow up (P>0.05). The mean duration of bone graft fusion was 8.6 ± 1.3 months. Conclusions Early surgical intervention may be beneficial for active thoracic spinal TB patients with paraparesis and paraplegia, with surgical intervention being more beneficial for recovery from paraparesis than paraplegia.

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Surgical Site Infection as a Surrogate Marker of Physician Impairment

Infection Control and Hospital Epidemiology ◽

10.1086/647982 ◽

2009 ◽

Vol 30 (11) ◽

pp. 1120-1122 ◽

Cited By ~ 3

Author(s):

Robert J. Sherertz ◽

Tobi B. Karchmer

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Surgical Site Infection ◽

Surrogate Marker ◽

Surgical Site Infections ◽

Baseline Period ◽

Site Infection ◽

Hepatitis C Virus Infection ◽

Physician Impairment

Our report details an implant-associated outbreak of surgical site infections related to the adverse effects of treatment for hepatitis C virus infection administered to surgeon X. During the 12-month period of this outbreak, 14 (9.5%) of 148 of surgeon X's patients developed a surgical site infection, a rate of SSI that was 8-fold higher than the rate during the 14-month baseline period or the 14-month follow-up period (P = .001), and higher than the rate among peer surgeons (P = .02).

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Compare the Incidence of Surgical Site Infection after Appendectomy Wound Irrigation with Normal Saline and Imipenem Solutions

10.53350/pjmhs211582184 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2184-2186

Author(s):

Ahmad Shah ◽

Nazeer Ahmad Sasoli ◽

Farrukh Sami

Keyword(s):

Surgical Site Infection ◽

Wound Infection ◽

Saline Solution ◽

Abscess Formation ◽

Site Infection ◽

Wound Irrigation ◽

Group I ◽

Perforated Appendix ◽

The Mean ◽

Group Ii

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

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Perioperative Antibiotic Use in Sleep Surgery: Clinical Relevance

Otolaryngology ◽

10.1177/01945998211048745 ◽

2021 ◽

pp. 019459982110487

Author(s):

Mohamed Abdelwahab ◽

Sandro Marques ◽

Isolde Previdelli ◽

Robson Capasso

Keyword(s):

Surgical Site Infection ◽

Hospital Readmission ◽

Antibiotic Prescription ◽

Postoperative Bleeding ◽

Upper Airway ◽

National Database ◽

Complication Rates ◽

Site Infection ◽

Tertiary Referral Center ◽

Obstructive Sleep

Objective Upper airway surgery is a common therapeutic approach recommended for patients with obstructive sleep apnea (OSA) to decrease disease burden. We aimed to evaluate the effect of perioperative antibiotic prescription on complication rates. Study Design Retrospective cohort (national database). Setting Tertiary referral center. Methods This is a retrospective study of a large national health care insurance database (Truven MarketScan) from 2007 to 2015. Subjects diagnosed with OSA who had uvulopalatopharyngoplasty (UPPP) were included and stratified in single versus multilevel surgery. Other variables included smoking, age, sex, antibiotic prescription, and comorbidities based on the Elixhauser index. Evaluated outcomes were postoperative bleeding, intubation, pneumonia, superficial surgical site infection, tracheostomy, and hospital readmission. A multivariate regression model was created to assess each complication. Results A total of 5,798,528 subjects received a diagnosis of OSA, of which 39,916 were >18 years old and underwent UPPP, either alone or with additional procedures. The mean age was 43 years, and 73.4% were male. Antibiotic prescription was associated with less bleeding in UPPP alone, UPPP with nasal surgery, and UPPP with nasal and tongue surgery ( P < .001, P < .001, and P = .006, respectively). It was also associated with a lower prevalence of surgical site infection, pneumonia, tracheostomy, intubation, and hospital readmission ( P < .001). On a multivariate model, antibiotic prescription was significantly associated with a decreased rate of complications. Conclusions Although former studies recommended against the use of antibiotics after tonsillectomy, our results suggest that antibiotic prescription after UPPP for OSA was associated with less bleeding, surgical site infection, pneumonia, intubation, tracheostomy, and hospital readmission 30 days postoperatively.

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The incidence of complications in elective cranial neurosurgery associated with dural closure material

Journal of Neurosurgery ◽

10.3171/2013.8.jns13703 ◽

2014 ◽

Vol 120 (1) ◽

pp. 278-284 ◽

Cited By ~ 10

Author(s):

Brian P. Walcott ◽

Jonathan B. Neal ◽

Sameer A. Sheth ◽

Kristopher T. Kahle ◽

Emad N. Eskandar ◽

...

Keyword(s):

Surgical Site Infection ◽

Corticosteroid Treatment ◽

Csf Leak ◽

Site Infection ◽

Exclusion Criteria ◽

Dural Closure ◽

Estimated Blood Loss ◽

Dural Graft ◽

Synthetic Grafts

Object Dural closure with synthetic grafts has been suggested to contribute to the incidence of infection and CSF leak. The objective of this study was to assess the contribution of choice of dural closure material, as well as other factors, to the incidence of infection and CSF leak. Methods A retrospective, consecutive cohort study of adult patients undergoing elective craniotomy was established between April 2010 and March 2011 at a single center. Exclusion criteria consisted of trauma, bur hole placement alone, and temporary CSF fluid diversion. Results Three hundred ninety-nine patients were included (mean follow-up 396.6 days). Nonautologous (synthetic) dural substitute was more likely to be used (n = 106) in cases of reoperation (p = 0.001). Seventeen patients developed a surgical site infection and 12 patients developed a CSF leak. Multivariate logistic regression modeling identified estimated blood loss (OR 1.002, 95% CI 1.001–1.003; p < 0.001) and cigarette smoking (OR 2.198, 95% CI 1.109–4.238; p = 0.019) as significant predictors of infection. Synthetic dural graft was not a predictor of infection in multivariate analysis. Infratentorial surgery (OR 4.348, 95% CI 1.234–16.722; p = 0.024) and more than 8 days of postoperative corticosteroid treatment (OR 3.886, 95% CI 1.052–16.607; p = 0.048) were significant predictors for the development of CSF leak. Synthetic dural graft was associated with a lower likelihood of CSF leak (OR 0.072, 95% CI 0.003–0.552; p = 0.036). Conclusions The use of synthetic dural closure material is not associated with surgical site infection and is associated with a reduced incidence of CSF leak. Modifiable risk factors exist for craniotomy complications that warrant vigilance and further study.

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