scholarly journals Surgical Site Infections in Spine Surgery: Preoperative Prevention Strategies to Minimize Risk

2018 ◽  
Vol 8 (4_suppl) ◽  
pp. 31S-36S ◽  
Author(s):  
Nicholas T. Spina ◽  
Ilyas S. Aleem ◽  
Ahmad Nassr ◽  
Brandon D. Lawrence
Keyword(s):  
Surgical Site Infection ◽  
Spine Surgery ◽  
Critical Role ◽  
Blood Glucose Control ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Preventive Strategies ◽  
Review Of The Literature ◽  
Prevention Strategies ◽  
Hospital System

Study Design: Literature review. Objectives: A review of the literature identifying preoperative risk factors for developing surgical site infections after spine surgery and discussion of the preventive strategies to minimize risks. Methods: A review of the literature and synthesis of the data to provide an updated review on the preoperative management of surgical site infection. Results: Preoperative prevention strategies of reducing surgical site infections in spine surgery remains a challenging problem. Careful mitigation of modifiable patient comorbidities, blood glucose control, smoking, obesity, and screening for pathologic microorganisms is paramount to reduce this risk. Individualized antibiotic regimens, skin preparation, and hand hygiene also play a critical role in surgical site infection prevention. Conclusions: This review of the literature discusses the preoperative preventive strategies and risk management techniques of surgical site infections in spine surgery. Significant decreases in surgical site infections after spine surgery have been noted over the past decade due to increased awareness and implementation of the prevention strategies described in this article. However, it is important to recognize that prevention of surgical site infection requires a system-wide approach that includes the hospital system, the surgeon, and the patient. Continued efforts should focus on system-wide implementation programs including careful patient selection, individualized antibiotic treatment algorithms, identification of pathologic organisms, and preoperative decolonization programs to further prevent surgical site infections and optimize patient outcomes.

scholarly journals Nursing interventions to reduce surgical site infection in potentially contaminated surgeries: an integrative review

2020 ◽  
Author(s):  
Tatiana Martins ◽  
Lúcia Nazareth Amante ◽  
Camila Vicente ◽  
Gabrielle Maciel de Sousa ◽  
Emanuele Pozzebon Caurio ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Blood Glucose Control ◽  
Surgical Site Infections ◽  
Final Analysis ◽  
Perioperative Period ◽  
Integrative Review ◽  
Nursing Interventions ◽  
Skin Closure ◽  
Site Infection ◽  
Sterile Glove

Objective: Identify nursing interventions that contribute to the reduction of surgical site infections in potentially contaminated surgeries. Methods: Integrative review, carried out in four databases. There were 5,888 articles published in the period from January 2008 to July 2018, in English, Portuguese and Spanish, from which nine articles were selected after final analysis. Results: The nursing interventions appeared according to the perioperative periods: preoperative (55.55%), intraoperative (33.33%), postoperative (66.66%), being associated with: antibiotic therapy, trichotomy, alcoholic chlorhexidine bathing, hand hygiene, sterile glove/wear/ package change for fascia and skin closure, degermination, antisepsis, surgical classification, surgical time, care with dressings and drains, temperature and blood glucose control, patient education, discharge and post-hospital discharge orientation. Conclusions: Nursing interventions were identified in each perioperative period, proving to be essential for the qualification of nursing care and effective in reducing surgical site infection in potentially contaminated surgeries.

scholarly journals The Use of Vacuum Dressings for Dead Space Management in Deep Surgical Site Infections Allows Implant and Bone Graft Retention

2017 ◽  
Vol 7 (8) ◽  
pp. 756-761 ◽  
Author(s):  
James P. Watt ◽  
Robert N. Dunn
Keyword(s):  
Surgical Site Infection ◽  
Bone Graft ◽  
Spine Surgery ◽  
Surgical Site Infections ◽  
Lumbar Spine Surgery ◽  
Causative Organism ◽  
Site Infection ◽  
Space Management ◽  
Acute Wound ◽  
Deep Surgical Site Infection

Study Design: Retrospective, descriptive study. Objectives: Managing early surgical site infection following elective lumbar spine surgery remains a challenge with controversy regarding retention of instrumentation and bone graft. Wound closure may also pose considerable challenges. We aim to report on our method of managing deep surgical site infections complicating elective spine surgery with surgeon assembled deep vacuum dressings. Identification of causative organisms with their sensitivities was a secondary objective. Methods: Patients were identified from a prospectively maintained, single-surgeon database from 2003-2015. Patients who had an infective or trauma related diagnosis, cervical procedures, and were younger than 18 years were excluded. Records were reviewed to identify bacteriology, laboratory tests performed, antibiotics administered, and type and frequency of surgical management. One thousand two hundred twenty patients qualified for inclusion, with 19 identified as having developed acute wound sepsis. Results: All patients had surgical debridement on the day of presentation and the majority of wounds were managed with a vacuum dressing. In all but 1 patient was instrumentation retained. Specimens for culture were taken at each debridement and antibiotics changed accordingly. Patients received a minimum 6 weeks of antibiotics. Conclusions: The management of deep surgical site infection is labor intensive and frustrating for both surgeon and patient due to the unexpected prolonged admission. Management goals are identification and eradication of the causative organism with subsequent healing of the surgical wound. This process is enhanced with the use of negative-suction dressings made from theatre stock replaced at regular intervals and allows retention of bone graft and instrumentation in the majority of cases.

scholarly journals Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Federico Coccolini ◽  
Mario Improta ◽  
Enrico Cicuttin ◽  
Fausto Catena ◽  
Massimo Sartelli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Sufficient Evidence ◽  
Wound Complications ◽  
Skin Closure ◽  
Immunocompromised Patients ◽  
Site Infection ◽  
Review Of The Literature ◽  
Strict Adherence

Abstract Background Immunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients. Methods A systematic review of the literature was conducted. Results Literature review shows that partial skin closure is effective to reduce SSI in this population. There is not sufficient evidence to definitively suggest in favour of prophylactic negative pressure wound therapy. The use of mammalian target of rapamycin (mTOR) and calcineurin inhibitors (CNI) in transplanted patient needing ad emergent or undeferrable abdominal surgical procedure must be carefully and multidisciplinary evaluated. The role of antibiotic prophylaxis in transplanted patients needs to be assessed. Conclusion Strict adherence to SSI infection preventing bundles must be implemented worldwide especially in immunocompromised patients. Lastly, it is necessary to elaborate a more widely approved definition of immunocompromised state. Without such shared definition, it will be hard to elaborate the needed methodologically correct studies for this fragile population.

scholarly journals Sweat Contamination Induced Surgical Site Infections After Spine Surgery: Three Case Reports and Literature Review

2021 ◽  
Author(s):  
Yuhang Ma ◽  
KELV SHEN ◽  
DUANRONG WU ◽  
ZHENGFENG LU
Keyword(s):  
Surgical Site Infection ◽  
Internal Fixation ◽  
Spine Surgery ◽  
Staphylococcus Epidermidis ◽  
Operation Time ◽  
Surgical Site Infections ◽  
Chronic Obstructive ◽  
Site Infection ◽  
Primary Suture ◽  
The Third

Abstract Background:Surgical site infection (SSI) is one of the most intractable complications following spine surgery during the early postoperative stage. Elderly (age > 70 years), body mass index > 30, smoking, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, anemia, low serum albumin, operation time > 3h, and perioperative blood loss > 500 ml are the common risk factors of SSI after spine surgery. However, there are few published reports about sweat contamination induced surgical site infections with Staphylococcus epidermidis up to date. Staphylococcus epidermidis is a permanent member of the normal human microbiota and has emerged as an important opportunistic pathogen in SSI. We aim to detect the influence of sweat infiltration on SSI with Staphylococcus epidermidis and effective management. Case presentation:A 73-year-old male, a 54-year-old male and a 73-year-old female were admitted to our hospital. All of them underwent posterior compression and fusion surgery with internal fixation and got surgical site infection after primary surgery. Two of them suffered moderate surgical site infection while the third patient with comorbidities suffered severe surgical site infection. Antibiotic therapy and debridement with internal fixation retained were utilized during which microbiological culture were taken. The moderate infection patients got fully recovered after debridement and primary suture while the serious one had recurrence after the first debridement, and then the second operation was performed. SSI, however, relapsed after three days. Vacuum-assisted closure (VAC) system was replaced in the third debridement. The severe patient got well recovered and discharged after displacement of VAC system. Conclusion:Sweat-contaminated is an inducement of SSI with Staphylococcus epidermidis that should attract surgeons’ attention. For mild infection, changing dressing and infrared treatment can achieve good results. For moderate infection, one debridement and primary suture are enough. For severe infection, early application of VAC system can reduce the number of debridement and achieve good clinical outcome.

Surgical Site Infections - A Hospital Havoc: Retrospective Study of Surgical Site Infections in Tertiary Health Care Centre in North East India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
V Singh ◽  
A B Khyriem, W V Lyngdoh ◽  
C J Lyngdoh
Keyword(s):  
Surgical Site Infection ◽  
Multiple Drug Resistance ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Site Infection ◽  
Retrospective Case ◽  
Acinetobacter Baumanii ◽  
Health Care Centre ◽  
North East

Objectives - Surgical site infections (SSI) has turn out to be a major problem even in hospital with most modern facilities and standard protocols of pre -operative preparation and antibiotic prophylaxis. Objective of this study is to know the prevalence of surgical site infection among the postoperative patients and to identify the relationship between SSI and etiological pathogens along with their antimicrobial susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Methods - A retrospective case study conducted at NEIGRIHMS, among patients admitted to the surgical departments during the period between January 1st and December 31st 2016. Swabs from the surgical sites were collected under sterile conditions and standard bacteriological tests were performed for identification and appropriate statistical methods were employed to look for association between SSI and etiological pathogens. Results - Out of the 1284 samples included in the study, 192 samples showed evidence of SSI yielding an infection rate of 14.9%. The most commonly isolated bacteria were: Escherichia coli, Acinetobacter baumanii and Staphylococcus aureus, of the gram negative isolates 6.2% were multidrug resistant of which 19% were carbapenem resistant. Conclusion - SSI with multiple drug resistance strains and polymicrobial etiology reflects therapeutic failure. The outcome of the SSI surveillance in our hospital revealed that in order to decrease the incidence of SSI we would have to: a) incorporate a proper antibiotic stewardship  b) conduct periodic surveillance to keep a check on SSI d) educate medical staffs regarding the prevention of surgical site infection.

Cranial Surgical Site Infection Interventions and Prevention Bundles: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Michael Mann ◽  
Christina Huang Wright ◽  
Tarun Jella ◽  
Collin M. Labak ◽  
Berje Shammassian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Review Of The Literature

58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John
Keyword(s):  
Surgical Site Infection ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Standard Operating Procedure ◽  
Site Infection ◽  
Infection Rates ◽  
Local Evidence ◽  
Audit Data ◽  
The Impact ◽  
To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

scholarly journals Incidence of Surgical Site Infection After Spine Surgery: What Is the Impact of the Definition of Infection?

2014 ◽  
Vol 473 (5) ◽  
pp. 1612-1619 ◽  
Author(s):  
Sjoerd P. F. T. Nota ◽  
Yvonne Braun ◽  
David Ring ◽  
Joseph H. Schwab
Keyword(s):  
Surgical Site Infection ◽  
Spine Surgery ◽  
Site Infection ◽  
Definition Of ◽  
The Impact

Surgical Site Infection as a Surrogate Marker of Physician Impairment

2009 ◽  
Vol 30 (11) ◽  
pp. 1120-1122 ◽  
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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