scholarly journals Interrupted sutures prevent recurrent abdominal fascial dehiscence: a comparative retrospective single center cohort analysis of risk factors of burst abdomen and its recurrence as well as surgical repair techniques

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias Mehdorn ◽  
Linda Groos ◽  
Woubet Kassahun ◽  
Boris Jansen-Winkeln ◽  
Ines Gockel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Analysis ◽  
Surgical Techniques ◽  
Intestinal Resection ◽  
Surgical Site Infections ◽  
Burst Abdomen ◽  
Surgical Closure ◽  
Operative Revision ◽  
Fascial Dehiscence ◽  
Repair Techniques

Abstract Background Burst abdomen (BA) is a severe complication after abdominal surgery, which often requires urgent repair. However, evidence on surgical techniques to prevent burst abdomen recurrence (BAR) is scarce. Methods We conducted a retrospective analysis of patients with BA comparing them to patients with superficial surgical site infections from the years 2015 to 2018. The data was retrieved from the institutional wound register. We analyzed risk factors for BA occurrence as well as its recurrence after BA repair and surgical closure techniques that would best prevent BAR. Results We included 504 patients in the analysis, 111 of those suffered from BA. We found intestinal resection (OR 172.510; 22.195–1340.796, p < 0.001), liver cirrhosis (OR 4.788; 2.034–11.269, p < 0.001) and emergency surgery (OR 1.658; 1.050–2.617; p = 0.03) as well as postoperative delirium (OR 5.058; 1.349–18.965, p = 0.016) as the main predictor for developing BA. The main reason for BA was superficial surgical site infection (40.7%). 110 patients received operative revision of the abdominal fascial dehiscence and 108 were eligible for BAR analysis with 14 cases of BAR. Again, post-operative delirium was the patient-related predictor for BAR (OR 13.73; 95% CI 1.812–104-023, p = 0.011). The surgical technique of using interrupted sutures opposed to continuous sutures showed a preventive effect on BAR (OR 0.143, 95% CI 0.026–0,784, p = 0.025). The implantation of an absorbable IPOM mesh did not reduce BAR, but it did reduce the necessity of BAR revision significantly. Conclusion The use of interrupted sutures together with the implantation of an intraabdominal mesh in burst abdomen repair helps to reduce BAR and the need for additional revision surgeries.

scholarly journals Risk Factors of Burst Abdomen in Emergency Laparotomy

2019 ◽  
Vol 46 (2) ◽  
pp. 38-42
Author(s):  
Muhammad Harun Ar Rashid ◽  
Liton Kumer Shaha ◽  
Sanjana Sharmin Shashi ◽  
Imtiaz Faruk
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Surgical Techniques ◽  
Abdominal Distension ◽  
Risk Groups ◽  
High Risk Group ◽  
Emergency Laparotomy ◽  
Burst Abdomen ◽  
Cross Sectional ◽  
Medical College

Burst Abdomen is a preventable condition in which many risk factors play their role and lead to life threatening complications. This study was carried out to find out various risk factors of burst abdomen following emergency laparotomy, to find out the high risk group of patients for burst abdomen, to determine the predictors of burst abdomen, to prevent the rate of burst abdomen & find out morbidity and mortality of burst abdomen. This cross sectional study was done among 100 cases of burst abdomen occurring in Sir Salimullah Medical College & Mitford Hospital, Dhaka and Dhaka Medical college,Dhaka during the period of July,2011 to December,2011. The patients were admitted for various surgical problems and underwent emergency laparotomy. Burst abdomen was taken into account. Another group of 100 patients who undergone emergency laparotomy but did not develop burst abdomen were also taken into account to make a comparison with the burst group. Patients who undergone elective laparotomy,paediatric age group,patients undergone exploration through mini laparotomy or transverse incision,patients with pregnancy were excluded from the study populations.Patients were assessed by history taking, examination and appropriate investigation before surgery and observed post operatively for any complication. The results were prepared on 100 patients underwent emergency laparotomy in SSMCMH & DMCH. Burst abdomen following emergency laparotomy results from multifactorial causes. The main outcome measure found significant as the risk factors of burst abdomen in this study were peritonitis (95%),anaemia (26%),malnutrition (18%), in the preoperative period; inadequate peritoneal toileting and faulty surgical techniques in the per operative period; and wound infection (62%), postoperative cough (28%), abdominal distension (22%). The result also shows that the rate of burst abdomen is still very high in SSMCMH & DMCH and most of them occur in operations done by trainee surgeons (86%) and in those patients who has 3 or more of the risk factors (44%). We hope this study will arouse awareness and concern about this problem, so that more active steps will be taken for its prevention by identifying the high risk groups. This will certainly reduce the incidence of burst abdomen. Bangladesh Med J. 2017 May; 46 (2): 38-42

scholarly journals Peptic perforations: comparative study of its closure (omentopexy versus figure of 8 closure)

2019 ◽  
Vol 6 (6) ◽  
pp. 2074
Author(s):  
Sanjay Changole ◽  
Maheshkumar Soni ◽  
Dattatray Thakare
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Hospital Stay ◽  
Recovery Time ◽  
Surgical Techniques ◽  
Postoperative Recovery ◽  
Wound Complications ◽  
Peptic Ulcer Perforation ◽  
Burst Abdomen ◽  
Ulcer Perforation

Background: Peptic ulcer perforation is one the most common and catastrophic maladies that affect mankind. The aim of this study was to compare the surgical techniques of peptic ulcer perforation closure namely omentopexy and figure of 8 stitch with reference to recovery time and complications rate.Methods: Of 80 selected patients, figure of 8 method for closure of peptic perforation was used in 40 patients and 40 by using omentopexy method. Outcomes were compared in view of postoperative recovery time and postoperative complications such as wound complications, respiratory complications, burst abdomen, septicaemia, hospital stay, death.Results: In our study it was noted that age of presentation was in elderly males with risk factors like alcohol, smoking, tobacco chewing, and NSAIDS use in decreasing order. Late presentation was associated with higher complication including one death. In figure of 8 group it was found that RT Removal was early, early oral resumption loss hospital stay in figure of 8 group than in omentopexy group. Complications such as wound complication, burst abdomen , leak, and septicaemia  were more in omentopexy group than figure of 8 group. Only one death occurred in study that was in omentopexy group.Conclusions: We came to conclusion that peptic perforation is more common in males around 50 years with risk factors of smoking and alcohol. Outcomes of surgery with figure of 8 stitch were better than omentopexy with respect to oral resumptions, early discharge, less complications such as wound complications, burst abdomen leak septicaemia and death.

Risk factors related to surgical site infections among surgical patients in developing world: a systematic review

2020 ◽  
pp. 1984-1992
Author(s):  
Faihan Alotaibi ◽  
Faisal Alnemari ◽  
Alwaleed Alsufyani ◽  
Aisha Al-sanea ◽  
Abeer Al-Nashri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Developing World ◽  
Surgical Site Infections ◽  
Surgical Patients

scholarly journals Prospective cohort study on hospitalised patients with suspected urinary tract infection and risk factors por multidrug resistance

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victor Garcia-Bustos ◽  
Ana Isabel Renau Escrig ◽  
Cristina Campo López ◽  
Rosario Alonso Estellés ◽  
Koen Jerusalem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Multidrug Resistance ◽  
Urinary Tract ◽  
Prospective Cohort ◽  
Bacterial Infections ◽  
Cohort Analysis ◽  
Term Care ◽  
Hospitalised Patients ◽  
Tract Infections

AbstractUrinary tract infections (UTIs) are among the most common bacterial infections and a frequent cause for hospitalization in the elderly. The aim of our study was to analyse epidemiological, microbiological, therapeutic, and prognostic of elderly hospitalised patients with and to determine independent risk factors for multidrug resistance and its outcome implications. A single-centre observational prospective cohort analysis of 163 adult patients hospitalized for suspected symptomatic UTI in the Departments of Internal Medicine, Infectious Diseases and Short-Stay Medical Unit of a tertiary hospital was conducted. Most patients currently admitted to hospital for UTI are elderly and usually present high comorbidity and severe dependence. More than 55% met sepsis criteria but presented with atypical symptoms. Usual risk factors for multidrug resistant pathogens were frequent. Almost one out of five patients had been hospitalized in the 90 days prior to the current admission and over 40% of patients had been treated with antibiotic in the previous 90 days. Infection by MDR bacteria was independently associated with the previous stay in nursing homes or long-term care facilities (LTCF) (OR 5.8, 95% CI 1.17–29.00), permanent bladder catheter (OR 3.55, 95% CI 1.00–12.50) and urinary incontinence (OR 2.63, 95% CI 1.04–6.68). The degree of dependence and comorbidity, female sex, obesity, and bacteraemia were independent predictors of longer hospital stay. The epidemiology and presentation of UTIs requiring hospitalisation is changing over time. Attention should be paid to improve management of urinary incontinence, judicious catheterisation, and antibiotic therapy.

scholarly journals Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

2020 ◽  
Vol 18 ◽  
pp. 205873922096054
Author(s):  
Faiz Ullah Khan ◽  
Yu Fang ◽  
Zakir Khan ◽  
Farman Ullah Khan ◽  
Zafar Iqbal Malik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transurethral Resection ◽  
Surgical Site Infections ◽  
Exploratory Laparotomy ◽  
Cross Sectional Study ◽  
Surgical Patients ◽  
Related Factors ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Associated Risk Factors

Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

Risk factors for surgical site infections after pediatric cardiovascular surgery

2004 ◽  
Vol 23 (3) ◽  
pp. 231-234 ◽  
Author(s):  
AMANDA L. ALLPRESS ◽  
GEOFFREY L. ROSENTHAL ◽  
KATHY M. GOODRICH ◽  
FLAVIAN M. LUPINETTI ◽  
DANIELLE M. ZERR
Keyword(s):  
Risk Factors ◽  
Cardiovascular Surgery ◽  
Surgical Site Infections ◽  
Pediatric Cardiovascular Surgery

Risk Factors for Redetachment and Worse Visual Outcome after Silicone Oil Removal in Eyes with Complicated Retinal Detachment

2007 ◽  
Vol 17 (4) ◽  
pp. 627-637 ◽  
Author(s):  
F. Goezinne ◽  
E.C. La Heij ◽  
T.T.J.M. Berendschot ◽  
A.T.A. Liem ◽  
F. Hendrikse
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Surgical Techniques ◽  
Visual Outcome ◽  
Oil Removal ◽  
Silicone Oil Removal ◽  
Male Sex ◽  
Anatomic Success

Purpose The goal of this study was to identify risk factors for redetachment and/or a worse visual outcome after silicone oil removal (SOR) for complicated retinal detachment. Methods The authors retrospectively analyzed 287 consecutive eyes with SOR between January 1999 and December 2003. Results Anatomic success after SOR was achieved in 81% of the eyes. The overall anatomic success at the end of follow-up was 94%. Postoperative ocular hypertension was found in 8% of the eyes, hypotony in 6% of the eyes, and keratopathy in 29% of the eyes. After SOR 43% of the eyes had an improvement in visual acuity of at least two Snellen lines. After multivariate analysis, male sex, the presence of preoperative rubeosis, and proliferative diabetic retinopathy (PDR) were found to be risk factors for recurrent retinal detachment. Male sex, preoperative visual acuity of <0.1 Snellen lines, PDR, the performance of three more operations, any size of retinectomy, and hypotony were found to be associated with a poor visual outcome of Snellen visual acuity <0.1. Conclusions Retinal detachment after SOR in the current unselected series of eyes occurred in approximately 20%, which is comparable to the Silicone Oil Study reports, published approximately 20 years ago. However, preoperative selection was then made, and less than 50% of the silicone oil-filled eyes had SOR. The higher overall anatomic success in the current study may be due to improved vitreoretinal surgical techniques.

scholarly journals Prevalence and Risk Factors Associated with Vancomycin-Resistant Staphylococcus aureus Precursor Organism Colonization among Patients with Chronic Lower-Extremity Wounds in Southeastern Michigan

2013 ◽  
Vol 34 (9) ◽  
pp. 954-960 ◽  
Author(s):  
Pritish K. Tosh ◽  
Simon Agolory ◽  
Bethany L. Strong ◽  
Kerrie VerLee ◽  
Jennie Finks ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Lower Extremity ◽  
Chronic Wounds ◽  
Cohort Analysis ◽  
Case Control ◽  
Control Analysis ◽  
Vancomycin Resistant ◽  
Clinical Records ◽  
Case Control Analysis

Background.Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Incl8-like plasmids in VRE and pSK41-like plasmids in S. aureus appear to be important precursors to this transfer.Objective.Identify the prevalence of VRSA precursor organisms.Design.Prospective cohort with embedded case-control study.Participants.Southeastern Michigan adults with chronic lower-extremity wounds.Methods.Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. aureus and VRE, which were tested for pSK41-like and Incl8-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive S. aureus were assessed among all study participants (cohort analysis) and among only S. aureus-colonized participants (case-control analysis).Results.Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible S. aureus, 27% were colonized with methicillin-resistant S. aureus, and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive S. aureus, and none had Incl8-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive S. aureus colonization in both analyses.Conclusions.Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive S. aureus colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.

scholarly journals Comparative study of open mesh repair and Desarda’s no-mesh repair for inguinal hernia, in GMKMCH, Salem, India

2018 ◽  
Vol 5 (9) ◽  
pp. 3139
Author(s):  
Prakash . ◽  
Padmalakshmi Bharathi Mohan
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Surgical Site Infections ◽  
Wall Stiffness ◽  
Open Mesh Repair ◽  
Scrotal Edema ◽  
Background Mesh ◽  
Surgical Field ◽  
Repair Techniques

Background: Mesh repair has gained popularity among the surgical repair of hernias but has limitations. This study is being carried out to compare the effectiveness of Desarda’s no mesh repair, with Lichtenstein’s tension free repair.Methods: This prospective study was carried out in GMKMCH, Salem, over a period of 2 years. A total of 60 cases with inguinal hernia were included in the study. 30 patients were randomly subjected to Desarda’s technique and 30 patients underwent Lichtenstein’s repair. After surgery, patients were followed up and noted for complications like groin pain, surgical site infections, duration of hospital stay, duration to return to normal activity.Results: Operative time was 45 minutes in Desarda’s group and 50 minutes in the Lichtenstein group which was highly significant (p<0.01). On 2-year follow-up there were no recurrences in both groups. There were no surgical site infections in the Desarda’s group, compared to whereas Lichtenstein’s repair where had 4 (10%) recurrences. The occurrence of complications like loss of sensation over the groin, scrotal edema, abdominal wall stiffness was not seen in Desarda’s group, whereas its occurrence was highly significant (p<.01) in Lichtenstein’s group.Conclusions: Desarda’s no mesh technique is easy to learn and simple when compared to other no mesh repair techniques and requires no mesh. It can be used in a contaminated surgical field, in young individuals and in cases of financial constraints. Hence, Desarda’s no mesh repair is favourably comparable with Lichtenstein’s mesh repair.

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