Reduction of Surgical-site Infections in Neurosurgery—The Advantage of Antiseptics Combined with a Sterile Surface

US Neurology ◽  
2010 ◽  
Vol 06 (01) ◽  
pp. 95
Author(s):  
Patrick J Parks ◽  
Georges K Nohra ◽  
◽  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Bacterial Density ◽  
High Morbidity ◽  
Site Infection ◽  
Operative Site ◽  
Wound Contamination ◽  
Concomitant Reduction

Infection at the operative site is associated with high morbidity, mortality, and prolonged hospitalization. Typically, in neurosurgical cases the infection rate varies between 1 and 4%. The rise in antimicrobial resistance makes pre-operative methods to reduce surgical-site infection even more important. This is essential since hospitalized patients tend to have a higher frequency of resistant organisms, and the rise in methicillin-resistantStaphylococcus aureus(MRSA) infections has made antibiotic prophylaxis of this highly virulent organism more difficult. In this article we consider the role of pre-operative antisepsis, which aims to reduce bacterial density in the operative site, and the development of a sterile surface concept as part of an approach to reduce surgical-site infection in a neurosurgical setting. The risk for surgical-site infection is proportional to residual bacteria at the wound site, so a reduction in skin bacterial density will be associated with a concomitant reduction in surgical-site infection. The cumulativein vitroandin vivoevidence related to wound contamination and extensive clinical experience with implanted neurosurgical devices illustrate the utility of using 3M™Ioban™2 as part of an infection prevention regimen within neurosurgery.

Reduction of Surgical-site Infections in Neurosurgery – The Advantage of Antiseptics Combined with a Sterile Surface

2009 ◽  
Vol 4 (2) ◽  
pp. 116
Author(s):  
Patrick J Parks ◽  
Georges K Nohra ◽  
◽  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Bacterial Density ◽  
High Morbidity ◽  
Site Infection ◽  
Operative Site ◽  
Hospitalised Patients ◽  
Concomitant Reduction

Surgical-site infections remain a significant contributor to hospital-acquired infections despite continued efforts to reduce their occurrence. Infection at the operative site is associated with high morbidity, mortality and prolonged hospitalisation. Typically, in neurosurgical cases the infection rate varies between 1 and 4%. The rise in antimicrobial resistance makes pre-operative methods to reduce surgical-site infection even more important. This is essential since hospitalised patients tend to have a higher frequency of resistant organisms, and the rise in methicillin-resistantStaphylococcus aureus(MRSA) infections has made antibiotic prophylaxis of this highly virulent organism more difficult. In this article we consider the role of pre-operative antisepsis, which aims to reduce bacterial density in the operative site, and the development of a sterile surface concept as part of an approach to reduce surgical-site infection in a neurosurgical setting. The risk of surgical-site infection is proportional to residual bacteria at the wound site, so a reduction in skin bacterial density will be associated with a concomitant reduction in surgical-site infection. The cumulativein vitroandin vivoevidence related to wound contamination and extensive clinical experience with implanted neurosurgical devices illustrate the utility of using 3M™Ioban™2 as part of an infection prevention regimen within neurosurgery.

Optimal Approaches to Skin Preparation Prior to Neurosurgery

US Neurology ◽  
2010 ◽  
Vol 06 (02) ◽  
pp. 14
Author(s):  
Vishad Sukul ◽  
Tamara Lynch ◽  
Christopher M Loftus ◽  
◽  
◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Skin Preparation ◽  
Operative Site ◽  
Incision Site ◽  
Neurosurgical Patient ◽  
Surgical Infections ◽  
The World ◽  
Infection Spread

Surgical site infections have always been and will likely remain a significant concern for physicians around the world. When almost 40% of nosocomial surgical infections are related to the incision site, appropriate preperation of the skin becomes a particular concern. Neurosurgery is no stranger to surgical site infection. Infections of this type in the neurosurgical patient can have serious, long-lasting consequences should infection spread deeper than skin level. In this article, the current recommendations for skin preparation at the start of surgery are reviewed, taking into account specific considerations that must be made for the neurosurgical patient. In addition, the use of adjunct methods, i.e. antibiotic-impregnated drapes, and the effects of clipping versus shaving hair at the operative site are discussed.

scholarly journals STUDY OF CLINICO BACTERIOLOGY OF POST OPERATIVE WOUND INFECTION

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Rajesh Kumar P. Shrivastava
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Surgical Procedure ◽  
Surgical Site Infections ◽  
Cost Of Care ◽  
Mucosal Barrier ◽  
High Morbidity ◽  
Site Infection ◽  
Gram Negative ◽  
Operative Wound

Introduction: Globally, surgical site infections (SSI) are known to be most common nosocominal infections in hospitalized patients after urinary tract infection. There are many studies which showed surgical site infection rates are reported globally as it range from 2.5% to 41.9% resulting in high morbidity and mortality. Surgical infections are those which caused infection as a result of a surgical procedure or those that require surgical intervention as part of their treatment which are characterized by breaking of anatomic defense mechanisms and are associated with greater morbidity, significant mortality, and increased cost of care. Though increasing the advance technology in surgical sciences post operative wound infection remains one of the common complications which surgeons encounter. If this problem is not evaluated and treated in timely then it can have significant sequel. The cutaneous or mucosal barrier, entrance of microbes into the host tissue is the initial requirement for infection. In SSI patient stays in hospital may be double the length of time and also increase the costs of health care. The main extra cost may be related to re-operation, extra nursing care and interventions, and drug treatment costs. AIM: The main aim of this study was to estimate the frequency of SSI with reference to factors contributing to it and the antimicrobial susceptibility pattern in surgery wards. Material and Methods: For this study patients were included as they were admitted in the surgical wards and the surgical emergencies that underwent surgical procedure in this hospital. The surgical procedures were classified as planned (elective) surgeries, emergency surgeries and clean, clean-contaminated surgeries, contaminated and dirty patients were divided accordingly. The discharged of infected wound were collected in sterilized container or the pus swab were collected aseptically procedure and send to microbiology laboratory for further process. By consulting with microbiologist the result were recorded. Result: On the base of surgeries were done total 452 cases were preformed. Out of 452 cases there were 132 cases in emergency out of which 29 get infected and in 320 elective cases 20 got infected. The overall rate of surgical site infection (SSI) was 10.8%. The occurrence of SSI in emergency cases (22%) was found to be higher compared to elective cases (6.3%). Out of total cases send for the culture and sensitivity, organism cultured gram negative organism predominate and and commonest was Escherchia coli, followed by Klebsiella, Pseudomonas and Staphylococcus aureus. E.coli and Klebsiella from emergency cases showed resistance to ciprofloxacin (83%) and ceftraixone (83%) and elective cases showed resistance of 70 % to ciprofloxacin and 40% to ceftriaxone. Therefore it was found that occurrence of SSI is significantly more in emergency cases. Conclusion: In this study rate of surgical site infection (SSI) was 10.8% whereas in clean 5.6%, in Clean and Contaminated 7.3% , in contaminated 21.2% and in dirty 25.9%. In gram negative bacteria E.coli were most commonly isolated bacteria followed by Pseudomonas and Klebsiella and in gram positive bacteria Staphylococcus aereus were most common isolated bacteria. Therefore antibiotics sensitive to the gram negative and pram positive bacteria should be initiative for establishing improved hospital antimicrobial policy and antimicrobial prescribing guidelines. Keywords: Surgical Site Infection, Post-operative wound infections, Antimicrobial resistance

scholarly journals ZnO-NPs embedded biodegradable thiolated bandage for postoperative surgical site infection: In vitro and in vivo evaluation

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217079 ◽  
Author(s):  
Rabia Arshad ◽  
Muhammad Farhan Sohail ◽  
Hafiz Shoaib Sarwar ◽  
Hamid Saeed ◽  
Imran Ali ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Site Infection ◽  
Zno Nps ◽  
In Vivo Evaluation

scholarly journals A PROSPECTIVE CLINICO- BACTERIOLOGICAL STUDY OF SURGICAL SITE INFECTION AT PBM HOSITAL

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Satyam Shukla ◽  
Naveen Lohar
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
General Surgery ◽  
Research Council ◽  
National Research Council ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Bacteriological Study ◽  
Class System ◽  
Wound Contamination

Background: This study aims at determining the risk factors and incidence of surgical site infections. Methods: The material for the present study was obtained from patient’s undergone surgery in Department of General Surgery, SPMC and PBM Hospital, Bikaner, Rajasthan from 1st Jan 2019 to 31th December, 2019. Surgical site were considered to be infected according to the definition by NNIS. The wounds were classified according to the wound contamination class system proposed by U.S. National Research Council. Results: A study of 400 operated cases was carried out of which 39 were diagnosed to be having surgical site infection as per the CDC criteria. Thus the incidence of SSI in this study is 9.75%. Conclusion: Incidence of surgical site infection was more in emergency surgery case as compare to elective. Keywords: SSI, Emergency, Elective

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.

Role of in vivo and in vitro Tests in the Diagnosis of Severe Cutaneous Adverse Reactions (SCAR) to Drug

2019 ◽  
Vol 25 (36) ◽  
pp. 3872-3880 ◽  
Author(s):  
Marcel M. Bergmann ◽  
Jean-Christoph Caubet
Keyword(s):  
Adverse Reactions ◽  
Lymphocyte Transformation ◽  
Stevens Johnson Syndrome ◽  
In Vitro Tests ◽  
High Morbidity ◽  
Patch Tests ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Severe cutaneous adverse reactions (SCAR) are life-threatening conditions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of causative underlying drug hypersensitivity (DH) is mandatory due to the high morbidity and mortality upon re-exposure with the incriminated drug. If an underlying DH is suspected, in vivo test, including patch tests (PTs), delayed-reading intradermal tests (IDTs) and in vitro tests can be performed in selected patients for which the suspected culprit drug is mandatory, or in order to find a safe alternative treatment. Positivity of in vivo and in vitro tests in SCAR to drug varies depending on the type of reaction and the incriminated drugs. Due to the severe nature of these reactions, drug provocation test (DPT) is highly contraindicated in patients who experienced SCAR. Thus, sensitivity is based on positive test results in patients with a suggestive clinical history. Patch tests still remain the first-line diagnostic tests in the majority of patients with SCAR, followed, in case of negative results, by delayed-reading IDTs, with the exception of patients with bullous diseases where IDTs are still contra-indicated. In vitro tests have shown promising results in the diagnosis of SCAR to drug. Positivity is particularly high when the lymphocyte transformation test (LTT) is combined with cytokines and cytotoxic markers measurement (cyto-LTT), but this still has to be confirmed with larger studies. Due to the rarity of SCAR, large multi-center collaborative studies are needed to better study the sensitivity and specificity of in vivo and in vitro tests.

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.

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