scholarly journals Correlation of intra-abdominal pressure with the outcome of perforation peritonitis

2017 ◽  
Vol 4 (5) ◽  
pp. 1584
Author(s):  
Saurabh Agrawal ◽  
Tarun Chaudhary ◽  
Shantanu Kumar Sahu
Keyword(s):  
Surgical Site Infection ◽  
Pearson Correlation ◽  
Wound Dehiscence ◽  
Bladder Pressure ◽  
Abdominal Pressure ◽  
Emergency Laparotomy ◽  
Site Infection ◽  
Abdominal Hypertension ◽  
Perforation Peritonitis ◽  
The Impact

Background: A progressive increase in intra-abdominal pressure (IAP) may cause abdominal compartment syndrome (ACS) with organ dysfunction. Studies have documented the impact of Intra-abdominal hypertension (IAH) on virtually every organ. However, it remains strangely underdiagnosed. Present study was aimed to correlate Intra- abdominal pressure with the outcome in perforation peritonitis patients.Methods: This study was done on 50 patients with perforation peritonitis and patients undergoing intervention in the form of either emergency laparotomy or drain placement. The abdominal pressures were indirectly determined by measuring urinary bladder pressure with a Foley's catheter. Pearson correlation was used to see relation between intra-abdominal pressure and outcome of peritonitis.Results: Mean intra-abdominal pressure during time of presentation to the hospital was 26.7±3.2cm H2O. Among various morbidities following operation, surgical site infection was most common (38%) followed by wound dehiscence (24%). There was weak linear correlation between intra-abdominal pressure and factors determining morbidity such as surgical site infection, wound dehiscence, burst abdomen, prolonged ileus, ARDS and ARF. However, this was not statistically significant.Conclusions: There is weak correlation of various co morbidities with increased intra-abdominal pressure in patients with perforation peritonitis which was not significant statistically.

scholarly journals CLINICAL SIGNIFICANCE AND CORRELATION OF INTRA-ABDOMINAL PRESSURE WITH THE OUTCOME OF PERFORATION PERITONITIS

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Naveen Gupta ◽  
Shilpi Gupta
Keyword(s):  
Surgical Site Infection ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Pearson Correlation ◽  
Wound Dehiscence ◽  
Bladder Pressure ◽  
Abdominal Pressure ◽  
Site Infection ◽  
Perforation Peritonitis ◽  
Abdominal Compartment

Background: A progressive increase in intra-abdominal pressure (IAP) may cause abdominal compartment syndrome (ACS) with organ dysfunction.  However, it remains strangely underdiagnosed. Objective: To correlate Intra-abdominal pressure with the outcome in perforation peritonitis patients. Methods: An Observational study was done on 50 patients with perforation peritonitis and patients undergoing intervention in the form of either emergency laparotomy or drain placement. The abdominal pressures were indirectly determined by measuring urinary bladder pressure with a Foley's catheter. Pearson correlation was used to see relation between intra- abdominal pressure and outcome of peritonitis. SPSS version 16 (trial) was used for analysis. Results: Mean intra-abdominal pressure during time of presentation to the hospital was 26.4±3.8cm H2O. Among various morbidities following operation, surgical site infection was most common (36%) followed by wound dehiscence (30%). There was strong linear correlation between intra-abdominal pressure and factors determining morbidity such as surgical site infection, wound dehiscence, burst abdomen. Conclusions: There is a strong correlation of various co morbidities with increased intra-abdominal pressure in patients with perforation peritonitis which was significant statistically. Keywords: Intra- Abdominal Pressure, Intravescical pressure, perforation peritonitis, Abdominal Compartment Syndrome.

Clinical outcome of V-Y flap with latissimus dorsi and gluteal advancement for treatment of large thoracolumbar myelomeningocele defects: a comparative study

2019 ◽  
Vol 24 (1) ◽  
pp. 75-84
Author(s):  
Mohammad Sadegh Masoudi ◽  
Mohammad Ali Hoghoughi ◽  
Fariborz Ghaffarpasand ◽  
Shekoofeh Yaghmaei ◽  
Maryam Azadegan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Comparative Study ◽  
Surgical Site Infection ◽  
Latissimus Dorsi ◽  
Primary Closure ◽  
Wound Dehiscence ◽  
Site Infection ◽  
Gluteal Muscle ◽  
Operative Duration ◽  
Csf Leakage

OBJECTIVESurgical repair and closure of myelomeningocele (MMC) defects are important and vital, as the mortality rate is as high as 65%–70% in untreated patients. Closure of large MMC defects is challenging for pediatric neurosurgeons and plastic surgeons. The aim of the current study is to report the operative characteristics and outcome of a series of Iranian patients with large MMC defects utilizing the V-Y flap and with latissimus dorsi or gluteal muscle advancement.METHODSThis comparative study was conducted during a 4-year period from September 2013 to October 2017 in the pediatric neurosurgery department of Shiraz Namazi Hospital, Southern Iran. The authors included 24 patients with large MMC defects who underwent surgery utilizing the bilateral V-Y flap and latissimus dorsi and gluteal muscle advancement. They also retrospectively included 19 patients with similar age, sex, and defect size who underwent surgery using the primary or delayed closure techniques at their center. At least 2 years of follow-up was conducted. The frequency of leakage, necrosis, dehiscence, systemic infection (sepsis, pneumonia), need for ventriculoperitoneal shunt insertion, and mortality was compared between the 2 groups.RESULTSThe bilateral V-Y flap with muscle advancement was associated with a significantly longer operative duration (p < 0.001) than the primary closure group. Those undergoing bilateral V-Y flaps with muscle advancement had significantly lower rates of surgical site infection (p = 0.038), wound dehiscence (p = 0.013), and postoperative CSF leakage (p = 0.030) than those undergoing primary repair. The bilateral V-Y flap with muscle advancement was also associated with a lower mortality rate (p = 0.038; OR 5.09 [95% CI 1.12–23.1]) than primary closure. In patients undergoing bilateral V-Y flap and muscle advancement, a longer operative duration was significantly associated with mortality (p = 0.008). In addition, surgical site infection (p = 0.032), wound dehiscence (p = 0.011), and postoperative leakage (p = 0.011) were predictors of mortality. Neonatal sepsis (p = 0.002) and postoperative NEC (p = 0.011) were among other predictors of mortality in this group.CONCLUSIONSThe bilateral V-Y flap with latissimus dorsi or gluteal advancement is a safe and effective surgical approach for covering large MMC defects and is associated with lower rates of surgical site infection, dehiscence, CSF leakage, and mortality. Further studies are required to elucidate the long-term outcomes.

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 Surgical Site Infection Following Caesarean Section by Acinetobacter Species: A Report from a Hyperendemic Setting in the Brazilian Amazon Region

2021 ◽  
Vol 9 (4) ◽  
pp. 743
Author(s):  
Blenda Gonçalves Cabral ◽  
Danielle Murici Brasiliense ◽  
Ismari Perini Furlaneto ◽  
Yan Corrêa Rodrigues ◽  
Karla Valéria Batista Lima
Keyword(s):  
Caesarean Section ◽  
Surgical Site Infection ◽  
Carbapenem Resistance ◽  
Brazilian Amazon ◽  
Amazon Region ◽  
Site Infection ◽  
Acinetobacter Species ◽  
Brazilian Amazon Region ◽  
Acinetobacter Spp ◽  
The Impact

Surgical site infection (SSI) following caesarean section is associated with increased morbidity, mortality, and significant health care costs. This study evaluated the epidemiological, clinical, and microbiological features of Acinetobacter spp. in women with SSIs who have undergone caesarean section at a referral hospital in the Brazilian Amazon region. This study included 69 women with post-caesarean SSI by Acinetobacter spp. admitted to the hospital between January 2012 and May 2015. The 69 Acinetobacter isolates were subjected to molecular species identification, antimicrobial susceptibility testing, detection of carbapenemase-encoding genes, and genotyping. The main complications of post-caesarean SSI by Acinetobacter were inadequate and prolonged antibiotic therapy, sepsis, prolonged hospitalization, and re-suture procedures. A. baumannii, A. nosocomialis and A. colistiniresistens species were identified among the isolates. Carbapenem resistance was associated with OXA-23-producing A. baumannii isolates and IMP-1-producing A. nosocomialis isolate. Patients with multidrug-resistant A. baumannii infection showed worse clinical courses. Dissemination of persistent epidemic clones was observed, and the main clonal complexes (CC) for A. baumannii were CC231 and CC236 (Oxford scheme) and CC1 and CC15 (Pasteur scheme). This is the first report of a long-term Acinetobacter spp. outbreak in women who underwent caesarean section at a Brazilian hospital. This study demonstrates the impact of multidrug resistance on the clinical course of post-caesarean infections.

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

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

scholarly journals Transmurally migrated gossypiboma rarely posing as surgical site infection: a case report and review of literature

2020 ◽  
Vol 7 (10) ◽  
pp. 3500
Author(s):  
Amrita Gaurav ◽  
Juhi Mishra ◽  
Om Kumari ◽  
Kavita Khoiwal ◽  
Farhanul Huda ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Surgical Site Infection ◽  
Sigmoid Colon ◽  
Primary Repair ◽  
Wound Dehiscence ◽  
Colon Perforation ◽  
Site Infection ◽  
Surgical Sponge ◽  
Ileal Loop ◽  
Sigmoid Colon Perforation

The term gossypiboma is used to describe a retained surgical sponge or gauge after surgery. The clinical features range from being asymptomatic to frank bowel obstruction, perforation and peritonitis. Radiological modalities also do not provide a definite diagnosis. We report a case of a 30-year-old lady who presented to the emergency room with recurrent surgical site infection. She had a history of caesarean section 5 months ago. Following the caesarean section, she developed superficial wound dehiscence which was re-sutured. At the present facility, the lady underwent Computed tomography (CT) scan and was suspected to have a foreign body around the gut. She was planned for an exploratory laparotomy. Upon laparotomy, a large thick-walled ileal loop with some unusual intra luminal mass was found. Dense adhesions were present between the ileal loop and sigmoid colon. Adhesiolysis led to an iatrogenic sigmoid colon perforation, around 2 cm length. On incision over the ileal loop, surgical sponge was retrieved. Ileal loop was resected along with perforated site with end-to-end ileo-ileal anastomosis was done. Primary repair of sigmoid colon perforation was done. Patient was stable in postoperative period. Although rare, gossypiboma should be kept in mind as a differential diagnosis in postoperative cases presenting with recurrent surgical site infection.

SP3.2.2 Closed Incision Negative Pressure Wound Therapy reduces Surgical Site Infection following Emergency Laparotomy: A Propensity Matched, NELA Registry Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Emma Hawthornthwaite ◽  
Jordan Ng- Cheong-Chung ◽  
Tom Watkinson ◽  
Ursula Blyth ◽  
Deena Harji ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Negative Pressure ◽  
Significant Proportion ◽  
Primary Outcome Measure ◽  
Emergency Laparotomy ◽  
Emergency Setting ◽  
Site Infection ◽  
Comprehensive Complication Index ◽  
Pressure Therapy ◽  
Operative Morbidity

Abstract Aims Surgical site infection (SSI) contributes to a significant proportion of post-operative morbidity in people undergoing emergency surgery. Prophylactic closed incision negative pressure therapy (CINPT) has been shown to reduce SSI rates in patients undergoing elective laparotomy however there is limited evidence for their use in the emergency setting. This study aimed to determine whether prophylactic CINPT provides comparable SSI rate to SSD for midline incision following emergency laparotomy. Methods A registry-based, prospective cohort study was undertaken using data from National Emergency Laparotomy Audit (NELA) database at our centre. The primary outcome measure was SSI as defined by the Centers for Disease Control (CDC) criteria. Secondary outcomes included 30 day post-operative morbidity and grade using Clavien-Dindo (CD) classification and the Comprehensive Complication Index, length of stay, 30 day mortality and readmission rates. CINPT and standard surgical dressing group were compared with respect to peri-operative characteristics and post-operative outcomes. A propensity- score matching (PSM) was performed to mitigate for selection bias. Results A total of 1484 patients were identified. Following PSM, a matched cohort of 474 patients were identified with 237 patients in each arm. SSI rate in CINPT cohort was found to be significantly lower compared to the SSD cohort (16.9% vs. 33.8%, p &lt; 0.001). The rate of superficial and deep infections were higher in the standard dressing arm compared to the CINPWT, p &lt; 0.001. There were no overall differences in 30-day morbidity and grade of post-operative complications. Conclusion Prophylactic CINPT in the emergency laparotomy is associated with reduced SSI rates.

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