scholarly journals Study of efficacy of short course peri-operative antibiotics in clean contaminated surgeries

2017 ◽  
Vol 4 (8) ◽  
pp. 2455
Author(s):  
Shivakumar C. R. ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Anil Reddy Pinate
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
Site Infection ◽  
Medical Sciences ◽  
Short Course ◽  
Perioperative Antibiotics ◽  
Clean Contaminated ◽  
Hospital Acquired

Background: Surgical site infection is a one of the most common postoperative complication and causes significant postoperative morbidity and mortality. WHO described Hospital acquired infections as one of the major infectious diseases having huge economic impact. Perioperative antibiotics constitute the bulk of antimicrobial consumption in any hospital. We need to adapt the policies that decrease the incidence of postoperative wound infection.Methods: Patients undergoing elective surgeries for clean contaminated cases for various causes from 15th May 2014 to 15th June 2017 under Surgical 1st Unit of District hospital Gulbarga (Affiliated to Gulbarga Institute of Medical Sciences, Gulbarga) are included in our study. During this period, a total of 216 patients participated, of which 145 were males and 71 were females. Patients received two doses of perioperative antibiotics, first dose before surgery and second dose after surgery, 12 hours apart during this period.Results: In this study, surgical site infection rate is 2.3% in clean-contaminated surgeries.Conclusions: The findings indicate that a short course of perioperative antibiotics where in first dose is given 30 minutes to one hour before surgery and second dose is given 12 hours after surgery are sufficient and efficacious as infection rate is acceptable (1%-3%).Infection rate in our study was 2.3%. It is cost-effective as well for prevention of surgical site infections in clean-contaminated surgeries in Indian surgical setup.

scholarly journals A study of clinico-microbiological profile of surgical site infections in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 324
Author(s):  
Niharika Kochhal ◽  
Gargi Dangre Mudey ◽  
Sonali Zadbuke Choudhari
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Microbial Pathogens ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Site Infection ◽  
Clean Contaminated

Background: Surgical Site Infection (SSI) is the 3rd most commonly reported infection accounting for 14-16% of all Health care associated infections among hospitalized patients. Surgical Site Infections are responsible for an increased economic burden to healthcare systems, including additional postoperative hospital stay and costs. The present study was conducted in a tertiary care hospital to study the incidence, risk factors and associated pathogens of Surgical Site Infection.Methods: A total of 100 patients operated of clean and clean-contaminated surgeries from Orthopaedics, Surgery and Obstetrics and Gynaecology Department of AVBRH, Sawangi were included.Results: Overall infection rate was 6%. Patients in the age of above 71 years showed maximum rate of infection (14.28%) followed by 61 to 70 years (10%) and 51-60 years (10%). Surgical site infection rate was 4.65% (2/43) in clean operative wounds and 7.02% (4/57) in clean contaminated operative wounds. Escherichia coli and Klebsiella pneumonia were the most common organisms causing SSI. None of the risk factor was found significantly associated with the development of SSI.Conclusions: This study gave a better understanding of microbial pathogens of our institute which may have epidemiological and therapeutic implications. It will act as a pilot study to conduct further such larger research.

scholarly journals A study of surgical site infections with and without the use of pre-operative antibiotics

2019 ◽  
Vol 6 (10) ◽  
pp. 3806
Author(s):  
Arun Kumar Gupta ◽  
Seema Mittal ◽  
Tejinder Singh Dall ◽  
Darpan Bansal
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical Sciences ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Group A ◽  
Group B ◽  
Clean Contaminated

Background: In spite of advances in infection control, infection still remains the major limitor of surgical horizons. After urinary tract infection, surgical site infection is a main factor contributing to morbidity and mortality.Methods: The present study was carried out in the department of General Surgery and Microbiology at Shri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Sri Amritsar. In this study 100 patients were selected undergoing clean or clean contaminated surgeries out of which 50 patients were not given pre-operative antibiotics (first group) and remaining 50 patients (second group) were given preoperative antibiotics.Results: Sample consisted of 100 patients with mean age of patients was 36.97 years. Total number of males was 57 and females were 43. 25 (50%) of patients who had not received prophylaxis developed SSI (group A) and 28 (56%) patients who received prophylaxis developed SSI (group B). Most common bacteria isolated from SSI was Staphylococcus aureus for both the groups. 10 (52.63%) Gram positive bacteria were isolated from microscopic examination of infected sample (A) and 25 (73.52%) were gram negative bacteria. 25 (73.52%) were Gram positive bacteria in group (b) and 9 (26.47%) were Gram negative isolates.Conclusions: It can be concluded from the present study that there is no need to give antibiotic prophylaxis prior to surgery in order to reduce the incidence of surgical site infection.

scholarly journals A Randomized Control Trial Comparing Transparent Film Dressings and Conventional Occlusive Dressings for Elective Surgical Procedures

2019 ◽  
Vol 7 (17) ◽  
pp. 2844-2850 ◽  
Author(s):  
Moushira Hosny Ezzelarab ◽  
Omar Nouh ◽  
Ahmed Nabil Ahmed ◽  
Mervat Gaber Anany ◽  
Nevine Gamal El Rachidi ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Financial Burden ◽  
P Value ◽  
Diabetic Patients ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Gauze Dressing ◽  
Clean Contaminated ◽  
The Impact

BACKGROUND: Surgical site infection is one of the major health-care-associated problems causing substantial morbidity and mortality and constituting a financial burden on hospitals as well. The wound management is one of the crucial evidence-based strategies in the reduction of surgical site infection rates AIM: To study the impact of standardisation of transparent semipermeable dressing procedure on the rate of surgical site infection in comparison with conventional dressing in clean and clean-contaminated surgeries. METHODS: The study included 100 patients who were admitted to surgical wards in Cairo university hospitals, for clean and clean-contaminated operations, in the period from February 2017 to August 2017. Immunocompromised and uncontrolled diabetic patients were excluded. Patients were randomly allocated into two groups; in the first group, patients wounds were covered using transparent semipermeable dressing, while the second group patients’ wounds were covered using conventional occlusive gauze dressing. Patients were followed up for criteria of infection every other day during the first week then at two weeks, three weeks and four weeks. RESULTS: In clean and clean-contaminated operations, the transparent dressing group showed a significantly lesser rate of surgical site infection at (2%), compared with the conventional occlusive gauze dressing group with a surgical site infection rate of (14%) (p-value of 0.02). CONCLUSION: The transparent semipermeable dressing is effective in reducing surgical site infection rate in clean and clean-contaminated operations.

Surgical Site Infection Rate after Hemilaminectomy and Laminectomy in Dogs without Perioperative Antibiotic Therapy

2018 ◽  
Vol 31 (03) ◽  
pp. 202-213 ◽  
Author(s):  
Hugo Schmökel ◽  
Barbara Dyall
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Medical Records ◽  
Bacterial Resistance ◽  
Site Infection ◽  
Surgical Wounds ◽  
Superficial Wound ◽  
Single Centre Study ◽  
Perioperative Antibiotics ◽  
Low Incidence

Objective The aim of this study was to retrospectively review the surgical site infection (SSI) rate in dogs undergoing laminectomies without perioperative antibiotics, and compare those data with the expected infection rate for clean surgical wounds in dogs undergoing similar procedures. Methods This was a retrospective single-centre study composed of dogs that underwent hemilaminectomies or laminectomies for thoracolumbar disc herniation or lumbosacral disease during a 2-year period (during 2015 and 2016). All incisional complications within 30 days were recorded and divided into superficial, deep or organ/space infections. Those dogs that received perioperative or postoperative antibiotics due to non-related comorbidities and those with incomplete medical records during the study period were excluded. Results Of 221 consecutive hemilaminectomy and laminectomy procedures, 154 were included in this research study. One superficial wound infection was recorded and treated with antimicrobials. Overall, the SSI rate was 0.6%, while the expected SSI rate in clean operative wounds in dogs and cats is 2.0 to 4.8%. The SSI rate in human spinal surgery is 0.7 to 4.3%. Clinical Significance Considering the low incidence of SSI in our study group, the routine use of perioperative antibiotic prophylaxis in dogs undergoing laminectomy procedures should be reconsidered to help address the global problem of bacterial resistance.

scholarly journals An observational study of incidence of surgical site infections in gastrointestinal surgeries

2021 ◽  
Vol 8 (12) ◽  
pp. 3595
Author(s):  
Jenishkumar Vijaykumar Modi ◽  
Darshit Kalaria
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Surgical Site Infection Rate ◽  
Long Time ◽  
Surgery Department

Background: This study analysed the incidence of surgical site infections in gastrointestinal surgeries and its risk factors. so this study helped us in reducing surgical site infection by avoiding or minimizing that risk factors.Methods: The present study was conducted at general surgery department, SMIMER, Surat. An observational study of 400 cases that have undergone abdominal surgery in SMIMER hospital and were followed up from the day of operation to 30 days after discharge was done.Results: The overall infection rate for a total of the 400 cases was 17.25%. The incidence rate in this study was well within the infection rates of 2.8% to 17% seen in other studies. Different studies from India at different places have shown the SSI (surgical site infection) rate to vary from 6.09% to 38.7%.Conclusions: Our study reveals that though SSIs have been widely studied since a long time, they still remain as one of the most important causes of morbidity and mortality in surgically treated patients.

Quality improvement initiative: Preventative Surgical Site Infection Protocol in Vascular Surgery

Vascular ◽  
2017 ◽  
Vol 26 (1) ◽  
pp. 47-53 ◽  
Author(s):  
David Parizh ◽  
Enrico Ascher ◽  
Syed Ali Raza Rizvi ◽  
Anil Hingorani ◽  
Michael Amaturo ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Vascular Surgery ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Quality Improvement Initiative ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Patient Demographics ◽  
Revascularization Procedures

Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. Summary background data: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications. Methods Retrospective review was performed between 2012 and 2016 for all surgical site infections after revascularization procedures of the lower extremity. A quality improvement protocol was initiated in January 2015. Primary outcome was the assessment of surgical site infection rate reduction in the pre-protocol vs. post-protocol era. Secondary outcomes evaluated patient demographics, closure method, perioperative antibiotic coverage, and management outcomes. Results Implementation of the protocol decreased the surgical site infection rate from 6.4% to 1.6% p = 0.0137). Patient demographics and comorbidities were assessed and failed to demonstrate a statistically significant difference among the infection and no-infection groups. Wound closure with monocryl suture vs. staple proved to be associated with decreased surgical site infection rate ( p < 0.005). Conclusions Preventative measures, in the form of a standardized protocol, to decrease surgical site infections in the vascular surgery population are effective and necessary. Our data suggest that there may be benefit in the incorporation of MRSA and Gram-negative coverage as part of the Surgical Care Improvement Project perioperative guidelines.

Value-based purchasing may unfairly penalize specialty centers performing combined liver–colon multivisceral resections

2018 ◽  
Vol 23 (4) ◽  
pp. 143-148
Author(s):  
Ira L Leeds ◽  
Peter J Pronovost ◽  
J Matthew Austin ◽  
Elliott R Haut
Keyword(s):  
Linear Regression ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Risk Adjustment ◽  
Surgical Site Infections ◽  
Multivisceral Resection ◽  
Colon Surgery ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Value Based Purchasing

Background Some of the measures in value-based purchasing programs may be flawed due to inadequate risk adjustment. The purpose of this study was to examine the effect of the surgical casemix on surgical site infection rates using combined colectomy–hepatectomy resections as a test case. Methods We identified all adult patients undergoing elective colon surgery (2007–2013) in the National Inpatient Sample. We defined patients with a concurrent liver resection as “multivisceral resections.” Cases from each hospital were pooled by hospital identifier. The association between surgical site infection rate and the proportion of multivisceral resections performed was compared statistically. Findings were further tested for independence against hospital-level characteristics similar to risk-adjusted surgical site infection rate reporting. Results We identified 1014 hospitals performing 127,646 colon surgeries including 1168 (0.9%) multivisceral resections. The overall surgical site infection rate for multivisceral resection was 11.3% versus 1.6% for colectomy-only resections (p < 0.001). Simple linear regression demonstrated a 2.3% increase in a hospital’s surgical site infection rate for each 1% increase in the proportion of multivisceral resections performed. Multivariable linear regression demonstrated a preserved association. Conclusion A hospital’s rate of surgical site infections is positively associated with the proportion of multivisceral resections performed. Value-based purchasing programs should assess readily available data for further risk-adjustment inclusion.

scholarly journals Prevalence of surgical site infections and their sensitivity patterns in elective abdominal surgeries in King George Hospital, Visakhapatnam

2020 ◽  
Vol 7 (7) ◽  
pp. 2247
Author(s):  
Pratha Anantha Ramani ◽  
Simhadri Uday Kiran ◽  
Murali Manohar Deevi ◽  
Ginni Vijay Sainath Reddy ◽  
Ginjupalli Saichand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Wound Dressings ◽  
Site Infection ◽  
Antibiotic Resistant ◽  
Clean Contaminated ◽  
King George Hospital ◽  
A Prospective Study ◽  
Prolonged Hospital

Background: Surgical site infections are one of the most common complications in the postoperative period leading to increased morbidity, prolonged hospital stay and reduced quality of life. The present study aims to identify the incidence of surgical site infection (SSI), risk factors, causative organisms, and their sensitivity patterns in patients who have undergone elective abdominal surgeries.Methods: A prospective study containing 200 patients who have undergone elective abdominal surgeries from May 2018 to January 2020 were evaluated. A thorough history was taken in all the patients. A detailed clinical examination and routine investigations were done. Parameters such as body mass index (BMI), diabetic status, type of surgery, wound grading, culture, and sensitivity patterns were considered. The patients underwent treatment based on their investigatory reports.Results: In the present study, 54 patients developed surgical site infection, and among them, 22 are diabetics. Only ten patients with normal BMI developed SSI, whereas the other 44 patients who developed SSI had abnormal BMI. The incidence of SSI was higher in clean-contaminated surgeries comprising up to 89% of cases. Staphylococcus aureus was the most commonly isolated organism, and cefoperazone plus sulbactam was the most sensitive on antibiogram.Conclusions: The surgical site infections are on rising trend due to the emergence of antibiotic-resistant microorganisms. Treatment of the underlying risk factors, regular wound dressings, and antibiotics, according to sensitivity patterns, are the mainstay. 

scholarly journals Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city

2018 ◽  
Vol 5 (2) ◽  
pp. 784
Author(s):  
Vidit Goyal ◽  
Rituja Kaushal
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Site Infection ◽  
Infection Rates ◽  
Routine Surveillance ◽  
Epidemiologic Profile ◽  
Hospital Acquired

Background: Post-operative surgical site infections are deadlock for any successful surgery. This exigency triggers draining of extra resources for management of the quagmire. Methods: This prospective direct surveillance study based on incidence design was undertaken to gauge and estimate the nature of propensity of various surgical site infections in a tertiary care hospital over a period of twelve months. Results: Calculated cumulative SSI rate for the year 2016 was found to be 4.32%. Conclusions: It was concluded that a multidisciplinary approach integrating periodic training sessions on infection control, checklists based routine surveillance & following some benchmark etc. are the linchpin in controlling hospital acquired infections including surgical site infection rates in any clinical setting.

scholarly journals ASSESSMENT OF TWO OR MORE ANTIBIOTICS REGIMEN VERSUS ONE OR NO ANTIBIOTIC REGIMEN IN POST-OPERATIVE SURGERY

2017 ◽  
Vol 9 (10) ◽  
pp. 188
Author(s):  
Mihirkumar B. ◽  
Ashley S. ◽  
Nawaz S. ◽  
Surekha G. ◽  
Padmaa M. Paarakh
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Antibiotic Regimen ◽  
Female Patients ◽  
Operative Surgery ◽  
Group A ◽  
Group B ◽  
Surgery Department ◽  
Hospital Acquired

Objective: Surgical site infections [SSI] are the leading cause of hospital-acquired infections. The objective of this study was to evaluate whether surgical site infections can be reduced with two or more antibiotics regimen versus one or no antibiotic regimen in post-operative surgery.Methods: The patients were grouped into 2 groups. Group A (two or more antibiotics regimen) and Group B (one or no antibiotic regimen). Then the patients were followed on 1st, 2nd, 3rd and 4th week respectively after surgery to check for any surgical site infection by direct interviewing the patients. Results: The overall surgical site infection rate was 48.3 % (58 out of 120 patients). However, this study was more dominated by female patients–there were 63% female patients compared to 37 % male patients enrolled in this study. Also, the post-operative surgical site infection was comparatively observed more in female patients than in male. General surgery department too had many gynaecology related patients followed by Orthopaedic and Endocrinology surgeries. Results revealed that the patients in Group A (Two or more antibiotics) had significantly lower number of surgical site infections when compared with Group B (One or no antibiotics) with p<0.001.Conclusion: Our study concludes that patients receiving two or more antibiotics had significantly less number of post-operative surgical site infections when compared to patients receiving one or no antibiotics and following two or more antibiotics can reduce the excess hospital cost.

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