scholarly journals Role of intraoperative wound irrigation with antibiotics in reducing surgical site infection in patients undergoing contaminated and dirty midline laparotomy surgical wound: a pilot study

2018 ◽  
Vol 5 (7) ◽  
pp. 2595
Author(s):  
Sandhiya P. ◽  
Sureshkumar S. ◽  
Vijayakumar C. ◽  
Palanivel C.
Keyword(s):  
Pilot Study ◽  
Surgical Site Infection ◽  
Rectus Sheath ◽  
Control Group ◽  
Site Infection ◽  
Surgical Wound ◽  
Wound Irrigation ◽  
Midline Laparotomy ◽  
The Difference ◽  
Length Of Hospitalization

Background: This study was carried to assess the effect of antibiotic wound irrigation in reducing the surgical site infection (SSI) in the patients undergoing midline laparotomy with contaminated and dirty surgical incision wound.Methods: All patients operated with class-IV- dirty and class III (contaminated) abdominal operative wound according to CDC (Centre for Disease Control and Prevention) were included in this pilot study. Study patients were divided into antibiotic irrigation group and control group. In control group, after rectus sheath closure, the wound was irrigated with 100 mL of normal saline before the skin closure. In antibiotic irrigation group, after rectus sheath closure, the wound was irrigated with Ceftriaxone (10 mL) and Metronidazole (100 mL). Incidence of SSI, degree of SSI and length of hospitalization were compared between two groups.Results: A total of 40 patients were included in the study, 20 in each group. Both the groups were comparable with respect the age, gender, co-morbidities and class of surgical wound. The incidence of SSI was lesser [10% versus 35%; p=0.06] in the antibiotic irrigation group compared to control group. However, the difference was not statistically significant. The length of hospitalization between the groups were comparable [13.5 versus 14.7 days; p=0.74]. The pain score was also not significantly different between the two groups.Conclusions: On comparing to saline irrigation, antibiotic irrigation in patients with contaminated and dirty operative wound results in a lesser SSI with comparable hospital stay and postoperative pain. However, the difference was not statistically significant. 

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

scholarly journals Superiority trial comparing intraoperative wound irrigation with aqueous 10% povidone–iodine to saline for the purpose of reducing surgical site infection after elective gastrointestinal surgery: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051374
Author(s):  
Ryo Maemoto ◽  
Hiroshi Noda ◽  
Kosuke Ichida ◽  
Sawako Tamaki ◽  
Rina Kanemitsu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Povidone Iodine ◽  
Medical Center ◽  
Controlled Trial ◽  
Gastrointestinal Surgery ◽  
Control Group ◽  
Site Infection ◽  
Wound Irrigation ◽  
Target Number ◽  
Medical University

IntroductionSurgical site infection (SSI) is one of the most common complications after gastrointestinal surgery, with a reported incidence of approximately 10%–25%, which is higher than the rates after other types of surgery. Intraoperative wound irrigation (IOWI) is a simple intervention for SSI prevention, and recent studies have reported that IOWI with aqueous povidone–iodine (PVP-I) is significantly more effective at reducing the incidence of SSI than saline. However, the evidence level of previous trials evaluating the efficacy of aqueous PVP-I solution for preventing SSI has been low.Methods and analysesWe propose a single-institute, prospective, randomised, blinded-endpoint trial to assess the superiority of IOWI with aqueous 10% PVP-I solution compared with normal saline for reducing SSI in clean-contaminated wounds after elective gastrointestinal surgery. In the study group, IOWI with 40 mL of aqueous 10% PVP-I solution is performed for 1 min before skin suture, and in the control group, IOWI with 100 mL of saline is performed for 1 min before skin suture. We hypothesise that IOWI with aqueous 10% PVP-I solution will achieve a 50% reduction in the incidence of SSIs. The target number of cases is set at 950. The primary outcome is the incidence of incisional SSI up to postoperative day 30 and will be analysed in the modified intention-to-treat set.Ethics and disseminationThis trial was designed and is being conducted by Saitama Medical Center, Jichi Medical University, with approval from the Bioethics Committee for Clinical Research, Saitama Medical Center, Jichi Medical University. Participant recruitment began in June 2019. The final results will be reported in international peer-reviewed journals immediately after trial completion.Trial registration numberUMIN000036889.

Influence of early postoperative showering in undressed surgical wound for better clinical outcome

2019 ◽  
Vol 30 (6) ◽  
pp. 163-169
Author(s):  
Anuradha Jayathilake ◽  
Jayaweera Arachchige Asela Sampath Jayaweera ◽  
Wikum Widuranga Kumbukgolla ◽  
Sudheera Herath
Keyword(s):  
Surgical Site Infection ◽  
Tap Water ◽  
Tendon Repair ◽  
Control Group ◽  
Site Infection ◽  
Surgical Wound ◽  
Breast Lump ◽  
Surgical Wounds ◽  
Clean Environment ◽  
Clean Contaminated

Surgeons instruct the patients to avoid postoperative bathing and dress the wounds until the sutures are removed. All wounds were sutured at the end of surgery and kept undressed. Participants received a tap water body bath where the water covered the wound after 24h of surgery. The control group were asked not to wet the dressed surgical site until wound inspection on days 3 and 5. The patients were followed up in the surgery clinic on days 14 and 30 after surgery, when age, sex and type of surgery-matched controls’ surgical site infection was significantly high in clean/contaminated and contaminated appendicectomy, breast lump excision, inguinal herniotomy and tendon repair surgeries. In contaminated appendicectomy, clean/contaminated and contaminated herniotomies postsurgical infections other than surgical site infection were significantly low in test groups. Early mobilisation, keeping the surgical wounds moist and providing a clean environment are suitable to minimise the surgical wound and other associated infections.

The effects of information platform-based nursing on preventing venous thromboembolism (VTE) in patients with hip fractures (Preprint)

2020 ◽  
Author(s):  
Yuan Gao ◽  
Xiaojie Fu ◽  
Mingxing Lei ◽  
Pengbin Yin ◽  
Qingmei Wang ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Subgroup Analysis ◽  
Nursing Intervention ◽  
Control Group ◽  
Study Group ◽  
Drug Compliance ◽  
Information Platform ◽  
The Difference ◽  
Length Of Hospitalization

BACKGROUND Mobile apps are becoming increasingly relevant to health care. Apps have been used to improve symptoms, quality of life, and adherence for oral drugs in patients with cancers, pregnancy, or chronic diseases, and the results were satisfying . OBJECTIVE This study aims to develop an information platform with the help of a mobile app and then evaluate whether information platform-based nursing can improve patient’s drug compliance and reduce the incidence of VTE in patients with hip fractures. METHODS We retrospectively analyzed hip fracture patients performed with traditional prevention and intervention of VTE (control group) between January 2008 and November 2012, and prospectively analyzed hip fracture patients conducted with nursing intervention based on the information platform (study group) between January 2016 and September 2017. The information platform can be divided into medical and nursing care end and the patient’s end. Based on the information platform, we could implement risk assessments, monitoring management and early warnings, preventions and treatments, health educations, follow-up and other aspects of nursing interventions for patients. We compared basic characteristics, outcomes including drug compliance, VTE occurrence, and mean length of hospitalization between the two groups. Besides, a subgroup analysis was performed in the study group according to different drug compliances. RESULTS Regarding baseline data, patients in the study group had more morbidities than those in the control group (P<0.05). The difference of drug compliance between the two groups was statistically significant (P<0.001): 64.7% of the patients in the control group had poor drug compliance and only 6.1% patients had poor drug compliance in the study group. In terms of VTE, 126 patients (10.7%) in the control group had VTE, while only 35 patients (7.1%) in the study group had VTE, and the difference was statistically significant (P=0.024). Moreover, the average length of hospitalization in the study group was also significantly lower than that in the control group (10.4 d vs. 13.7 d, P=0.000). Subgroup analysis of the study group showed that the incidence of VTE in patients with non-compliance, partial compliance, and good compliance was 56.7%, 5.8% and 2.8%, respectively (P=0.000). CONCLUSIONS Poor drug compliance leads to higher VTE occurrence. The information platform-based nursing can effectively improve the compliance of patients with hip fracture and thus significantly reduce the incidence of VTE.

scholarly journals Surgical Site Infection and Analytic Morphometric Assessment of Body Composition in Patients Undergoing Midline Laparotomy

2011 ◽  
Vol 213 (2) ◽  
pp. 236-244 ◽  
Author(s):  
Jay S. Lee ◽  
Michael N. Terjimanian ◽  
Lindsay M. Tishberg ◽  
Abbas Z. Alawieh ◽  
Calista M. Harbaugh ◽  
...  
Keyword(s):  
Body Composition ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Midline Laparotomy ◽  
Morphometric Assessment

Compare the Incidence of Surgical Site Infection after Appendectomy Wound Irrigation with Normal Saline and Imipenem Solutions

2021 ◽  
Vol 15 (8) ◽  
pp. 2184-2186
Author(s):  
Ahmad Shah ◽  
Nazeer Ahmad Sasoli ◽  
Farrukh Sami
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Saline Solution ◽  
Abscess Formation ◽  
Site Infection ◽  
Wound Irrigation ◽  
Group I ◽  
Perforated Appendix ◽  
The Mean ◽  
Group Ii

Objective: To compare the incidence of surgical site infection after appendectomy wound irrigation with regular saline solution and imipenem solution. Study Design: Comparative randomized control trial Place and Duration of Study: Department of Surgery Unit-1, Sandeman Provincial Hospital Quetta from 1st September 2020 to 30th April 2021. Methodology: Eighty patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients underwent for appendectomy wound irrigation were included. Patients were equally divided into two equal groups, I and II. Group I had 40 patients and received imipenem and group II irrigated with saline solution with 40 patients. Outcomes were surgical site infection, deep abscess formation was observed post-operatively. Results: The mean age of the patients in group I was 26.11±2.03 years with mean BMI 23.61±3.32 kg/m2 and in group II mean age was 25.14±3.12 years with mean BMI 22.14±4.88 kg/m2. In group I, 32 (80%) patients had inflamed appendix, perforated appendix was in 7 (17.5%) and gangrenous appendix in 1 (2.5%) while in group II inflamed appendix in 34 (85%), perforated appendix in 4 (10%) and gangrenous appendix 2 (5%). Surgical site infection in group I was 3 (7.5%) and abscess formation in 2 (5%) cases while in group II SSI in 6 (15%) and abscess formation in 3 (7.5%) cases. Conclusion: Imipenem irrigation after appendectomy reduces wound infection. Healthcare costs and patient suffering due to infection can be reduced. Keywords: Imipenem solution, Wound irrigation with saline, Appendectomy wound infection

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 Using Sensor Graphs for Monitoring the Effect on the Performance of the OTAGO Exercise Program in Older Adults

Sensors ◽  
2022 ◽  
Vol 22 (2) ◽  
pp. 493
Author(s):  
Björn Friedrich ◽  
Carolin Lübbe ◽  
Enno-Edzard Steen ◽  
Jürgen Martin Bauer ◽  
Andreas Hein
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Exercise Program ◽  
Exercise Programme ◽  
Control Group ◽  
Motion Sensors ◽  
Surrogate Variable ◽  
Physical Sensor ◽  
The Difference ◽  
Positive Effect

The OTAGO exercise programme is effective in decreasing the risk for falls of older adults. This research investigated if there is an indication that the OTAGO exercise programme has a positive effect on the capacity and as well as on the performance in mobility. We used the data of the 10-months observational OTAGO pilot study with 15 (m = 1, f = 14) (pre-)frail participants aged 84.60 y (SD: 5.57 y). Motion sensors were installed in the flats of the participants and used to monitor their activity as a surrogate variable for performance. We derived a weighted directed multigraph from the physical sensor network, subtracted the weights of one day from a baseline, and used the difference in percent to quantify the change in performance. Least squares was used to compute the overall progress of the intervention (n = 9) and the control group (n = 6). In accordance with previous studies, we found indication for a positive effect of the OTAGO program on the capacity in both groups. Moreover, we found indication that the OTAGO program reduces the decline in performance of older adults in daily living. However, it is too early to conclude causalities from our findings because the data was collected during a pilot study.

Sign in / Sign up

Export Citation Format

Share Document