scholarly journals Study the early complications of modified radical mastectomy performed

2018 ◽  
Vol 6 (1) ◽  
pp. 239 ◽  
Author(s):  
Naman Chandrakar ◽  
Raju K. Shinde
Keyword(s):  
Surgical Site Infection ◽  
Radical Mastectomy ◽  
Wound Dehiscence ◽  
Cancer Registries ◽  
Site Infection ◽  
Modified Radical Mastectomy ◽  
Carcinoma Breast ◽  
Medical College ◽  
History Of ◽  
Jawaharlal Nehru

Background: According to the national and regional cancer registries, breast cancer is the most common cancer among women in Delhi, Mumbai, Kolkata, Ahmadabad and Thiruvananthapuram.Methods: The present Prospective and observational study was conducted in the Department of Surgery of Acharya Vinoba Bhave Rural Hospital attached to Jawaharlal Nehru Medical College.  Forty-one patients of carcinoma breast were treated with modified radical mastectomy from September 2013 to September 2015.Results: The mean age of cases was 50.90 years with a standard deviation of 11.61 years. only 1 male patient (2.44%) was diagnosed with carcinoma breast and 40 female patients (97.56%) out of 41 total cases. In all the 41 cases (100%) chief complaint was lump in breast, followed by axillary swelling in 11 cases (26.83%) and history of pain (in lump) in 8 cases (19.51%). ecchymosis of the flap was seen in 8 patients (19.51%).  The 10 cases (24.39) had surgical site infection, Minimal seroma collection (<10ml) was seen in 9 cases. 3 cases (7.32%) had pain at the surgical site. Tissue necrosis was observed in 7 cases (17.07%).Conclusions: It was concluded that Post-operative complications of MRM included wound dehiscence, seroma, surgical site infection, hematoma, altered sensation and pain.

scholarly journals The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya

2021 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
General Hospital ◽  
Radical Mastectomy ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Modified Radical Mastectomy ◽  
Significant Difference

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

scholarly journals Experience with modified radical mastectomy in a low-income country: a multi-center prospective observational study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giziew Bawoke ◽  
Segni Kejela ◽  
Abebe Alemayehu ◽  
Girmaye Tamirat Bogale
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Observational Study ◽  
Surgical Site Infection ◽  
Low Income ◽  
Prospective Observational Study ◽  
Radical Mastectomy ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Modified Radical Mastectomy ◽  
Retroviral Infections

Abstract Background Modified radical mastectomy is the procedure of choice in centers with little to no radiotherapy services. Studying the in-hospital outcome and complications associated with the procedure is important in low-income countries. Methods This is a multi-center prospective observational study involving all patients operated with modified radical mastectomy with curative intent. Results A total of 87 patients were studied with 10.3% of which were male and 54% were between the age of 30–49 years. Clinical stage IIB and IIIA were reported in 33 (37.9%) and 25 (28.7%) respectively and 62.1% had clinically positive lymph nodes at presentation. All of the studied patients underwent curative surgery, with an average lymph node dissection of 10.2 ± 0.83. Seroma rate was 17.2% and was significantly associated with diabetes (AOR: 6.2 (CI 1.5–8.7)) and neoadjuvant chemotherapy (AOR: 8.9 (CI 1.2–14.2)). Surgical site infection occurred in 14.9% and was significantly associated with Retroviral infections (AOR: 4.2 (CI 2.1–5.8)) and neoadjuvant chemotherapy (AOR: 1.8 (CI 1.3–3.9)). No in-hospital mortality occurred during the course of the study. Conclusion Seroma rate was lower than published studies while surgical site infections rate was higher. Neoadjuvant chemotherapy was associated with increase in seroma and surgical site infection rates. Additionally, diabetes increased the rate of seroma. Surgical site infections were higher in patients with retroviral infections.

scholarly journals Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical College ◽  
Related Risk ◽  
Microbiological Methods ◽  
Duration Of Surgery ◽  
History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

scholarly journals The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya

2020 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
General Hospital ◽  
Radical Mastectomy ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Modified Radical Mastectomy ◽  
Significant Difference

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

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.

scholarly journals Risk factors for deep surgical site infection following thoracolumbar spinal surgery

2020 ◽  
Vol 32 (2) ◽  
pp. 292-301 ◽  
Author(s):  
Hansen Deng ◽  
Andrew K. Chan ◽  
Simon G. Ammanuel ◽  
Alvin Y. Chan ◽  
Taemin Oh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Spine Surgery ◽  
Thoracolumbar Spine ◽  
Hospital Length Of Stay ◽  
Site Infection ◽  
Asa Classification ◽  
Estimated Blood Loss ◽  
History Of ◽  
The Mean

OBJECTIVESurgical site infection (SSI) following spine surgery causes major morbidity and greatly impedes functional recovery. In the modern era of advanced operative techniques and improved perioperative care, SSI remains a problematic complication that may be reduced with institutional practices. The objectives of this study were to 1) characterize the SSI rate and microbial etiology following spine surgery for various thoracolumbar diseases, and 2) identify risk factors that were associated with SSI despite current perioperative management.METHODSAll patients treated with thoracic or lumbar spine operations on the neurosurgery service at the University of California, San Francisco from April 2012 to April 2016 were formally reviewed for SSI using the National Healthcare Safety Network (NHSN) guidelines. Preoperative risk variables included age, sex, BMI, smoking, diabetes mellitus (DM), coronary artery disease (CAD), ambulatory status, history of malignancy, use of preoperative chlorhexidine gluconate (CHG) showers, and the American Society of Anesthesiologists (ASA) classification. Operative variables included surgical pathology, resident involvement, spine level and surgical technique, instrumentation, antibiotic and steroid use, estimated blood loss (EBL), and operative time. Multivariable logistic regression was used to evaluate predictors for SSI. Odds ratios and 95% confidence intervals were reported.RESULTSIn total, 2252 consecutive patients underwent thoracolumbar spine surgery. The mean patient age was 58.6 ± 13.8 years and 49.6% were male. The mean hospital length of stay was 6.6 ± 7.4 days. Sixty percent of patients had degenerative conditions, and 51.9% underwent fusions. Sixty percent of patients utilized presurgery CHG showers. The mean operative duration was 3.7 ± 2 hours, and the mean EBL was 467 ± 829 ml. Compared to nonfusion patients, fusion patients were older (mean 60.1 ± 12.7 vs 57.1 ± 14.7 years, p < 0.001), were more likely to have an ASA classification > II (48.0% vs 36.0%, p < 0.001), and experienced longer operative times (252.3 ± 120.9 minutes vs 191.1 ± 110.2 minutes, p < 0.001). Eleven patients had deep SSI (0.49%), and the most common causative organisms were methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus. Patients with CAD (p = 0.003) or DM (p = 0.050), and those who were male (p = 0.006), were predictors of increased odds of SSI, and presurgery CHG showers (p = 0.001) were associated with decreased odds of SSI.CONCLUSIONSThis institutional experience over a 4-year period revealed that the overall rate of SSI by the NHSN criteria was low at 0.49% following thoracolumbar surgery. This was attributable to the implementation of presurgery optimization, and intraoperative and postoperative measures to prevent SSI across the authors’ institution. Despite prevention measures, having a history of CAD or DM, and being male, were risk factors associated with increased SSI, and presurgery CHG shower utilization decreased SSI risk in patients.

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.

scholarly journals Delayed Primary Closure of Wound Prevents Wound Infection after Surgery in Patients with Obstructive Jaundice

2020 ◽  
Vol 14 (1) ◽  
pp. 37-40
Author(s):  
Md Aslam Hossain ◽  
Md Julfiqur Rahman Khan ◽  
SM Rokonuzzaman ◽  
Md Maniruzzaman Khan ◽  
Md Mobaraque Hossain Khan ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Surgical Site Infection ◽  
Wound Infection ◽  
Primary Closure ◽  
Wound Dehiscence ◽  
Control Group ◽  
Site Infection ◽  
Septic Complications ◽  
Delayed Primary Closure ◽  
Experimental Group

Surgery in jaundiced patients is associated with a higher risk of postoperative complications compared with surgery in non jaundiced patients. These complications primarily consists of septic complications, hemorrhage, superficial surgical site infection (SSSI), wound dehiscence and renal disorders. Of them Surgical Site Infection (SSI) is found more commonly than other. This study was done to evaluate the effect of delayed primary closure on preventing wound infection than that of primary closure of wound after surgery in patients with obstructive jaundice. This randomized clinical trial was carried out at the Hepatobiliary and Pancreatic division of Department of Surgery in Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2012 to June 2013. A total of 88 patients were included in this study who underwent surgical intervention for obstructive jaundice. These patients were divided into two groups randomly; control group (n=44) who underwent primary closure of the wound and experimental group (n=44) who underwent delayed primary closure of the wound. Patients demography, clinical presentation, comorbidities, pre, per and post operative variables and outcome were compared between two groups. Mean age of the patients of experimental and control group was 47.91± 14.63 and 42.25±12.13 years respectively. Duration of jaundice was significantly higher in experimental group 4.91±2.87 months than in control group 3.10±1.62 months. Postoperative wound infection was found significantly higher in control group (43.2%) than that of experimental group (11.4%). Postoperative hospital stay was significantly longer in control group (18.77± 6.24 days) than in experimental group (13.52±3.61 days). Delayed primary closure of wound reduces wound infection significantly than primary closure of wound in patients with obstructive jaundice. Faridpur Med. Coll. J. Jan 2019;14(1): 37-40

scholarly journals Role of hyperoxygenation on surgical site wound infection: a randomised case control study

2019 ◽  
Vol 6 (8) ◽  
pp. 2927
Author(s):  
Samba Siva Rao G. ◽  
Kiran Kumar Suggala
Keyword(s):  
Surgical Site Infection ◽  
Case Control Study ◽  
Elective Surgery ◽  
Randomized Study ◽  
Control Group ◽  
Site Infection ◽  
Medical College ◽  
Induction Of Anaesthesia ◽  
Control Study

Background: The aim of this study was to assess the influence of hyperoxygenation on surgical site wound infections.Methods: Using prospective randomized study, conducted from January 2018 to December 2018 at Mamata Medical College and General hospital, Khammam. This study includes 100 patients who were going for elective surgery at various divisions of Department of surgery. Patients were assigned randomly to an oxygen/air mixture with a faction of inspiration (FiO2) of 30% (n=50) and 60% (n=50). Administration was started after induction of anaesthesia and maintained for 3hours after surgery.Results: Surgical site infection was recorded in 5 patients (2 of 50, 10%) in the hyperoxygenation group and 11 patients (11 of 50, 22%) in the control group (p<0.05). Time of hospitalization was 5±3 days in the hyperoxygenation group and 9±4 days in the control group (p<0.05).Conclusions: Hyperoxygenation was associated with a reduction in surgical site infection. It also decreases the duration of hospital stay and decreases economic burden.

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