scholarly journals A comparative study on surgical site infections after primary closure and delayed primary closure in clean contaminated laparotomy cases

2019 ◽  
Vol 6 (3) ◽  
pp. 989
Author(s):  
T. J. Pauly ◽  
T. V. Haridas ◽  
E. Manoj Prabhakar ◽  
Roshjo Roshan
Keyword(s):  
Surgical Site Infection ◽  
Primary Closure ◽  
Surgical Site Infections ◽  
P Value ◽  
Skin Closure ◽  
Site Infection ◽  
Chi Square ◽  
Delayed Primary Closure ◽  
Laparotomy Wound ◽  
Clean Contaminated

Background: Surgical site infection is a significant cause of post operative morbidity. Timing of skin closure following a surgery and its relation to incidence of infection has been studied. The debate whether primary or delayed primary closure have been around for a long time. The aim of this study is to compare the rate of infection in a laparotomy wound in clean contaminated laparotomy cases after primary and delayed primary closure.Methods: 132 patients who underwent laparotomy for clean contaminated were selected. Of this primary closure of the skin was done in 66 cases and delayed primary closure at 48 hours were done in the other 66 patients. Wounds were followed up till post op day 7. The results between two groups were compared using chi square test.Results: two out of 66 cases developed SSI in the delayed primary sutured group whereas 8 out of 66 cases developed SSI in primary suturing group. The results were compared using chi square test and the chi square statistic was 3.8951 and the p value is 0.048428 (<0.05) proving the result significant.Conclusions: The incidence of surgical site infection in laparotomy wound after a primary closure was higher compared to delayed primary closure in clean contaminated laparotomy wounds and the difference is significant based on statistical evaluation.

scholarly journals Superficial Surgical Site Infection after Primary Closure Versus Delayed Primary Closure of Wound in Perforated Appendicitis

2021 ◽  
Vol 10 (02) ◽  
pp. 94-97
Author(s):  
Yabinda Sahrish ◽  
Zainab Abdullah Kaludi ◽  
Shamaila Ayub ◽  
Khurram Zia ◽  
Muhammad Athar Khan ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Primary Closure ◽  
Immunosuppressive Agents ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Signs And Symptoms ◽  
P Value ◽  
Site Infection ◽  
Delayed Primary Closure ◽  
Perforated Appendix

Objective: To assess the superficial surgical site infection after primary closure versus delayed primary closure of wound in perforated appendicitis. Study Design and Setting: This was an observational study conducted at Darul Sehat Hospital & Civil Hospital Karachi during March 2019 to August 2019 Methodology: All patients of either gender between 18-50 years of age undergoing open Appendectomy through standard gridiron incision in emergency having consented for participation in the study prior to surgery and with per-operative finding of perforated appendix in emergency were included. Patients on steroids or immunosuppressive agents, smoker staking 5 or more cigarettes per day, patients with history of Diabetes Mellitus, chronic liver disease and chronic renal failure were excluded from the study. Patients with perforated appendix were randomly allocated into two Groups. Group A received delayed primary closure at 3rd post-operative day while in Group B primary closure was done immediately after appendectomy. All patients were examined for signs and symptoms of superficial surgical site infection at the 5th postoperative day before discharge from the hospital. SPSS version 13 was used for data analysis. Chi square test was applied to compare the outcome (superficial surgical site infection) in both groups. P-value <0.05 was considered as significant. Results: A total sixty patients were allocated in each group. Wound infection was very high among patients with immediate closure (40%) as compared to group which received delayed primary closure (15%) (p=0.020). Conclusion: The superficial surgical site infection was significantly higher after primary closure versus delayed primary closure of wound in perforated appendicitis.

scholarly journals Surgical site infection among gynecological group: risk factors and postoperative effect

2018 ◽  
Vol 7 (3) ◽  
pp. 966 ◽  
Author(s):  
Sunanda Bharatnur ◽  
Vandana Agarwal
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Substantial Reduction ◽  
Postoperative Recovery ◽  
P Value ◽  
Site Infection ◽  
Continuous Variables ◽  
Chi Square ◽  
Mattress Suture ◽  
Clean Contaminated

Background: This study was carried out to evaluate the preoperative and intraoperative risk factors associated with surgical site infection amongst gynecology patients and its impact on postoperative recovery.Methods: A prospective, observational study was conducted among 285 patientsWho underwent surgery over a period of two years. Diagnosis of SSI was made as per CDC criteria. Various risk factors and impact of SSI on postoperative recovery were analysed. Statistical analysis was carried out with SPSS version 16.0. Range and mean was calculated for continuous variables and overall incidence rate of SSI is also calculated. Pearson Chi-square test was used to test risk factor association with SSI. Odds ratios and 95% confidence intervals (CI) was calculated. Significance was assumed at a p value of less than 0.05.Results: The incidence of SSI was found to be 52 out of 285 women (46%). Majority of SSI, i.e. 49 out of 52 (94%) were superficial in nature. Deep SSI was seen in 3 patients (6%). No organ/space infection was noted in any patient. Women who were over 50 years had higher risk of developing SSI than women between 36 to 50 years (OR 0.519 Vs 0.214). The risk of SSI was 4 times in case of clean contaminated wounds as compared to clean wounds (OR 3.877). The risk further increased to 7 times in case of dirty wounds (OR 6.753). Other risk factors which are significantly associated with SSI were BMI (p value <0.001), midline incisions (p <0.001) and Mattress suture (p <0.001). Presence of previous scar had intraoperative adhesions, weaker scar and poor healing which predispose to development of SSI. Comorbidities which influence SSI’s in the present study are diabetes mellitus (OR 5.49, 95% CI 2.506-12.066, P <0.001), anaemia (OR 4.63, Cl 2.458-8.756) and hypertension (OR 2.46, Cl 0.994-6.117). Wound swab was sterile in 33(63%) cases and 18(35%) cases showed growth of the organism. Most common organism noted was E. coli 9 (50%) followed by Klebsiella and Staph aureus.Conclusions: SSIs are increasing in the current scenario due to increase in the number of surgeries, however they can be prevented by early identification and optimization of medical comorbidities and BMI. Meticulous preoperative workup and intraoperative surgical steps are important in reducing the risk of developing SSI.  A decrease in infection rate can lead to substantial reduction in the burden of disease.

scholarly journals To Evaluate Povidone-iodine Effect On Post Appendectomy Surgical Site Infection

2018 ◽  
Vol 08 (04) ◽  
pp. 214-217
Author(s):  
Rizwanullah Junaid Bhanbhro ◽  
Khalil Ahmed Almani ◽  
Sadia Kazi ◽  
Navaid Kazi ◽  
Sumayya Kazi
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Povidone Iodine ◽  
University Hospital ◽  
P Value ◽  
Skin Closure ◽  
Site Infection ◽  
Chi Square ◽  
Female Population ◽  
Normal Wound Healing

Objective: Evaluating the effects of Povidone- Iodine against the surgical site infection in post- appendectomy wound infection. Study design: Randomized clinical trial Place and duration: Department of Surgery, Isra University Hospital Hyderabad from January 2016 to December 2017. Subjects and Methods: Patients of acute appendicitis with classical clinical presentation were selected according to inclusion and exclusion criteria. 60 patients were those in which wound was irrigated with 1% povidone-iodine solution versus 60 patients in whom wound not irrigated with it before skin closure. Data was analyzed on SPSS 22.0 using Student t-test and Chi- square test respectively. Data was analyzed at 95% confidence interval (P=0.05). P-value of =0.05 was taken statistically. Results: Mean ± SD age of control and cases was noted as 22.5 ± 7.5 and 23.5 ± 6.5 years respectively (P=0.86). Male and female population in control and cases were noted as 45 (75%) and 15 (25%) & 47 (78.33%) and 13 (21.66%) respectively (P >0.05). Grade 4 pus discharging wound infection was noted in 3.33% in control compared to 1.66% in cases (P= 0.87). Normal wound healing (grad 0) was noted in 37 (61.6%) and 43 (71.6%) of control and cases respectively. In control grade 1-4 lesions were noted in 38.4% compared to 28.4% in cases (P < 0.05). Conclusion: Simple irrigation of appendectomy wound with 1% povidone- iodine significantly prevents against the surgical site infection and pus formation

scholarly journals Tingkat Pengetahuan Ibu Tentang Perawatan Luka Dan Kejadian Infeksi Daerah Operasi Di RSUD Banyumas

2021 ◽  
Vol 6 (2) ◽  
pp. 75
Author(s):  
Utami Purwaningsih ◽  
Kris Linggardini
Keyword(s):  
Surgical Site Infection ◽  
Wound Care ◽  
Good Health ◽  
P Value ◽  
Wound Infections ◽  
Knowledge Level ◽  
Site Infection ◽  
Chi Square ◽  
Cross Sectional ◽  
The Relationship

Surgical Site Infection is infections that occur after surgery. Control of the incidence of nosocomial infection is part of the parameters of good health services at the hospital. One in 10 mothers who give birth by cesarean has an infection. The level of patient knowledge about how to care for wounds is an important factor in decreasing the incidence of wound infection in the surgical area in SC patients. Objective: knowing the relationship between levels of knowledge of post-operative SC patients about wound care and the incidence of surgical site wound infections. Method: The design used descriptive correlative and cross sectional approach. The sample were 76 respondents. The data were collected in December 2019 by using a knowledge level questionnaire and a form of signs of infection from Morison 2004. Data analysis using chi square).  The results showed that there was a relationship between knowledge and the incidence of infection in the area of ​​operation (p value 0.001).  Keywords: nosocomial, surgical site infection (SSI), section caesarea (SC) 

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 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 Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections

2019 ◽  
Vol 09 (02) ◽  
pp. e167-e171 ◽  
Author(s):  
Benjamin Harris ◽  
Maeve Hopkins ◽  
Margaret Villers ◽  
Jeremy Weber ◽  
Carl Pieper ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Surgical Site Infections ◽  
Type I ◽  
Site Infection ◽  
Beta Lactam ◽  
Postpartum Visit ◽  
Chi Square ◽  
Lower Odds ◽  
Logistic Regression Models

Objective To examine the association between perioperative Beta (β))-lactam versus non-β-lactam antibiotics and cesarean delivery surgical site infection (SSI). Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β-lactam versus non-β-lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders. Results Of the 929 women included, 826 (89%) received β-lactam prophylaxis and 103 (11%) received a non-β-lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β-lactam prophylaxis. SSI occurred in 7% of women who received β-lactam antibiotics versus 15% of women who received a non-β-lactam (p = 0.004). β-Lactam prophylaxis was associated with lower odds of SSI compared with non-β-lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22–0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI). Conclusion β-Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non-β-lactam antibiotics.

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.

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