scholarly journals Predictive Factors of Surgical Site Infection in Prosthetic Joint Surgery. A Prospective Study on 760 Arthroplasties.

2021 ◽  
Author(s):  
Martina Maritati ◽  
Alessandro Trentini ◽  
Davide Chemello ◽  
Elisa Mazzoni ◽  
Gustavo Zanoli ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Site Infection ◽  
Surgical Suture ◽  
Group A ◽  
Group B

Abstract Purpose: Surgical site infection (SSI) is a debilitating complication of total joint arthroplasty (TJA) with significant morbidity and increased costs. Aim of our study was to identify potential risk factors for SSIs in a population of patients undergoing TJA. Methods: TJA were prospectively recruited at Santa Maria Maddalena Hospital from February 2019 to April 2020. Age, sex, major comorbidities, American Society of Anesthesiologists (ASA) class, length of surgery, type of surgical suture, total hospital length of stay and clinical laboratory data were collected. The study population was then divided into two groups: Group A, normal post-operative course, and Group B, patients who developed SSI at follow-up (17-25 days).Results: 25/760 (3.3%) patients developed SSIs at follow-up. Clinical and demographic parameters were not different between the two groups. Total leucocyte and neutrophil values at discharge resulted to be significatively higher in Group B compared to Group A (p=0.025 and p=0.016, respectively). Values of 7860/mL for total leucocyte, and 5185/mL for neutrophil count at discharge significantly predicted the future development of SSI (AUC 0.623 and AUC 0.641, respectively; p<0.05) independently from confounding factors (total leukocytes: O.R.=3,69 [95% C.I. 1,63-8,32]; neutrophils: O.R.=3,98 [95% C.I. 1,76-8,97. Deep SSIs has been diagnosed significantly before superficial SSIs (p=0,008), with a median advance of 9 days. Conclusion: Total leukocytes and neutrophils at discharge seem useful to identify a population at risk for the development of SSIs following TJA. Further studies on larger populations are needed to develop a predictive SSIs risk score that should include those variables.

scholarly journals Comparative study of single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for pediatric inguinal herniotomy

2021 ◽  
Vol 7 (3) ◽  
pp. 134-139
Author(s):  
Pinaki Ranjan Debnath ◽  
Arnab Kumar Saha ◽  
Rashmi D ◽  
Vasu Gautam ◽  
Chetna Khanna ◽  
...  
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Wound Care ◽  
Oral Antibiotic ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Inguinal Herniotomy

To compare single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for the pediatric inguinal herniotomy.The present study was conducted on 100 patients of elective inguinal herniotomy from January 2019 to April 2020 and compared on the basis of single dose preoperative antibiotic versus five days antibiotic course. All the patients were evaluated on the 3rd, 7th and 28th post-operative period and instructions were given to the guardians about wound care and to attend for early follow up if any signs & symptoms of wound infection appear.50% of the patients were treated with prophylactic single dose antibiotic, i.e. inj. Ceftriaxone (30 mg/kg/dose) at the time of induction only and rest 50% were treated with inj. Ceftriaxone(30mg/kg/dose) at the time of induction as well as postoperatively at night followed by four days of oral antibiotic with Syr/Tablet. Cephalexin (25mg/kg/day) three times daily for another 4 days.Surgical Site Infection (SSI) in Group-B (4.0%) was higher than that of Group-A (2.0%) on day 3 but it was not significant (p=0.40). There was no significant difference in health status of the patients of the two groups when compared on post-operative day 7 and day 28 (p=0.99, p=0.99 respectively).Implementation of single dose antibiotic prophylaxis regimes tailored to the prevalent organisms in the institution can result in enormous savings, as the study shows significant reduction in hospital stay with no significant increase in incidence of SSI.

scholarly journals Topical vancomycin: Does it reduce surgical site infection in bone tumors?

2017 ◽  
Vol 06 (03) ◽  
pp. 099-101
Author(s):  
Suman Byregowda ◽  
Ajay Puri ◽  
Ashish Gulia
Keyword(s):  
Surgical Site Infection ◽  
Bone Tumors ◽  
Site Infection ◽  
Perioperative Antibiotics ◽  
Deep Surgical Site Infection ◽  
Group A ◽  
Wound Discharge ◽  
Group B ◽  
Closure Group

Abstract Introduction: We retrospectively analyzed a consecutive group of patients operated for bone tumors of extremity and pelvis who received only perioperative antibiotics (Group A) against a similar group that had additional 1 g topical vancomycin sprinkled in the wound before closure (Group B). The aim was to determine if the addition of topical vancomycin decreases the incidence of deep surgical site infection (SSI). Materials and Methods: A total of 221 patients operated between January 2011 and December 2011 were analyzed in Group A and 254 patients operated between April 2012 and March 2013 were analyzed in Group B. Any patient who required operative intervention for wound discharge was considered to be infected. All patients had a 1 year follow-up to determine the incidence of SSI. Results: The overall rate of SSI was 7% (31 of 475 patients). Seventeen (8%) of Group A patients had SSI as against 14 (6 %) of Group B patients (P = 0.337). A subgroup analysis of endoprosthetic reconstructions, internal fixation implants (plates/intramedullary nails), extracorporeal radiation treated bones and strut allografts showed no difference between the two groups of patients. Conclusion: Our data suggest that the addition of topical vancomycin before wound closure in patients operated for bone tumors does not decrease the incidence of SSI. Further investigation of this technique using a case–controlled methodology with an increase in the dose of vancomycin may be warranted.

Comparison of Frequency of Surgical Site Infection with or without Bile Spillage during Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (6) ◽  
pp. 1449-1452
Author(s):  
M. Asif ◽  
L. A. Deokah ◽  
R. N. Malik
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Controlled Trial ◽  
Operational Definition ◽  
Study Group ◽  
Site Infection ◽  
Group A ◽  
Group B ◽  
Bile Spillage

Aim: To compare the frequency of surgical site infection with or without bile spillage during Laparoscopic Cholecystectomy. Methods: This randomized controlled trial was conducted at Department of Surgery, M. Islam Medical and Dental College Gujranwala from March 2020 to September 2020 over the period of 6 months. Total 68 pppatients of acute cholecystitis (as per operational definition) undergoing laparoscopic cholecystectomy either male or female having age from 20 60 years with duration of gal stone (single or multiple) ≥ 6 months were selected. After 2 weeks follow-up, surgical site infection was assed. Results: Mean age of the patients was 39.90 ± 12.04, mean age of patients of study group A was and B was 38.88 ± 13.01 and 40.91 ± 11.08 years respectively. Comparison of frequency of surgical site infection was done between both groups. In study group A (spillage group), SSI was found in 12 (35.29%) patients while in study group B (without spillage group), SSI was noted in 4 (11.76%) patients. Difference of frequency of SSI between the study group A and B was statistically significant (P = 0.022). Conclusion: Results of present study showed that surgical site infection is mostly occurred in patients with spillage of bile during Laparoscopic Cholecystectomy. Most of the patients were belonged to 3rd and 4th decade of life. Significantly higher rate of surgical site infection was noted in female patients of spillage of bile group. Keywords: Bile spillage, Laparoscopic Cholecystectomy, gall bladder, surgical site infection

Video-Assisted Thoracoscopic Surgery as a Primary Intervention in Pediatric Parapneumonic Effusion and Empyema

2010 ◽  
Vol 76 (9) ◽  
pp. 957-961 ◽  
Author(s):  
Christopher R. Schneider ◽  
Michael W.L. Gauderer ◽  
Dawn Blackhurst ◽  
John C. Chandler ◽  
Randel S. Abrams
Keyword(s):  
Thoracoscopic Surgery ◽  
Fluid Collection ◽  
Laboratory Data ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Video Assisted ◽  
Thoracic Drainage ◽  
Group A ◽  
Group B ◽  
Video Assisted Thoracoscopic Surgery

The use and effectiveness of video-assisted thoracoscopic surgery (VATS) for the treatment of empyema and complex parapneumonic collections in pediatric patients is well documented. Timing of this intervention still remains controversial. We reviewed our experience with VATS to determine if it should be used as the initial procedure in children with pleural collections. We reviewed all pediatric (age younger than 17 years) patients with a diagnosis of pneumonia admitted between July 1998 and June 2008. Demographics, comorbidities, laboratory data, and hospital length of stay (LOS) were evaluated. Patients were divided into groups: those who only had thoracentesis or thoracostomy (Group A), those who underwent a procedure and then required VATS (Group B), and those who went directly to VATS (Group C). We identified 382 patients admitted with pneumonia. Of these, 79 (21%) required a thoracic drainage procedure. Overall, 49 (67%) of patients with a thoracic fluid collection underwent VATS at some point. With regard to type of intervention, there was no statistical difference noted in clinical variables. Thirty (38%) patients were in Group A, 18 (22%) in Group B, and 31 (39%) in Group C. LOS for Group C (10.5 days) was significantly ( P < 0.05) shorter than for both Group A (14.8 days) and Group B (15 days). Only two (6%) patients required conversion to open thoracotomy. A high percentage of children initially treated by tube thoracostomy eventually require additional interventions, leading to increased LOS. As a result of its simplicity, safety, and efficacy, VATS pleural evacuation can be recommended as the initial intervention in pediatric parapneumonic effusions and empyema in patients who do not require emergent drainage.

scholarly journals Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial

2018 ◽  
Vol 5 (4) ◽  
pp. 1438
Author(s):  
Aditya N. Patil ◽  
Veerendra M. Uppin
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Intravenous Route ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Open Appendicectomy ◽  
Group A ◽  
Group B

Background: Surgical site infection (SSI) is one of the most common postoperative complications following abdominal surgeries. Whilst the use of prophylactic antibiotics has been shown to reduce postoperative wound infection, controversy still remains as to the optimum route of administration and the duration of treatment. This study aims to compare the efficacy of a preoperative single dose of a cephalosporin antibiotic (cefotaxime) administered intraincisionally versus that administered intravenously, in preventing postoperative surgical site infections following appendicectomy.Methods: Sixty consecutive cases diagnosed as uncomplicated appendicitis who consented for open appendicectomy at a tertiary care institute were included in the study. Cases were randomized to 2 comparable groups of 30 patients each. Preoperatively, patients in Group A received a single dose of Inj. Cefotaxime 1g intraincisionally while those in Group B received the same intravenously. Incision sites were examined every alternative day starting on postoperative day 3 until removal of sutures. Signs of surgical site infection, if any, were recorded and outcomes were statistically tested for significance.Results: One patient in Group A (3.3%) and 4 patients in Group B (13.3%) showed signs of postoperative surgical site infection (p >0.05) during the follow up period which prolonged their hospital stay.Conclusions: This study showed that a single dose preoperative intraincisional administration of cefotaxime was as effective as intravenous administration for prevention of postoperative surgical site infection after open appendicectomy. Although the difference was not statistically significant, there was a reduced incidence of SSI in individuals who received intraincisional antibiotic. These results are encouraging for a way forward in reducing unnecessary burdening of systemic antibiotics in patients undergoing abdominal surgeries. 

scholarly journals 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Túlio Alves Jeangregório Rodrigues ◽  
Guilherme Fernandes de Oliveira ◽  
Júlia G C Dias ◽  
Laís Souza Campos ◽  
Letícia Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Exploratory Laparotomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Site Infection ◽  
The Impact

Abstract Background Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of SSI in the hospital length of stay and hospital mortality? (c) What are risk factors for SSI after exploratory abdominal surgery? Methods A retrospective cohort study assessed meningitis and risk factors in patients undergoing exploratory laparotomy between January 2013 and December 2017 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. 26 preoperative and operative categorical and continuous variables were evaluated by univariate and multivariate analysis (logistic regression). Outcome variables: Surgical site infection (SSI), hospital death, hospital length of stay. Variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%. Results A sample of 6,591 patients submitted to exploratory laparotomy was analyzed (SSI risk = 4.3%): Hospital length of stay in noninfected patients (days): mean = 16, median = 6, std. dev. = 30; hospital stay in infected patients: mean = 32, median = 22, std. dev. = 30 (P < 0.001). The mortality rate in patients without infection was 14% while hospital death of infected patients was 20% (P = 0.009). Main risk factors for SSI: ügeneral anesthesia (SSI = 4.9%, relative risk – RR = 2.8, P < 0.001); preoperative hospital length of stay more than 4 days (SSI=3.9%, RR=1.8, P = 0.003); wound class contaminated or dirty (SSI = 5.4%, RR = 1.5, P = 0.002); duration of procedure higher than 3 hours (SSI = 7.1%, RR = 2.1, P < 0.001); after trauma laparotomy (SSI = 7.8%, RR = 1.9, P = 0.001). Conclusion We identified patients at high risk of surgical site infection after exploratory laparotomy: trauma patients from contaminated or dirty wound surgery, submitted to a procedure with general anesthesia that last more than 3 hours have 13% SSI. Patients without any of these four risk factors have only 1.2% SSI. Disclosures All authors: No reported disclosures.

scholarly journals Abdominal Wound Closure in Gynaecological or Obstetrical Surgery with Vicryl® (Polyglactin910) Versus Vicryl Plus® (Polyglactin910 with Triclosan Added): A Comparative Study

2019 ◽  
Vol 17 (1) ◽  
pp. 10-12
Author(s):  
Binod Kumar Mahaseth
Keyword(s):  
Surgical Site Infection ◽  
Surgical Complication ◽  
College Teaching ◽  
Controlled Study ◽  
Skin Closure ◽  
Site Infection ◽  
Comparative Efficacy ◽  
Group A ◽  
Group B ◽  
Johnson Company

Background: Surgical site infection is the most common post-surgical complication in surgical patients. The incidence of surgical site infection varies from 3-20% (or even more) in different part of the world. To date, the best method and material for skin closure has not been recommended by anybody. Triclosan is an antiseptic agent used for coating a suture material to prevent the infections. This case-controlled study was carried out to determine the comparative efficacy of sutures; Objective: This case-controlled study was carried out to determine the comparative efficacy of sutures: vicryl® and vicryl plus® (triclosan, an antiseptic incorporated with suture), in reducing surgical site infection in laparotomy for clean Gyn/Obs operations. Material and method: This case-controlled study was carried out in Dept. Of Gynae/Obs at Nepalgunj Medical College Teaching Hospital, Kohalpur. The period of the study was from Jan 2018 to January 2019. A total of 50 participants were enrolled in the study, who met the inclusion criteria. The patients were divided into two groups A and B, each consisting of 25 patients. The patients were allocated in the groups alternately to remove bias. The Group A consisted of patients where Vicrylplus® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 with triclosan) was used and Group B consisted of patients where vicryl ® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 alone) was used. Patients whose abdominal wounds were found infected, pus swab for culture were taken and sent for aerobic culture and sensitivity. All patients received ceftriaxone and metronidazole single dose before operations prophylactically. Result: Surgical site infection ingroup A was 3 cases out of 25 (12%) and in group B it was 6 cases out of 25(24%). Triclosan added polyglactin910 suture found to be statistically non significant concerning prevention of SSI as compared to polyglactin910 (p=0.472). The mean age of the study population was in group A was (29.76±7.47) and in group B was (27.12±7.42).

Surgical Site Infection After Pediatric Cardiothoracic Surgery

2016 ◽  
Vol 8 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Anthony A. Sochet ◽  
Alexander M. Cartron ◽  
Aoibhinn Nyhan ◽  
Michael C. Spaeder ◽  
Xiaoyan Song ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Heart Surgery ◽  
Hospital Costs ◽  
Congenital Heart Surgery ◽  
Hospital Length ◽  
Cardiothoracic Surgery ◽  
Hospital Length Of Stay ◽  
Published Data ◽  
Site Infection

Background: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. Methods: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure. Results: Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01). Conclusions: Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.

scholarly journals Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study

2019 ◽  
Vol 6 (1) ◽  
pp. 106
Author(s):  
M. Bharath ◽  
J. R. Galagali ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
E. Nikhilesh
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Prophylactic Use ◽  
Group B ◽  
Clean Contaminated

<p class="abstract"><strong>Background:</strong> Many clinicians continue to use antibiotic prophylaxis routinely in all surgical procedures, ignoring the guidelines issued by policy makers. In this prospective study we compared the rate of surgical site infection (SSI) in patients who received prophylactic antibiotics as a routine; with the rate of SSI in patients getting antibiotics strictly as per SIGN 104 Guidelines, for clean and clean contaminated procedures.</p><p class="abstract"><strong>Methods:</strong> The study population comprised 235 patients. Group A consisted of 119 patients having 77 (65%) males and 42 (35%) females while Group B had 116 patients - 71 (61%) males and 45 (39%) females. Group A received routine antibiotic prophylaxis in all cases, while Group B received antibiotic prophylaxis as per SIGN 104 guidelines only. Both the groups were followed up for one month post-operatively for SSI and complications.</p><p class="abstract"><strong>Results:</strong> SSI occurred in 2 patients (1.68%) in Group A and in 3 (2.59%) patients in Group B. There was no significant difference in the rate of SSI between the two groups (p=0.68). Procedure wise maximum SSI occurred in tympanoplasty and laryngectomy. Due to infection one case of tympanoplasty had graft failure and one case of laryngectomy had delayed wound healing. No major complications related to infection or antibiotic use occurred in either group.</p><p class="abstract"><strong>Conclusions:</strong> Selective use of antibiotic prophylaxis as per SIGN 104 Guidelines does not lead to increase in SSI in clean and clean contaminated ENT procedures.</p>

scholarly journals A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 253 ◽  
Author(s):  
Pramod Singh ◽  
Sumit Kumar Gupta ◽  
Mukesh Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
City Hospital ◽  
Site Infection ◽  
First Choice ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

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