scholarly journals Role of topical vancomycin in reduction of postoperative infections in head trauma patients: A developing country experience

2021 ◽  
Vol 12 ◽  
pp. 600
Author(s):  
Ahmed Atallah ◽  
Mohammad Elbaroody ◽  
Ahmed A. Aziz N. Hassan ◽  
Ahmed M. Ali ◽  
Mohamed E. Elhawary
Keyword(s):  
Developing Countries ◽  
Head Trauma ◽  
Financial Burden ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Outcome Variable ◽  
Trauma Patients ◽  
Wound Infections ◽  
Operative Care ◽  
Vancomycin Powder

Background: Postoperative cranial wound infections are a major cause of morbidity, mortality, and financial burden, especially in developing countries. Methods: We prospectively studied 86 patients in a randomized trial; 39 patients received one gram of topical vancomycin powder in the subgaleal space while 47 matched control patients did not. Both groups received identical intraoperative and post-operative care. The primary outcome variable was the postoperative wound infections rate factored by cohort. Secondary outcomes were the timing of infection and the rate of adverse events. Results: Adding topical vancomycin was associated with a significantly lower rate of infection than the standard of care alone (2.6% [1/39] vs. 14.9% [7/47], P =.004). No adverse reactions occurred. Conclusion: Topical vancomycin is safe, and effective in the prevention of surgical site infections following craniotomy. These findings have broad consequences for neurosurgery practice, especially in developing countries with high incidence of head trauma.

155 Topical Vancomycin Reduces Surgical-site Infections After Craniotomy: A Prospective, Controlled Study

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 238-238
Author(s):  
Kalil G Abdullah ◽  
Arka Mallela ◽  
Andrew Richardson ◽  
Timothy H Lucas
Keyword(s):  
Cohort Study ◽  
Hospital Costs ◽  
Secondary Analysis ◽  
Cost Savings ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Potential Method ◽  
Outcome Variable ◽  
Controlled Study ◽  
Neurosurgical Patients

Abstract INTRODUCTION Surgical site infections are an important cause of morbidity and mortality in neurosurgical patients. Topical antibiotics are one potential method to reduce the incidence of these infections. This study examined the efficacy of topical vancomycin applied within the wound during craniotomy in a large prospective cohort study at a major academic center. METHODS 355 patients were studied prospectively in this cohort study. 205 patients received 1 g of topical vancomycin powder in the subgaleal space while 150 matched control patients did not. Patients otherwise received identical care. The primary outcome variable was surgical-site infection rate factored by cohort. Secondary analysis examined cost-savings from vancomycin usage estimated from hospital costs associated with SSI in craniotomy patients. RESULTS >The addition of topical vancomycin was associated with a significantly lower rate of surgical site infections than standard of care alone (0.49% (1/205) vs. 6% (9/150), P = 0.002). Based on the costs of revision surgery for infections, topical vancomycin usage was estimated to save $1367,446 per 1000 craniotomy patients. No adverse reactions occurred. CONCLUSION Topical vancomycin is a safe, effective, and cost-saving measure to prevent surgical-site infections following craniotomy. These results have broad implications for standard of care in craniotomy.

scholarly journals Topical Vancomycin Reduces Surgical-Site Infections After Craniotomy: A Prospective, Controlled Study

Neurosurgery ◽  
2017 ◽  
Vol 83 (4) ◽  
pp. 761-767 ◽  
Author(s):  
Arka N Mallela ◽  
Kalil G Abdullah ◽  
Cameron Brandon ◽  
Andrew G Richardson ◽  
Timothy H Lucas
Keyword(s):  
Cohort Study ◽  
Hospital Costs ◽  
Secondary Analysis ◽  
Cost Savings ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Potential Method ◽  
Outcome Variable ◽  
Controlled Study ◽  
Neurosurgical Patients

Abstract BACKGROUND Surgical-site infections (SSIs) are an important cause of morbidity and mortality in neurosurgical patients. Topical antibiotics are one potential method to reduce the incidence of these infections. OBJECTIVE To examine the efficacy of topical vancomycin applied within the wound during craniotomy in a large prospective cohort study at a major academic center. METHODS Three hundred fifty-five patients were studied prospectively in this cohort study; 205 patients received 1 g of topical vancomycin powder in the subgaleal space while 150 matched control patients did not. Patients otherwise received identical care. The primary outcome variable was SSI rate factored by cohort. Secondary analysis examined cost savings from vancomycin usage estimated from hospital costs associated with SSI in craniotomy patients. RESULTS The addition of topical vancomycin was associated with a significantly lower rate of SSI than standard of care alone (0.49% [1/205] vs 6% [9/150], P = .002). Based on the costs of revision surgery for infections, topical vancomycin usage was estimated to save $1367 446 per 1000 craniotomy patients. No adverse reactions occurred. CONCLUSION Topical vancomycin is a safe, effective, and cost-saving measure to prevent SSIs following craniotomy. These results have broad implications for standard of care in craniotomy.

scholarly journals Postoperative spine infections

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Paolo Domenico Parchi ◽  
Gisberto Evangelisti ◽  
Lorenzo Andreani ◽  
Federico Girardi ◽  
Lebl Darren ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wound Infection ◽  
Web Of Science ◽  
Financial Burden ◽  
Surgical Site Infections ◽  
Wound Infections ◽  
Medical Databases ◽  
Incidence Risk ◽  
Postoperative Spine ◽  
Modern Era

Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of post-operative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases <em>Pubmed</em>, <em>Google</em> <em>Scholar</em>, <em>Web of Science</em> and <em>Scopus</em> for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication.

Olfactory Function in Head Trauma Patients a Link to Frontal Brain Damage?

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
V. Schriever ◽  
T. Hummel ◽  
K. Grosser ◽  
M. Smitka
Keyword(s):  
Brain Damage ◽  
Head Trauma ◽  
Olfactory Function ◽  
Trauma Patients ◽  
Frontal Brain

scholarly journals Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing

2021 ◽  
Vol 6 (1) ◽  
pp. e000779
Author(s):  
Sebastian Casu
Keyword(s):  
Major Trauma ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Standard Of Care ◽  
Trauma Team ◽  
Trauma Patients ◽  
Treatment Protocols ◽  
Treatment Algorithms ◽  
Number Of Treatment ◽  
Uncontrolled Bleeding

Uncontrolled bleeding after major trauma remains a significant cause of death, with up to a third of trauma patients presenting with signs of coagulopathy at hospital admission. Rapid correction of coagulopathy is therefore vital to improve mortality rates and patient outcomes in this population. Early and repeated monitoring of coagulation parameters followed by clear protocols to correct hemostasis is the recommended standard of care for bleeding trauma patients. However, although a number of treatment algorithms are available, these are frequently complex and can rely on the use of viscoelastic testing, which is not available in all treatment centers. We therefore set out to develop a concise and pragmatic algorithm to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing. The algorithm we present here is based on published guidelines and research, includes recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow. In this way, we have demonstrated that treatment protocols can be developed and adapted to the resources available, to offer clear and relevant guidance to the entire trauma team.

scholarly journals 291 Pre-Operative Venepuncture: An Audit of The Trauma and Orthopaedic Department at The Royal Sussex County Hospital, Brighton

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Harris ◽  
T Antonio ◽  
A Hagiga ◽  
D Crone
Keyword(s):  
Major Trauma ◽  
Elective Surgery ◽  
Financial Burden ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Inclusion Criteria ◽  
Blood Testing ◽  
Orthopaedic Department ◽  
Minor Surgery ◽  
Routine Coagulation

Abstract Background NICE recommends that patients undergoing intermediate or minor elective surgery do not need routine coagulation or transfusion blood testing unless they are ASA 3+ or taking anticoagulation mediation, where testing may be considered. Currently there is no guidance for trauma patients. Method We identified all patients that underwent intermediate or minor trauma and orthopaedic surgery within a three-month period from December 2019- February 2020 at the RSCH. We excluded major trauma patients, patients taking anticoagulants and patients with complex admission or past medical history. Computer records were used to identify pre-operative investigations and admission history. Results 843 patients met our inclusion criteria. In total, 92 clotting studies and 200 transfusion samples were taken preoperatively. The majority of tests were for patients undergoing ankle 130/292 (45%) or Tibia/Fibula 54/292 (18%) procedures. This equates to approximately 1168 blood tests per year. Based on the lab cost of £15.97 for a transfusion sample and £18 for a coagulation sample, this is a cost of approximately £19,616 each year on blood testing that is not indicated. Discussion We hope that by presenting these results we will help reduce the unnecessary time and financial burden of routine venipuncture in departments undertaking intermediate and minor surgery.

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