scholarly journals EMERGENCY LAPAROTOMY;

2017 ◽  
Vol 24 (06) ◽  
pp. 808-811
Author(s):  
Ch. Muhammad Atif Niaz ◽  
Awais Talib ◽  
Yasir Sultan ◽  
Asim Shahzad Niazi
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care ◽  
Primary Data ◽  
Emergency Laparotomy ◽  
Care Hospital ◽  
Site Infection ◽  
Increased Risk ◽  
Deep Surgical Site Infection ◽  
Male Patients ◽  
Hospital Study

Objectives: Emergency laparotomy followed by placement of drain is acommon procedure in tertiary care hospitals but there are contradictory evidences regardingits association with deep surgical site infection. Thus current study was planned with anobjective to compare the frequency of deep surgical site infection among patients with andwithout postoperative drains after undergoing an emergency laparotomy at a tertiary carehospital. Data source: Primary data based on patients undergoing emergency laparotomy attertiary care hospital. Study design: Randomized control trial. Setting: Department of surgicalunit-III, Jinnah Hospital Lahore. Duration of study: Study was conducted from January 2016to December 2016. Subjects & methods: About 400 patients of 15-70 years undergoingemergency laparotomy were selected using non-probability consecutive sampling techniqueafter informed consent. Information regarding their demographic characteristics and studyvariable was recorded in a structured proforma. All the subjects were randomized into twogroups i.e. with and without post-operative drains using table of random number. Frequencyof deep surgical site infection was assessed on 7th post operative day and data was analyzedusing SPSS version 21.0. Result: The mean age of patients was 38.92 ± 6.246 years withabout 229(57.2%) male patients. The frequency of development of deep surgical site infectionin first postoperative week was 51(12.7%) overall, with 24(12%) patients in the group of postoperativedrains and 27(13.5%) patients without post-operative drains. The differences betweentwo groups were statistically insignificant. Moreover, it was not significantly related to the age,gender, duration of stay in the hospital and smoking. Conclusion: It can be concluded from thestudy that there is no significantly increased risk of deep surgical site wound infection with orwithout placement of drain. So it is reasonable and safe approach to place a drain in the woundfor the early detection of bleeding or leakage to decrease the morbidity and complication in thepatients.

scholarly journals Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section

2008 ◽  
Vol 29 (6) ◽  
pp. 477-484 ◽  
Author(s):  
Margaret A. Olsen ◽  
Anne M. Butler ◽  
Denise M. Willers ◽  
Preetishma Devkota ◽  
Gilad A. Gross ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
University Teaching ◽  
Skin Closure ◽  
Care Hospital ◽  
Site Infection ◽  
Increased Risk ◽  
Independent Risk Factors

Background.Independent risk factors for surgical site infection (SSI) after cesarean section have not been well documented, despite the large number of cesarean sections performed and the relatively common occurrence of SSI.Objective.To determine independent risk factors for SSI after low transverse cesarean section.Design.Retrospective case-control study.Setting.Barnes-Jewish Hospital, a 1,250-bed tertiary care hospital.Patients.A total of 1,605 women who underwent low transverse cesarean section during the period from July 1999 to June 2001.Methods.Using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for SSI or wound complication and/or data on antibiotic use during the surgical hospitalization or at readmission to the hospital or emergency department, we identified potential cases of SSI in a cohort of patients who underwent a low transverse cesarean section. Cases of SSI were verified by chart review using the definitions from the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System. Control patients without SSI or endomyometritis were randomly selected from the population of patients who underwent cesarean section. Independent risk factors for SSI were determined by logistic regression.Results.SSIs were identified in 81 (5.0%) of 1,605 women who underwent low transverse cesarean section. Independent risk factors for SSI included development of subcutaneous hematoma after the procedure (adjusted odds ratio [aOR], 11.6 [95% confidence interval {CI}, 4.1–33.2]), operation performed by the university teaching service (aOR, 2.7 [95% CI, 1.4–5.2]), and a higher body mass index at admission (aOR, 1.1 [95% CI, 1.0–1.1]). Cephalosporin therapy before or after the operation was associated with a significantly lower risk of SSI (aOR, 0.2 [95% CI, 0.1–0.5]). Use of staples for skin closure was associated with a marginally increased risk of SSI.Conclusions.These independent risk factors should be incorporated into approaches for the prevention and surveillance of SSI after surgery.

Surgical site infection in colorectal surgeries: Experience in tertiary care hospital

2015 ◽  
Vol 12 ◽  
pp. S11
Author(s):  
Afshan Anjum Wani ◽  
Nisar Ahmad Chowdri ◽  
Fazal Q. Parray ◽  
Rouf A. Wani
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection

scholarly journals Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

2020 ◽  
Vol 27 (4) ◽  
pp. E202043
Author(s):  
Aamir Hussain Hela ◽  
Haseeb Mohammad Khandwaw ◽  
Rahul Kumar ◽  
Mir Adnan Samad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Bile Duct ◽  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Site Infection ◽  
The Mean

Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder.  It is estimated that approximately 90% of cholecystectomies in the  United States are performed using a laparoscopic approach.  The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital.  Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%).  Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.

Indices of Surgical Site Infection Risk and Prediction of Other Adverse Outcomes During Hospitalization

2006 ◽  
Vol 27 (08) ◽  
pp. 825-828 ◽  
Author(s):  
Miguel Delgado-Rodríguez ◽  
Silvia Palma ◽  
Antonio Gómez-Ortega ◽  
Gabriel Martínez-Gallego ◽  
Marcelino Medina-Cuadros
Keyword(s):  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Roc Curve ◽  
Tertiary Care ◽  
Hospital Death ◽  
Consecutive Series ◽  
Care Hospital ◽  
Site Infection ◽  
Postsurgical Outcomes ◽  
Better Than

Objective.To assess which adverse postsurgical outcomes are best predicted by the Study on the Efficacy of Nosocomial Infection Control (SENIC) index and the National Nosocomial Infection Surveillance system (NNIS) index.Design.Prospective cohort study.Setting.The service of general surgery at a tertiary care hospital.Patients.A consecutive series of patients hospitalized for more than 1 day (n= 2,989).Results.The outcome best predicted by the SENIC and NNIS indices was assessed by estimating the area under the receiver operating characteristic (ROC) curve. The areas under the ROC curves for nosocomial infection and in-hospital death were higher for the NNIS index than they were for the SENIC index (P<.05). The NNIS index predicted in-hospital death better than it predicted surgical site infection (area under the ROC curve ± SE, 0.836 ± 0.022 vs 0.689 ± 0.017;P= .001).Conclusions.The NNIS index is superior to the SENIC index for all adverse postsurgical outcomes. Its ability to predict in-hospital mortality is clearly better than its ability to predict surgical site infection.

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