A STUDY OF SURGICAL SITE INFECTION AFTER GASTROINTESTINAL SURGERY

Background: Surgical site infection (SSI) is one of the most common complications of abdominal surgery. The goal of this study was to evaluate the surgical site infection in patients undergoing gastrointestinal surgery. Methods: This prospective study was conducted on100 patients of all age group and both sexes undergoing gastrointestinal surgery were analysed for surgical site infection. Result: 42 (21.00%) developed SSI post operatively, 13 patients developed SSI in the period of 3–4 days postoperatively, 21 patients developed the infection in the period of 5–6 days postoperatively, and 8 developed the infection one week after the operation. Most of SSI cases (95.24%) were detected during hospital stay periods and the remaining cases were detected in the post-discharge follow-ups. Superficial SSI was the most common type of SSIs (92.86%). Conclusion: The results showed a high prevalence of SSI among patients attending the gastrointestinal tract surgical unit and it was associated with the malignant diseases, intraoperative blood loss, intra-operative hypotension, presence of surgical drains, and long operative duration. Keywords: Infection, Gastrointestinal, Surgery

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Clinical outcome of V-Y flap with latissimus dorsi and gluteal advancement for treatment of large thoracolumbar myelomeningocele defects: a comparative study

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.1.peds18232 ◽

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.

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Factors Influencing the Outcome of Intestinal Anastomosis

The American Surgeon ◽

10.1177/000313481107700929 ◽

2011 ◽

Vol 77 (9) ◽

pp. 1169-1175 ◽

Cited By ~ 12

Author(s):

Juan J. LujÁN ◽

ZoltÁN H. NÉMeth ◽

Patricia A. Barratt-Stopper ◽

Rami Bustami ◽

Vadim P. Koshenkov ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Blood Loss ◽

Surgical Site Infection ◽

Bowel Disease ◽

Intestinal Anastomosis ◽

Significant Risk ◽

Left Colon ◽

Site Infection ◽

Intraoperative Blood Loss ◽

Inflammatory Bowel

Anastomotic leak (AL) is one of the most serious complications after gastrointestinal surgery. All patients aged 16 years or older who underwent a surgery with single intestinal anastomosis at Morristown Medical Center from January 2006 to June 2008 were entered into a prospective database. To compare the rate of AL, patients were divided into the following surgery-related groups: 1) stapled versus hand-sewn, 2) small bowel versus large bowel, 3) right versus left colon, 4) emergent versus elective, 5) laparoscopic versus converted (laparoscopic to open) versus open, 6) inflammatory bowel disease versus non inflammatory bowel disease, and 7) diverticulitis versus nondiverticulitis. We also looked for surgical site infection, estimated intraoperative blood loss, blood transfusion, comorbidities, preoperative chemotherapy, radiation, and anticoagulation treatment. The overall rate of AL was 3.8 per cent. Mortality rate was higher among patients with ALs (13.3%) versus patients with no AL (1.7%). Open surgery had greater risk of AL than laparoscopic operations. Surgical site infection and intraoperative blood transfusions were also associated with significantly higher rates of AL. Operations involving the left colon had greater risk of AL when compared with those of the right colon, sigmoid, and rectum. Prior chemotherapy, anticoagulation, and intraoperative blood loss all increased the AL rates. In conclusion, we identified several significant risk factors for ALs. This knowledge should help us better understand and prevent this serious complication, which has significant morbidity and mortality rates.

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2: Improving post-discharge surveillance of surgical site infection following cesarean section

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2015.09.035 ◽

2015 ◽

Vol 213 (6) ◽

pp. 896-897

Author(s):

J. Van Schalkwyk ◽

F. Wong ◽

N. Prestley ◽

S. Dhillon ◽

A. Albert ◽

...

Keyword(s):

Cesarean Section ◽

Surgical Site Infection ◽

Site Infection ◽

Post Discharge

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The Incidence of Surgical Site Infection in Acute Non Perforated Appendicitis

Journal of Chitwan Medical College ◽

10.3126/jcmc.v9i2.24525 ◽

2019 ◽

Vol 9 (2) ◽

pp. 11-14

Author(s):

Suraj Raj Bhattarai ◽

Kishor Kumar Tamrakar

Keyword(s):

Single Dose ◽

Surgical Site Infection ◽

Perforated Appendicitis ◽

College Teaching ◽

Cross Sectional Study ◽

Age Group ◽

Site Infection ◽

Cross Sectional ◽

Significant Difference ◽

Group Sex

Background: Appendectomy is the most commonly performed emergency surgical procedure and has significant morbidity of surgical site infection (SSIs). Regarding this, there are conflicting reports and dilemma on use of optimal duration of antibiotics. The aim of this study was to evaluate the incidence of SSIs after three doses of perioperative prophylactic antibiotics (single dose before surgery and two doses postoperatively) after appendectomy in acute non- perforated appendicitis (NPA). Methods: This cross sectional study was conducted in the department of General surgery, Chitwan Medical College Teaching Hospital, from May 2018 to April 2019. All the cases received single dose of antibiotics (ceftriaxone and metronidazole) during the induction of anesthesia and two doses of the same antibiotics postoperatively within 24 hours. SSIs was assessed on 2nd and followed up till 7th postoperative day. The data collected was analyzed using SPSS version 16. Results: In the study of 100 patients, who received perioperative three doses of antibiotics, the overall frequency of SSIs on 2nd and 3rd post-operative day were 2% (p=.840) and 6% (p=.539) respectively, which was statistically not significant. In follow up after 3rd postoperative day, there was no evidence of SSIs. Statistically there was no significant difference in the incidence and grade of SSIs between age group, sex and duration of operation. Conclusions: A combined three doses of perioperative antibiotics was adequate for SSIs prevention in patients of any age group and sex with acute NPA after appendectomy in usual operative time.

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Surgical site infection in Laparoscopic versus Open appendicectomy

Journal of Nobel Medical College ◽

10.3126/jonmc.v7i2.22306 ◽

2018 ◽

Vol 7 (2) ◽

pp. 39-43

Author(s):

Ashok Koirala ◽

Dipendra Thakur ◽

Sunit Agrawal ◽

Bhuwan Lal Chaudhary ◽

Sagar Poudel

Keyword(s):

Acute Appendicitis ◽

Surgical Site Infection ◽

Age Groups ◽

Laparoscopic Appendicectomy ◽

Surgical Removal ◽

Age Group ◽

Site Infection ◽

Open Appendicectomy ◽

Number Of Patients ◽

The Mean

Background: Acute appendicitis is very common surgical cause of acute abdomen and needs surgical removal either by laparoscopic or open appendicectomy. The aim of this study is to compare frequency of surgical site infection (SSI) in patients undergoing laparoscopic and open appendicectomy. Materials and Methods: The study was prospective study conducted in NMCTH, Biratnagar. Total 200 patients with diagnosis of acute appendicitis admitted through the emergency department of our hospital were included in the study. The patients were randomly allocated in two groups: Laparoscopic appendicectomy group (LA) and Open appendicectomy group (OA). Both groups underwent successful emergency appendicectomy. Wound infections in terms of surgical site infection (SSI) if present were recorded. All age groups and both sexes were included. Results: Two hundred patients underwent appendicectomy, one hundred Laparoscopic appendicectomy (LA) and another hundred open appendicectomy (OA). The mean age of patients with acute appendicitis was 30.63±16.14 years with minimum of 6 years and maximum of 77 years. The highest number of patients were in age group of 10 to 20 years (29.5%). In LA group SSI noted in 3 patients (3%) whereas in OA group it was found in 12 patients (12%). Conclusion: Laparoscopic appendicectomy is better and offers great advantages in terms of SSI as compared to Open appendicectomy.

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