ROLE OF SUBCUTANEOUS SUCTION DRAIN IN REDUCING SURGICAL SITE INFECTIONS AFTER EMERGENCY LAPAROTOMY AT SKMCH, MUZAFFARPUR, BIHAR

2021 ◽  
pp. 54-55
Author(s):  
Sanjay Kumar ◽  
Kumar Vikram ◽  
Manoj Kumar ◽  
Debarshi Jana
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
P Value ◽  
Emergency Laparotomy ◽  
Emergency Setting ◽  
Site Infection ◽  
Randomised Study ◽  
Medical College ◽  
Suction Drain ◽  
Drain Group

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous uids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed. Methods: A prospective interventional study of 100 subjects done in department of surgery at Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. On the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play signicant role in reducing the incidence of surgical site infection which is signicant statistically. Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically signicant. Conclusions: Subcutaneous drain in emergency laparotomy play signicant role in reducing the incidence of surgical site infection

scholarly journals Role of subcutaneous suction drain in reducing surgical site infections after emergency laparotomy

2017 ◽  
Vol 4 (8) ◽  
pp. 2717
Author(s):  
Poonam Gupta ◽  
Rajesh Kumar
Keyword(s):  
Surgical Site Infection ◽  
Significant Role ◽  
Surgical Site Infections ◽  
P Value ◽  
Emergency Laparotomy ◽  
Emergency Setting ◽  
Site Infection ◽  
Randomised Study ◽  
Suction Drain ◽  
Drain Group

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous fluids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed.Methods: A prospective interventional study of 100 subjects done in department of surgery at rural tertiary centre. on the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play significant role in reducing the incidence of surgical site infection which is significant statistically.Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically significant.Conclusions: Subcutaneous drain in emergency laparotomy play significant role in reducing the incidence of surgical site infection

scholarly journals Post-operative surgical site infection among general surgery patients: Rate and risk factors.

2021 ◽  
Vol 28 (09) ◽  
pp. 1276-1281
Author(s):  
Shahid Nazir Memon ◽  
Shehzada Ameer Ahmed Babar ◽  
Sarwat Sultana ◽  
Sulhera Khan ◽  
Amir Hussain Khan ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
General Surgery ◽  
Surgical Site Infections ◽  
High Rate ◽  
P Value ◽  
Emergency Setting ◽  
Site Infection ◽  
Emergency Case ◽  
Cross Sectional

Objectives: High rate of post-surgical infections are reported with scanty effort for controlling them. The objectives were to evaluate frequency of surgical site infections in patients undergoing general surgery. Study Design: Cross Sectional Observational Study. Setting: Naz Memorial Hospital. Period: March 2019 to March 2020. Material & Methods: This study was conducted in general surgery ward for 1 year. All patients over 18 years admitted in surgery ward either as elective or emergency case were included while patients having any wound infection, operated in other hospital or diabetic foot and all those operated for incision and drainage of abscess were excluded. All patients that were operated during the study period were followed for any wound infection development till one qAqmonth. SPSS was used for data entry and analysis keeping p-value of <0.05 as significant. Results: 75 from 200 patients developed surgical site infection, 46 (61.3%) were operated in emergency. Among 24 contaminated surgeries type, 70.8% were reported having SSI (p-0.05) while from 28 dirty types of surgeries 78.6% of patients had a SSI (p-0.03). 25% were anemic, 21% diabetic while (20%) were reported to be hypertensive, 13 (17%) gave positive history of smoking while 12 (16%) were obese. Conclusion: Higher proportion of surgical site infection was observed in patients undergoing contaminated and dirty type of surgeries. Most patients with SSI were operated in emergency setting and anemia and diabetes were the most common risk factor reported in the infected patients.

SP3.2.2 Closed Incision Negative Pressure Wound Therapy reduces Surgical Site Infection following Emergency Laparotomy: A Propensity Matched, NELA Registry Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Emma Hawthornthwaite ◽  
Jordan Ng- Cheong-Chung ◽  
Tom Watkinson ◽  
Ursula Blyth ◽  
Deena Harji ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Negative Pressure ◽  
Significant Proportion ◽  
Primary Outcome Measure ◽  
Emergency Laparotomy ◽  
Emergency Setting ◽  
Site Infection ◽  
Comprehensive Complication Index ◽  
Pressure Therapy ◽  
Operative Morbidity

Abstract Aims Surgical site infection (SSI) contributes to a significant proportion of post-operative morbidity in people undergoing emergency surgery. Prophylactic closed incision negative pressure therapy (CINPT) has been shown to reduce SSI rates in patients undergoing elective laparotomy however there is limited evidence for their use in the emergency setting. This study aimed to determine whether prophylactic CINPT provides comparable SSI rate to SSD for midline incision following emergency laparotomy. Methods A registry-based, prospective cohort study was undertaken using data from National Emergency Laparotomy Audit (NELA) database at our centre. The primary outcome measure was SSI as defined by the Centers for Disease Control (CDC) criteria. Secondary outcomes included 30 day post-operative morbidity and grade using Clavien-Dindo (CD) classification and the Comprehensive Complication Index, length of stay, 30 day mortality and readmission rates. CINPT and standard surgical dressing group were compared with respect to peri-operative characteristics and post-operative outcomes. A propensity- score matching (PSM) was performed to mitigate for selection bias. Results A total of 1484 patients were identified. Following PSM, a matched cohort of 474 patients were identified with 237 patients in each arm. SSI rate in CINPT cohort was found to be significantly lower compared to the SSD cohort (16.9% vs. 33.8%, p &lt; 0.001). The rate of superficial and deep infections were higher in the standard dressing arm compared to the CINPWT, p &lt; 0.001. There were no overall differences in 30-day morbidity and grade of post-operative complications. Conclusion Prophylactic CINPT in the emergency laparotomy is associated with reduced SSI rates.

scholarly journals A forgotten risk factor for surgical site infection: Hypocholesterolemia

2018 ◽  
Vol 5 (7) ◽  
pp. 2482
Author(s):  
Manjunath B. D. ◽  
Harindranath H. R. ◽  
Abdul Razak ◽  
Mohammed Arafath Ali
Keyword(s):  
Surgical Site Infection ◽  
Minor Role ◽  
P Value ◽  
Site Infection ◽  
Hernia Surgery ◽  
Medical College ◽  
Increased Risk ◽  
Subcutaneous Tissues ◽  
A Minor ◽  
A Prospective Study

Background: Postoperative infection is one of the most common complications after any surgery. In the present study, surgical site infection (SSI) is described as; superficial (i.e., skin and subcutaneous tissues) and deep (i.e., fascia and muscles) infections occurring in the short term (i.e., 1-month) after surgery. The objective of this study was to detect various risk factors for SSI development.Methods: In this study, we prospectively enrolled 217 patients undergoing spinal surgery over an 8 months period. In a prospective study from January 2017 to August 2017, 217 patients who were admitted and operated for elective hernia surgery in hospitals attached to Bangalore Medical College and Research Institute, patients with immunodeficiency disorders and obstructed hernias were excluded.Results: Of 217 patients 35 (16.12%) patients developed SSI, multi-variant data analysis indicated that multiple factors correlated with an increased risk of SSI of which one of the important factor was hypocholesterolemia with 32.8% people developing SSI with p-value <0.01 along with Hypoalbuminemia and diabetes. Whereas other factors shuch as age had a minor role in increasing the incidence of SSI other factors such as smoking, alcoholism, gender, hypertension was found not to have much significant contribution in the development of SSI in the present study.Conclusions: Hypocholesterolemia is one on the forgotten factors which is usually brushed aside whose consideration can lead to significant decrease in this preventable complication especially in a malnourished population presenting in a government setup.

scholarly journals Effect of duration of pre-operative admission on surgical site infection in major abdominal surgeries: an observational study

2019 ◽  
Vol 8 (6) ◽  
pp. 2306
Author(s):  
Alka Shantiprakash Gupta ◽  
Arthika Shetty
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Surgical Patient ◽  
P Value ◽  
Site Infection ◽  
Admission Time ◽  
Long Run ◽  
Skin Flora ◽  
Significant Difference ◽  
Prolonged Hospital

Background: Surgical site infection (SSI) are second most common cause of mortality in surgical patient, situation has been further complicated by emergence of drug resistant strains. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stays, need for readmission, high end antibiotic treatment and re-surgery. The study was done to see if   incidence of SSI is decreased with decreased pre-operative admission time. Others factors associated with SSI were analysed including the microbiological spectrum.Methods: The study was an analytical, observational, case control study. Sixty (60) cases each of gynaecology and obstetrical post-operative patients who developed SSI within 30 days were taken as cases and who did not develop SSI were taken as controls and preoperative admission time was analysed in both cases and controls to observe if risk of surgical site infections decreases due to decreased exposure to nosocomial pathogens when the pre-operative admission time was less than 48 hours.Results: Author found that there was statistically significant difference in the time between surgery and admission in the gynaecological surgeries with p value 0.023, as compared to the obstetrics surgeries where there was no statistically significant difference. Common organism isolated was E. coli sensitive to gentamicin.Conclusions: From this study, it seems to be a good policy to evaluate the patient on OPD basis and admit them about 24 to 48 hours prior to the surgery rather them keeping them admitted for prolonged duration in wards for diagnostic evaluation. This prevents nosocomial contamination in the patient’s skin flora thereby preventing SSI. This practice not only conserves the hospital resources but also makes the patient turn over faster. Further this might in the long run reduce the antibiotic resistant hospital flora.

scholarly journals Magnitude of Surgical Site Infection and Its Associated Factors Among Patients Who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

2020 ◽  
Author(s):  
Mequanint Bezie Walelign ◽  
Tadesse Wuletaw Demissie ◽  
Abaynew Honelign Desalegn
Keyword(s):  
Surgical Site Infection ◽  
General Hospital ◽  
Surgical Procedure ◽  
Surgical Site Infections ◽  
Northwest Ethiopia ◽  
P Value ◽  
Age Group ◽  
Site Infection ◽  
Co Morbidity ◽  
Debre Tabor

Abstract Background: Surgical site infections are the commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine the magnitude and factors associated with surgical site infections at the surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross-sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using the single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. The odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. A P-value of less than 0.05 will be considered statistically significant.Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and unable to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%). The factors existence of comorbidity and antibiotic prophylaxis was given were found to be significantly associated with the magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia, and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

scholarly journals Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

2021 ◽  
Vol 28 (2) ◽  
pp. 136-141
Author(s):  
Shahfinaz Mehzabin ◽  
Mohmmad Mahbub Elahi ◽  
Debashish Bar ◽  
Banalata Sinha ◽  
Tahmina Akter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Medical College ◽  
Related Risk ◽  
Microbiological Methods ◽  
Duration Of Surgery ◽  
History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

scholarly journals Superficial surgical site infections following stone and non-stone bile duct surgery- A comparative analysis

2021 ◽  
Vol 11 (2) ◽  
pp. 458-462
Author(s):  
Chishti Tanhar Bakth Choudhury ◽  
BH Nazma Yasmeen ◽  
Manir Hossain Khan ◽  
AHM Towhidul Alam ◽  
Shirin Akhter
Keyword(s):  
Bile Duct ◽  
Surgical Site Infection ◽  
Wound Infection ◽  
Surgical Site Infections ◽  
Stone Disease ◽  
P Value ◽  
Site Infection ◽  
Causative Agents ◽  
Group A ◽  
Group B

Background : Superficial surgical site infection (SSSI) is a vital issue after biliary surgery. Surgical site infections remain a major cause of illness in the post-operative period. Objectives : The purpose of the present study was to compare the number of wound infection and the causative organism of surgical site infection of patient of stone and non-stone bile duct surgery. Methodology : This cross-sectional study was carried out in the Department of Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2017 to April 2018 for a period of 12 months. Patients presented with biliary disease of stone and non-stone variety were selected as study population. Patients were divided into 2 groups designated as group A and group B. Patients with the biliary stone disease were enrolled in group A and the biliary nonstone disease patients were in the group B. Patients were followed up in the postoperative period up to 2 weeks to find out the incidence of wound infection and its risk factors, causative agents, and some other variables. Certain variables were closely monitored to find the postoperative outcome as these variables were standard parameters in assessment of the outcome of the study. Results : A total number of 50 patients were recruited for this study of which 25 patients were enrolled in group A and the 25 patients were enrolled in group B. Mean age was 42.48 ± 17.21 years in group A and 40.04 ± 21.37 years in group B. The difference was not statistically significant ( p=0.659). Males were predominant in both groups. Male female ratio was 1.77:1 and 1.08:1 in group A and group B respectively. Inflammatory evidence of gall bladder with pericholecystic collection was found in 5 (20%) and 6 (24%) patients in group A and group B. There was evidence of cholangitis in 8 (32%) and 4 (16%) patients in group A and group B respectively. Evidence of inflammation at the wound site, was found in 14 (56%) patients in group A and 7 (28%) patients in group B. There was statistically significant difference between these 2 groups in the incidence of superficial surgical site infection, ( p value is 0.045). Regarding per operative collected bile, we found E. Coli in 4 cases in group A and 3 cases in group B ( p value is 0.408). Klebsiella spp. was found in 1 patient in group A. Wound swab C/S identified E. Coli in 1 patient in group A. Staph aureus was found in 1 and 2 patients in group A and group B respectively ( p value is nonsignificant). Conclusion : In conclusion, there is a difference in the incidence of occurrence of surgical site infection and causative agents after stone and non-stone bile duct surgery. Stone disease has increased chance of wound infection than nonstone disease of bile ducts. Northern International Medical College Journal Vol.11 (2) Jan 2020: 458-462

scholarly journals Does Skin Preparation Influence Surgical Site Infection in Laparotomy Wounds: Comparative Evaluation of Preoperative Skin Preparation With 4% Chlorhexidine With 5% Povidone Iodine in Laparotomy Wounds: A Prospective Trial

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Ravindran Chirukandath ◽  
Manoj P. Elangovan ◽  
Agil B. ◽  
Reshma A. Cheedhamadathil ◽  
Ayana M. Dev ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Povidone Iodine ◽  
Prospective Trial ◽  
Surgical Site Infections ◽  
P Value ◽  
Site Infection ◽  
Related Complication ◽  
Skin Preparation ◽  
Emergency Procedures ◽  
Significant Difference

Introduction: Surgical site infection is a dangerous condition causing a heavy burden on the patient and social health system. Surgical site infections are among the most common hospital acquired infections comprising 14 to 16% of inpatient infections. There are various factors predisposing the infections and many of them are patient related or disease related. The use of pre-operative skin preparation by effective antiseptic plays an important role in reducing postoperative wound infections. There are several kinds of antiseptics available for preoperative skin preparation; however povidone iodine and spirit are commonly used in clinical practice. Materials and Methods: This study compared the incidence of surgical site infections within 7 days of postoperative period in laparotomy wounds prepared using 4% Chlorhexidine and those prepared with 5% Povidone iodine for pre-laparotomy skin preparation. Results: This study compared 128, 4% Chlorhexidine prepared patients and 109,  5% Povidone iodine prepared patients undergoing various elective n = 114 and emergency procedures n = 123. The overall SSI rates in 7 days in the whole group were 13.44 %. The SSI rates on the 4% Chlorhexidine group were 10.16% and 5% povidone iodine group were 17.27% and it was statically significant with a p value of p = 0.00413 showing significant reduction in the 4% Chlorhexidine group. The study also compared the SSI rates in elective and emergency procedures in both groups with significant difference in emergency procedures. More variables are also compared between the groups and results were analyzed. Conclusion: This study shows the use of Chlorhexidine 4% reduces the morbidity of one of the most common wound related complication in laparotomy patients in all categories of laparotomy wounds.

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.

Sign in / Sign up

Export Citation Format

Share Document