scholarly journals A Randomized Control Trial Comparing Transparent Film Dressings and Conventional Occlusive Dressings for Elective Surgical Procedures

2019 ◽  
Vol 7 (17) ◽  
pp. 2844-2850 ◽  
Author(s):  
Moushira Hosny Ezzelarab ◽  
Omar Nouh ◽  
Ahmed Nabil Ahmed ◽  
Mervat Gaber Anany ◽  
Nevine Gamal El Rachidi ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Financial Burden ◽  
P Value ◽  
Diabetic Patients ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Gauze Dressing ◽  
Clean Contaminated ◽  
The Impact

BACKGROUND: Surgical site infection is one of the major health-care-associated problems causing substantial morbidity and mortality and constituting a financial burden on hospitals as well. The wound management is one of the crucial evidence-based strategies in the reduction of surgical site infection rates AIM: To study the impact of standardisation of transparent semipermeable dressing procedure on the rate of surgical site infection in comparison with conventional dressing in clean and clean-contaminated surgeries. METHODS: The study included 100 patients who were admitted to surgical wards in Cairo university hospitals, for clean and clean-contaminated operations, in the period from February 2017 to August 2017. Immunocompromised and uncontrolled diabetic patients were excluded. Patients were randomly allocated into two groups; in the first group, patients wounds were covered using transparent semipermeable dressing, while the second group patients’ wounds were covered using conventional occlusive gauze dressing. Patients were followed up for criteria of infection every other day during the first week then at two weeks, three weeks and four weeks. RESULTS: In clean and clean-contaminated operations, the transparent dressing group showed a significantly lesser rate of surgical site infection at (2%), compared with the conventional occlusive gauze dressing group with a surgical site infection rate of (14%) (p-value of 0.02). CONCLUSION: The transparent semipermeable dressing is effective in reducing surgical site infection rate in clean and clean-contaminated operations.

A Perioperative Systems Design to Improve Intraoperative Glucose Monitoring Is Associated with a Reduction in Surgical Site Infections in a Diabetic Patient Population

2017 ◽  
Vol 126 (3) ◽  
pp. 431-440 ◽  
Author(s):  
Jesse M. Ehrenfeld ◽  
Jonathan P. Wanderer ◽  
Maxim Terekhov ◽  
Brian S. Rothman ◽  
Warren S. Sandberg
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Glucose Monitoring ◽  
Surgical Site Infections ◽  
Interrupted Time Series ◽  
Glucose Measurement ◽  
Diabetic Patients ◽  
Site Infection ◽  
Surgical Site Infection Rate

Abstract Background Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. Methods With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose. Interrupted time series and propensity score matching were used to quantify pre- and postintervention impact on outcomes. Chi-square/likelihood ratio tests were used to compare surgical site infections at patient follow-up. Results The authors analyzed 15,895 cases (3,994 preintervention and 11,901 postintervention; similar patient characteristics between groups). Intraoperative glucose monitoring rose from 61.6 to 87.3% in cases after intervention (P = 0.0001). Recovery room entry hyperglycemia (fraction of initial postoperative glucose readings greater than 250) fell from 11.0 to 7.2% after intervention (P = 0.0019), while hypoglycemia (fraction of initial postoperative glucose readings less than 75) was unchanged (0.6 vs. 0.9%; P = 0.2155). Eighty-seven percent of patients had follow-up care. After intervention the unadjusted surgical site infection rate fell from 1.5 to 1.0% (P = 0.0061), a 55.4% relative risk reduction. Interrupted time series analysis confirmed a statistically significant surgical site infection rate reduction (P = 0.01). Propensity score matching to adjust for confounders generated a cohort of 7,604 well-matched patients and confirmed a statistically significant surgical site infection rate reduction (P = 0.02). Conclusions Anesthesiologists add healthcare value by improving perioperative systems. The authors leveraged the one-time cost of programming to improve reliability of intraoperative glucose management and observed improved glucose monitoring, increased insulin administration, reduced recovery room hyperglycemia, and fewer surgical site infections. Their analysis is limited by its applied quasiexperimental design.

Nine-year downward trends in surgical site infection rate in southeast France (1995–2003)

2007 ◽  
Vol 67 (2) ◽  
pp. 127-134 ◽  
Author(s):  
C.M. Couris ◽  
M. Rabilloud ◽  
R. Ecochard ◽  
M.H. Metzger ◽  
E. Caillat-Vallet ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Site Infection ◽  
Surgical Site Infection Rate

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

scholarly journals Study of efficacy of short course peri-operative antibiotics in clean contaminated surgeries

2017 ◽  
Vol 4 (8) ◽  
pp. 2455
Author(s):  
Shivakumar C. R. ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Anil Reddy Pinate
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
Site Infection ◽  
Medical Sciences ◽  
Short Course ◽  
Perioperative Antibiotics ◽  
Clean Contaminated ◽  
Hospital Acquired

Background: Surgical site infection is a one of the most common postoperative complication and causes significant postoperative morbidity and mortality. WHO described Hospital acquired infections as one of the major infectious diseases having huge economic impact. Perioperative antibiotics constitute the bulk of antimicrobial consumption in any hospital. We need to adapt the policies that decrease the incidence of postoperative wound infection.Methods: Patients undergoing elective surgeries for clean contaminated cases for various causes from 15th May 2014 to 15th June 2017 under Surgical 1st Unit of District hospital Gulbarga (Affiliated to Gulbarga Institute of Medical Sciences, Gulbarga) are included in our study. During this period, a total of 216 patients participated, of which 145 were males and 71 were females. Patients received two doses of perioperative antibiotics, first dose before surgery and second dose after surgery, 12 hours apart during this period.Results: In this study, surgical site infection rate is 2.3% in clean-contaminated surgeries.Conclusions: The findings indicate that a short course of perioperative antibiotics where in first dose is given 30 minutes to one hour before surgery and second dose is given 12 hours after surgery are sufficient and efficacious as infection rate is acceptable (1%-3%).Infection rate in our study was 2.3%. It is cost-effective as well for prevention of surgical site infections in clean-contaminated surgeries in Indian surgical setup.

scholarly journals Dual antibiotic prevention bundle is associated with decreased surgical site infections

2020 ◽  
Vol 30 (9) ◽  
pp. 1411-1417
Author(s):  
Michelle Kuznicki ◽  
Adrianne Mallen ◽  
Emily Clair McClung ◽  
Sharon E Robertson ◽  
Sarah Todd ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Infection Prevention ◽  
Gynecologic Oncology ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Readmission Rates ◽  
Optimal Method ◽  
Bundle Versus ◽  
Exact Test

BackgroundGynecologic oncology surgery is associated with a wide variation in surgical site infection risk. The optimal method for infection prevention in this heterogeneous population remains uncertain.Study DesignA retrospective cohort study was performed to compare surgical site infection rates for patients undergoing hysterectomy over a 1-year period surrounding the implementation of an institutional infection prevention bundle. The bundle comprised pre-operative, intra-operative, and post-operative interventions including a dual-agent antibiotic surgical prophylaxis with cefazolin and metronidazole. Cohorts consisted of patients undergoing surgery during the 6 months prior to this intervention (pre-bundle) versus those undergoing surgery during the 6 months following the intervention (post-bundle). Secondary outcomes included length of stay, readmission rates, compliance measures, and infection microbiology. Data were compared with pre-specified one-sided exact test, Chi-square test, Fisher’s exact test, or Kruskal–Wallis test as appropriate.ResultsA total of 358 patients were included (178 PRE, 180 POST). Median age was 58 (range 23–90) years. The post-bundle cohort had a 58% reduction in surgical site infection rate, 3.3% POST vs 7.9% PRE (−4.5%, 95% CI −9.3% to −0.2%, p=0.049) as well as reductions in organ space infection, 0.6% POST vs 4.5% PRE (−3.9%, 95% CI −7.2% to −0.7%, p=0.019), and readmission rates, 2.2% POST vs 6.7% PRE (−4.5%, 95% CI −8.7% to −0.2%, p=0.04). Gram-positive, Gram-negative, and anaerobic bacteria were all prevalent in surgical site infection cultures. There were no monomicrobial infections in post-cohort cultures (0% POST vs 58% PRE, p=0.04). No infections contained methicillin-resistant Staphylococcus aureus.ConclusionImplementation of a dual antibiotic infection prevention bundle was associated with a 58% reduction in surgical site infection rate after hysterectomy in a surgically diverse gynecologic oncology practice.

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