Prognostic factors influencing the outcome of empyema surgical management: prospective study in a Moroccan university center.

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Sara Hafidi ◽  
Souheil Boubia ◽  
Abdellah Fatene ◽  
Najat Id El Haj ◽  
Mohammed Ridai
Keyword(s):  
Surgical Treatment ◽  
Surgical Management ◽  
Public Health Problem ◽  
Pleural Empyema ◽  
Chronic Alcoholism ◽  
University Teaching ◽  
University Center ◽  
Post Traumatic ◽  
Surgery Department ◽  
Delay Of Diagnosis

Background: Pleural empyema is a public health problem, and is the most frequent complication of pleural infection with significant morbidity and mortality worldwide. Our study aims to highlight the management of pleural empyema and evaluate its prognosis factors involved especially in surgical treatment. Patients and Methods: A prospective analysis of 53 patients who underwent surgical treatment of pleural empyema, from January 2015 to December 2019 at the thoracic surgery department in a tertiary referral university teaching hospital. Our study included patients who required surgical treatment for pleural empyema and were excluded patients with destroyed lungs associated with pyothorax. Results: The mean age of patients was 39.24±15.89 years and 79,24% of them were males. In 85.7% of the cases, the etiology was undetermined in 34%, parapneumonic in 1.9%, of tuberculosis in 54.71%, post-traumatic in 11, 3%, postoperative in 7.5% and iatrogenic in 1.9%. 45 patients were treated with broad-spectrum antibiotics therapy adapted after antibiogram 14.38±21.76 days before the operation. A complete debridement and decortications were performed by VATS in 28 and by PLT in 22 patients. No major complications occurred. At a mean term follow-up of 20 months (3months—3 years); all patients were alive with no recurrence. The analysis of the results showed 4 factors of poor prognosis: delay of diagnosis and surgery (P = 0.02), chronic alcoholism (P = 0.034), preoperative ventilation disorder/COPD (P = 0.04) and active tuberculosis (P= 0, 05). Conclusion: The success of surgical management of pleural empyema depends on several factors, which predict the prognosis, but can be prevented.

scholarly journals Aplication of videothoracoscopy in trauma - experience of a service

2015 ◽  
Vol 42 (5) ◽  
pp. 295-298
Author(s):  
Bruno Vaz de Melo ◽  
Felipe Guedes Siqueira ◽  
Thales Siqueira Di Tano ◽  
Paulo Oliveira Silveira ◽  
Mariama Barroso de Lima
Keyword(s):  
Conversion Rate ◽  
Chest Trauma ◽  
Trauma Surgery ◽  
Penetrating Trauma ◽  
Pleural Empyema ◽  
Therapeutic Procedure ◽  
Post Traumatic ◽  
Retained Hemothorax ◽  
Surgery Department ◽  
Complications And Mortality

Objective: To evaluate patients with chest trauma submitted to videothoracoscopy during hospitalization. In 2007, the Trauma Surgery Group was created in the General Surgery Department of the Hospital Municipal Lourenço Jorge of Rio de Janeiro-RJ, and started following all trauma victims who were admitted to the Hospital. Methods : We conducted a retrospective analysis of patients submitted to thoracoscopy from July 2007 to May 2015, based on a database started at the beginning of this period and on data collection from patients who underwent thoracoscopy. We evaluated the following parameters: procedure effectiveness, indication of the procedure, conversion rate, complications and mortality. We included patients who presented post-traumatic pleural collections, such as retained hemothorax and pleural empyema, and penetrating injury in the thoracoabdominal transition. All patients were hemodynamic stable and signed an informed consent. Results: In the analyzed period 53 patients were submitted to videothoracoscopy; 24 had penetrating trauma (45.3%) and 29, blunt (54.7%), with a predominance of males (75.5%). The procedure was performed in 26 cases of retained hemothorax (49%), 14 cases of empyema (26.5%) and in 13 patients for evaluation of injury in the thoracoabdominal transition (24.5%). The thoracoscopy was effective in resolution of 36 cases (80%), without need for further procedure. There was a conversion rate of 15.5% and 3 procedure complications related (6.6%). Mortality was nil. Conclusion: In this series, videothoracoscopy proved that this diagnostic and therapeutic procedure is safe and effective, if performed by a surgeon with appropriate training, especially when it is indicated in cases of retained hemothorax and evaluation of penetrating thoracoabdominal trauma.

The use of Integra dermal regeneration matrix in the surgical treatment of a recurrent, extensive malignant skin lesion in the temporal region

2013 ◽  
Vol 154 (6) ◽  
pp. 225-227 ◽  
Author(s):  
Csaba Halmy ◽  
Zoltán Nádai ◽  
Krisztián Csőre ◽  
Adrienne Vajda ◽  
Róbert Tamás
Keyword(s):  
Surgical Treatment ◽  
Skin Lesion ◽  
Surgical Management ◽  
Skin Grafting ◽  
Skin Tumor ◽  
Temporal Region ◽  
Aesthetic Result ◽  
Malignant Skin ◽  
Dermal Regeneration Template ◽  
Dermal Regeneration

Authors report on the use of Integra dermal regeneration template after excision of an extended, recurrent skin tumor in the temporal region. The area covered with Integra was 180 cm2. Skin grafting to cover Integra was performed on the 28th day. Both Integra and the skin transplant were taken 100%. Integra dermal regeneration template can provide good functional and aesthetic result in the surgical management of extended skin tumors over the skull. Orv. Hetil., 2013, 154, 225–227.

Comprehensive Surgical Management of Chronic Suppurative Osteomyelitis Extending to The Lower Border of Mandible – A Case Report

2018 ◽  
Vol 5 (3) ◽  
Author(s):  
Deepak Kaul ◽  
Farahnaz Muddebihal ◽  
Mohammed Anwar Ul Haque Chand
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Surgical Debridement ◽  
Reconstruction Plate ◽  
Left Posterior ◽  
High Nutrient ◽  
Inferior Border ◽  
Precipitating Factor

Osteomyelitis of maxillofacial skeleton is common in developing countries such as India. This case report describes successful surgical treatment of chronic suppurative osteomyelitis {CSO} of the mandible of a 35yr old female. The precipitating factor was thought to be eventful extraction in the {left } posterior body at the inferior border of mandible. Methods: Presurgical course of antibiotics ( Amoxycillin and metronidazole for 7 days and later followed by doxycycline for 1 month).Surgical debridement of the affected bone and reinforcing it with reconstruction plate using AO principles was done . Patient was kept on a high nutrient diet consisting of proteins. Conclusion: The case report demonstrates the typical features of CSO . The combination of the antibiotics therapy and surgical debridement was successful in the treatment of chronic suppurative osteomylitis.

MRSA/MSSA causing infections: prevalence of mecA gene

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
G Vieira ◽  
N Leal ◽  
A Rodrigues ◽  
C Chaves ◽  
F Rodrigues ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Meca Gene ◽  
Public Health Problem ◽  
Penicillin Binding Protein ◽  
Genetic Determinants ◽  
Tissue Samples ◽  
University Center ◽  
Mrsa Strains ◽  
Human Flora ◽  
Hospital Acquired

Abstract Introduction Staphylococcus aureus is part of the human flora, present in the skin and mucous membranes but can become pathogenic, causing a wide spectrum of infections that were initially treated with penicillin. However, were observed some strains with resistance to this antibiotic and, therefore was developed a new antibiotic, the methicillin. After its introduction, arose the first S. aureus with resistance to methicillin (MRSA) due to the presence of a gene known as mecA that encodes an altered penicillin binding protein (PBP2a). In Europe, it is estimated that MRSA are associated to 44% of hospital acquired infections and its mortality rate is around 20%. Objectives Prevalence of MRSA strains in different types of infection in Coimbra district. Methodology Were analysed a total of 539 isolates of S. aureus previously characterized to the antibiotic susceptibility profile in the Hospital and University Center of Coimbra. Through the minimum inhibitory concentration (MIC) of oxacillin we classified our strains into MRSA and S. aureus methicillin-sensitive (MSSA); simultaneously, the mecA gene was detected by Polymerase Chain Reaction (PCR). Results Of the 539 isolates, 49% were considered MRSA and 51% MSSA. All MRSA isolates express the mecA gene, but from the total of 276 MSSA, 191 show this gene but do not express it. MRSA isolates were mostly from respiratory tract samples (48%) and blood cultures (21%) while MSSA were isolated in skin and soft tissue samples (35%). Conclusion MRSA are considered one of the primary pathogens for the development of pneumonia and septicaemia due to its highly virulent potential and the increasing expression of genetic determinants of antimicrobial resistance. Therefore, infections caused by MRSA continue with highly representability in the clinical context and their dissemination is a public health problem.

Lung Decortication With Argon Plasma Energy for the Treatment of Chronic Pleural Empyema

2021 ◽  
pp. 155698452110111
Author(s):  
Savvas Lampridis ◽  
Sofoklis Mitsos ◽  
David R. Lawrence ◽  
Nikolaos Panagiotopoulos
Keyword(s):  
Energy Source ◽  
Surgical Management ◽  
Argon Plasma ◽  
Pleural Empyema ◽  
Controlled Trials ◽  
Air Leak ◽  
Pulmonary Tissue ◽  
Pure Argon ◽  
Plasma Energy ◽  
Minimal Depth

Lung decortication for the treatment of chronic pleural empyema remains a technically challenging procedure that is associated with bleeding and air leak. The recent advent of pure argon plasma has provided thoracic surgeons with an electrically neutral energy source for dissection and coagulation of pulmonary tissue with minimal depth of necrosis. In this article, we describe the technique of lung decortication with argon plasma energy (PlasmaJet, Plasma Surgical, Roswell, GA, USA) for the treatment of chronic pleural empyema. With appropriate application, the PlasmaJet can facilitate the removal of fibrous cortex with satisfactory hemostasis and aerostasis. Argon plasma energy can potentially be a useful adjunct in lung decortication. Controlled trials are needed to determine its role in the surgical management of advanced pleural empyema.

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