Surgical Site Infection Incidence Following Hip Surgery: A Cross-Sectional Study

Objective: To determine the incidence of surgical site infection among patients with hip fracture and undergo a surgical procedure for management. And to spotlight on the risk factors which may lead to surgical site infection among them. Also, to look for other complications following the surgery. Methods: This is a descriptive, correlational cross-sectional study design. The study was conducted at Orthopedic Department, Mohammad Medical College and Hospital Mirpurkhas, Pakistan for one-year duration from March 2019 to March 2020. All patients had hip fracture and received management at the department of orthopedic. All patients were adults and older than 20 years of age. Data was analyzed using SPSS program. Results: The study included 103 patients who had hip fractures. The most frequent age group was 40-50 years. Patients had a mix of modifiable and non-modifiable risk factors for developing surgical site infection. The incidence rate of surgical site infection in this study was 3.2%. It was correlated to having hypertension and diabetes as complications. Conclusion: This study aimed to spotlight on the SSI following hip surgeries and to look for complications and risk factors. We noticed that the SSI rate among the study populations is almost similar as the worldwide range. This is due to the agreed protocol for managing patients. However, there is a need for log-term follow up for our patient to discover the cases of delayed SSI.

The effect of peroperative erythrocyte transfusion on infectious complications in patients with gastric cancer undergoing curative gastrectomy

Background: In this study, the effect of perioperative blood transfusion on infectious complications in patients undergoing curative surgery for gastric adenocarcinoma was investigated.Methods: The clinicopathological results of 312 patients who underwent curative gastrectomy were retrospectively analyzed. The effect of blood transfusion on the development of postoperative infectious complications were statistically analyzed.Results: In the subgroup of patients with intraoperative transfusion, surgical site infection incidence was found to be significantly higher in patient with 2U above ES transfusions. (p=0.014). In the subgroup of patients with postoperative transfusion, hospital stay (p<0.001), postoperative CRP values (p<0.001), surgical site infection incidence (p=0.049) and anastomosis leakage incidence (p<0.001) were found to be significantly higher in patient with 2U above ES transfusions. In the subgroup of patients with both intraoperative and postoperative transfusion, SSI, anastomotic leakage and any infective complication incidences were found to be significantly higher in patients with 2U and above transfusions. In multivariate analysis, age (p=0.015), BMI (p=0.011), intraoperative transfusion (p=0.011) and both intraoperative and postoperative transfusion (p=0.045) were found to be independent risk factors for infective complications.Conclusions: It was found that performing peroperative ES transfusion is associated with increased rates of infectious complications in patients undergoing curative gastrectomy for gastric cancer by causing immunomodulation.

Surgical site infection incidence and risk factors in thoracic surgical procedures: A 12-year prospective cohort study

Introduction: Surgical site infections (SSI) continue to be a major problem for thoracic surgery patients. We aimed to determine incidence rate (IR) and risk factors for SSI in patients with thoracic surgical procedures. Methodology: During 12 years of hospital surveillance of patients with thoracic surgical procedures, we prospectively identified SSI. Patients with SSI were compared with patients without SSI. Results: We operated 3,370 patients and 205 (6.1%) developed SSI postoperatively. We detected 190 SSI among open thoracic surgical procedures (IR 7.1%) and 15 SSI after video-assisted thoracic surgery (IR 2.1%). Five independent risk factors for SSI were identified: wound contamination (p = 0.013; relative risk (RR) 2.496; 95%, confidence interval (CI): 1.208-5.156), American Society of Anesthesiologist (ASA) score (p = 0.012; RR: 1.795; 95% CI: 1.136-2.834), duration of drainage (p < 0.001; RR: 1.117; 95% CI: 1.085-1.150), age (p = 0.036; RR: 1.018; 95% CI: 1.001-1.035) and duration of operation (p < 0.001; RR:1.005; 95% CI:1.002-1.008). Conclusion: The results are valuable in documenting risk factors for SSI in patients undergoing thoracic surgery. The knowledge and prevention of controllable risk factors is necessary in order to reduce the incidence of SSI.

A comparative study to test the effectiveness of triclosan coated polyglactin 910 in reduction of surgical site infection in clean wounds

Background: Surgical site infection (SSI) has been pointed out as the 2nd most common nosocomial infection. Since suture materials have been proven to be a contributor to SSI, they have been the focus of research and development centered on making them less conducive to bacterial overgrowth. The Triclosan coated suture slowly releases Triclosan, which is an antibacterial agent that inhibits bacterial colonization of the suture and wound site and thus, promises prevention of surgical site infection.Methods: Total of 100 patients undergoing excision of uninfected subcutaneous benign lumps and cutaneous swellings were randomized in two groups: group A in which triclosan coated polyglactin 910 suture was used for wound closure (50 patients) and Group B in whom conventional uncoated Polyglactin 910 suture was used for wound closure (50 patients).Results: In this study, maximum number of patients was in the age group of 46-60 years. Mean age of subjects in triclosan- coated suture group was 45.03 years while it was 47.32 in conventional uncoated suture group. Among 100 subjects in triclosan- coated suture group, 26 (52%) were males and 24 (48%) were females. In comparison to it, male and female subjects in conventional uncoated suture group were 25 (50%) each. Among 50 subjects in triclosan- coated suture group, only 2 (4.0%) had surgical site infection while in conventional uncoated suture group, 8 (16.0%) had surgical site infection. Incidence of surgical site infection with use of triclosan- coated suture was significantly lower compared to conventional uncoated suture group. (p 0.04).Conclusions: Triclosan coated suture surely, helps in preventing surgical site infection which, not only increases the morbidity of the patient but also has long-term implications.