clean contaminated
Recently Published Documents


TOTAL DOCUMENTS

212
(FIVE YEARS 72)

H-INDEX

23
(FIVE YEARS 2)

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Prasanth Bhatt ◽  
Swamynathan Ganesan ◽  
Infant Santhose ◽  
Thirumurugan Durairaj

Abstract Phytoremediation is a process which effectively uses plants as a tool to remove, detoxify or immobilize contaminants. It has been an eco-friendly and cost-effective technique to clean contaminated environments. The contaminants from various sources have caused an irreversible damage to all the biotic factors in the biosphere. Bioremediation has become an indispensable strategy in reclaiming or rehabilitating the environment that was damaged by the contaminants. The process of bioremediation has been extensively used for the past few decades to neutralize toxic contaminants, but the results have not been satisfactory due to the lack of cost-effectiveness, production of byproducts that are toxic and requirement of large landscape. Phytoremediation helps in treating chemical pollutants on two broad categories namely, emerging organic pollutants (EOPs) and emerging inorganic pollutants (EIOPs) under in situ conditions. The EOPs are produced from pharmaceutical, chemical and synthetic polymer industries, which have potential to pollute water and soil environments. Similarly, EIOPs are generated during mining operations, transportations and industries involved in urban development. Among the EIOPs, it has been noticed that there is pollution due to heavy metals, radioactive waste production and electronic waste in urban centers. Moreover, in recent times phytoremediation has been recognized as a feasible method to treat biological contaminants. Since remediation of soil and water is very important to preserve natural habitats and ecosystems, it is necessary to devise new strategies in using plants as a tool for remediation. In this review, we focus on recent advancements in phytoremediation strategies that could be utilized to mitigate the adverse effects of emerging contaminants without affecting the environment.


2021 ◽  
Author(s):  
Jan Mikael Gerl ◽  
Truls Leegaard ◽  
Rohit Singh ◽  
Preben Homøe ◽  
Gregor Bachmann-Harildstad

UNSTRUCTURED Surgical site infections (SSIs) from nasal bacteria are an increasingly feared complication in general surgery, in implantation surgery and in intensive care units with consequences for the patient and society not only in the short, but also in the long run. The increasing hazard of antibiotic resistances may accelerate this problem. In rhinosurgery, SSIs as a complication consist of either local wound infections, septal perforation, pneumonia or life-threatening sepsis. Standard of care for rhinosurgery is surgical hand wash, sterile drapes, gloves and antiseptic disinfection of the skin around the mid-face. Surgeons perform septoplasties in a clean contaminated field and the disinfection of the surgical field in the nasal vestibule and nasal cavity at nasal surgery is not common practice. The infection rates for septorhinoplasty spread along the range of 1 to 27 % according to the literature. It is therefore unknown, whether endonasal disinfection at nasal surgery will prevent the rate of postoperative SSIs. For the proposed pragmatic randomized controlled trial (pRCT), we chose the following primary goal: The preventive effect of aqueous povidine-iod (PVP-I) disinfection on septoplasty related SSIs. As secondary goals serve (a) to determine the safety of endonasal disinfection using PVP-I, (b) to identify the risk of endonasal PVP-I toxicity on olfactory epithelium, (c) to characterize the endonasal microbiota dependent on endonasal PVP-I disinfection in the short- and the long-term and d) to identify the endonasal microbiota in septoplasty related SSI and in septoplasty related uneventful follow-up.


2021 ◽  
Vol 9 (1) ◽  
pp. 129
Author(s):  
Swapan Das ◽  
Rajib Kundu ◽  
Bani Prasad Chattopadhyay

Background: Surgical site infection is a common problem following general surgical procedures. Despite major improvement in antibiotics, improved antiseptic measures SSI continues to present a big challenge. In this study we will compare single dose versus multiple dose antibiotic prophylaxis for prevention of SSI in clean and clean contaminated surgical wound.Methods: This is an institution based prospective, comparative study, with total 60 patients as study population. Clinical finding, wound swab culture and routine haematological reports were taken as study variables. Patients receiving single dose antibiotic and multiple dose antibiotic were included in ‘Group A’ and ‘Group B’ respectively. The surgical sites were examined from post-operative days 3 to 8 for signs of infection.Results: In This study, 46.7% patients were female, and 53.3% patients were male. In Group-A, patients having post operative fever, tachycardia and leucocytosis were 16.7%, 13.3% and 20.0% respectively. 6.7% patients had purulent and 10.0% patients had seropurulent discharge from wound. In Group-B, patients having post operative fever, tachycardia, and leucocytosis were 13.3%, 16.7% and 13.3% respectively. 6.7% patients had purulent and seropurulent discharge from wound. There is no statistically significant difference between two groups regarding post operative fever, tachycardia, leucocytosis and wound discharge.Conclusions: There is no significant difference between single dose and multiple dose antibiotic prophylaxis to prevent SSI in patients for elective clean and clean contaminated surgery however single dose is more cost effective.


Author(s):  
J Daly ◽  
P Gearing ◽  
N Tang ◽  
A Ramakrishnan ◽  
K P Singh

Abstract Background Adherence to guidelines for antibiotic prophylaxis is often poor and is an important target for antimicrobial stewardship programs. Prescribing audits that suggested poor adherence to guidelines in a plastic surgery department led to a targeted education program to bring antibiotic prescriptions in line with hospital guidelines. We reviewed whether this intervention was associated with changed perioperative prescribing and altered surgical outcomes, including the rate of surgical site infections, specifically looking at clean-contaminated head and neck tumour resections with free flap reconstruction. Methods A retrospective cohort study was performed on 325 patients who underwent clean-contaminated head and neck tumour resection and free flap reconstruction from January 1, 2013 to February 19, 2019. Patients were divided into two groups, those before (pre-intervention) and after (post-intervention) the education campaign. We analysed patient demographic and disease characteristics, intraoperative and postoperative factors and surgical outcomes. Results Patients pre-intervention were prescribed longer courses of prophylactic antibiotics (median = 9 [interquartile range = 8] vs. median = 1 [interquartile range = 1], p < 0.001), more topical chloramphenicol ointment (21.82% vs. 0%, p < 0.001) and more oral nystatin (36.9% vs. 12.2%, p < 0.001). Patients post-intervention had higher rates of recipient infections (36.11% vs. 17.06%, p < 0.001) and donor site infections (6.94% vs. 1.19%, p = 0.006). Conclusion Following the education campaign, patients were prescribed shorter courses of prophylactic antibiotics, more of the recommended cefazolin-metronidazole regimen and less use of topical antibiotics. However, patients also had a higher rate of surgical site infections.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S60-S61
Author(s):  
Kelley M Boston ◽  
Misti Ellsworth ◽  
Jocelyn Thomas ◽  
Tawanna A McInnis-Cole ◽  
Luis Ostrosky-Zeichner

Abstract Background Colon surgery (COLO) is one of the focus areas for the the Centers for Medicare and Medicaid Services (CMS) Hospital Inpatient Quality Reporting (IQR) Program. Standardized criteria from the National Healthcare Surveillance Network (NSHN) are used to define surgical site infections (SSI) and to assess and weight standardized risk variables, so that all organizations can be judged to the same standard. Performance is compared though use of a standardized infection ratio (SIR), which is the observed number of infections, divided by the “predicted” number of infections, given the number and type of surgeries performed. Methods A retrospective review of medical records and NHSN documentation was conducted for 778 COLO procedures that were performed at a large academic and level 1 trauma center between January 2019 and December 2020. Initial review of the data showed that the increases in SIR were primarily concentrated in trauma patients with intestinal injury and fecal spillage. SIR for adult procedures were calculated using the NHSN Complex 30-Day SSI Data for IQR Report model, which the metric used by the CMS IQR. The CDC NHSN Statistics Calculator was used to compare SIR for procedures coded as trauma and non-trauma. As a proxy for patients with penetrating trauma, SIR for patients coded as trauma who had a surgical wound class noted as dirty was compared to SIR for patients coded as trauma with surgical wound class coded as contaminated or clean-contaminated. Results For the CMS model, there was a statistically significant difference (p = 0.0003) between SIR for trauma (SIR = 3.451) and non-trauma (SIR = 1.071) procedures. There was also a statistically significant difference (p=0.0014) between trauma procedures with dirty surgical wound class (SIR = 6.608), compared to those with wounds categorized as contaminated or clean-contaminated (SIR = 2.235). NHSN Adult Complex 30 Days SIR comparison for COLO SSI with and without trauma NHSN Adult Complex 30 Days SIR comparison for trauma COLO procedures with dirty wound class description, against COLO procedures with wound class described as clean or clean-contaminated Conclusion Risk factors currently included in the model for COLO SSI may not adequately account for the increased risk from penetrating trauma with fecal spillage. Trauma and wound class should be added to the CMS IQR risk model for SIR. Disclosures Kelley M. Boston, MPH, CIC, CPHQ, FAPIC, Infection Prevention & Management Associates (Employee, Shareholder) Luis Ostrosky-Zeichner, MD, Amplyx (Consultant)Cidara (Consultant)F2G (Consultant)Gilead (Grant/Research Support, Speaker's Bureau)Pfizer (Scientific Research Study Investigator, Speaker's Bureau)Scynexis (Grant/Research Support, Scientific Research Study Investigator)Viracor (Consultant)


2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Sammy Othman ◽  
Adrienne Christopher ◽  
Viren Patel ◽  
Hanna Jia ◽  
Joseph Mellia ◽  
...  

Abstract Aim The literature currently lacks comparative studies examining the relative effectiveness of anatomic planes and mesh selection when combating abdominal wall reconstruction (AWR), particularly when the retrorectus sublay space is not available. The aim of this study was to examine the efficacy of resorbable synthetic mesh onlay (RSOM) plane against biologic mesh in the intraperionteal plane (BIPM). Methods A single center, two surgeon, 5-year retrospective review (2014-2019) was performed examining subjects who underwent AWR in the onlay plane with resorbable synthetic mesh or the intraperitoneal plane with biologic mesh. A matched paired analysis was conducted. Data examining demographic characteristics, intraoperative variables, post-operative outcomes, and costs were analyzed. Results A total of 88 subjects (44 per group) were identified (median follow-up: 24.5 months). The mean age was 57.7 years, with a mean BMI of 30.4 kg/m2. The average defect size was 292 ± 237 cm2, with most wounds being clean-contaminated (48.9%), and 55% having prior failed repair. RSOM subjects were significantly less likely (4.5%) to experience recurrence compared to BIPM (22.7%; p<0.026.). Additionally, RSOM suffered less post-operative surgical site occurrences (18.2% vs. 40.9%;p<0.019) and required fewer procedural interventions (11.4% vs. 36.4%;p<0.011). RSOM was also associated with significantly less total costs ($16,658 ± 14,930) compared to BIPM ($27,645 ± 16,864;p<0.001). Conclusion When faced with hernia repair, the selection of resorbable synthetic mesh in the onlay plane may be preferable to biologic mesh place in the intraperitoneal plane due to lower long-term recurrence rates, surgical site complications, and costs.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Alireza Fahimzad ◽  
Bahador Mirrahimi ◽  
Farideh Shiva ◽  
Niloofar Esfahanian ◽  
Seyyedeh Azam Mousavizadeh ◽  
...  

Background: Surgical procedures may be complicated by post-surgical infections. This study investigates the role of administering perioperative narrow-spectrum antibiotic prophylaxis in preventing post-surgical infections as compared to routine broad-spectrum antibiotic usage in the surgical ward. Methods: Narrow-spectrum perioperative antibiotic prophylaxis, in accordance with CDC guidelines, was implemented in our hospital in October 2019. In this quasi-experimental study, all the children (one month to fifteen years old) who underwent surgery from April to September 2019 and had received broad-spectrum antibiotics for various durations, as well as those operated after the implementation of the perioperative narrow-spectrum antibiotic prophylaxis plan (October 2019 to March 2020) were enrolled. Surgical wound type (clean, clean/contaminated, contaminated, and dirty), type and site of the infection, and the patient’s age and sex were recorded. Cases with postoperative infections were followed up in the two groups during hospitalization and for 30 days (or 90 days if a prosthetic material was implanted) after discharge. The rate of post-surgical infections was compared between the two groups by the Mann-Whitney and Chi-squared tests. Results: In total, 4308 cases were enrolled in the first six months and 3650 in the second six months of the study. The rate of post-surgical infections in the first group was 31/4380 (23.7%) as compared to 22/3650 (20%) in the second group (P-value = 0.3365) Conclusions: There was no increase in the frequency of post-surgical infections after the implementation of the perioperative narrow-spectrum antibiotic prophylaxis protocol. Reducing the use of antibiotics before surgery shrinks costs and antibiotic resistance without any effect on the post-surgical infection rate.


Sign in / Sign up

Export Citation Format

Share Document