COMPARISION OF SURGICAL SITE INFECTION BETWEEN OPEN APPENDECTOMY AND LAPAROSCOPIC APPENDECTOMY

Appendectomy is most common surgical procedure in emergency surgery. Inamed appendix can be removed laparoscopically (laparoscopic appendectomy) or openly (open appendectomy). Surgical site infection is representative of health care associated infection in which it may effect on patients' morbidity and mortality. The aim of the study is to compare laparoscopic appendectomy and open appendectomy in terms of surgical site infection. The frequency of 60 patients who underwent appendectomy open appendectomy-40;laparoscopic appendectomy-20 between September 2019- march2020 which were retrospectively reviewed for demographic and pathological characteristic, recovery of bowel movements, length of hospital stay and post-operative complications. The frequency of purulent/gangrenous or perforated appendix were Laparoscopic appendectomy-10% and in open appendectomy 20%. The time of rst atus after surgery were 2.9 days and in open appendectomy were 2.97 days in laparoscopic appendectomy. Length of hospital stay were relatively short in laparoscopic appendectomy group and in open appendectomy group The frequency of overall surgical site infection were not that difference between the two groups laparoscopic appendectomy -15% open appendectomy group were22%But that of supercial surgical site infection was signicantly lower in laparoscopic appendectomy group5% open appendectomy group 15%.

Surgical Antimicrobial Prophylaxis—Where Do We Stand?

Introduction Surgical site infection (SSI) is the commonest preventable health care–associated infection among postoperative cases. Several guidelines are available for surgical antimicrobial prophylaxis (SAP) and other measures which prevent SSI. National Center for Disease Control (NCDC), India, has also provided a guideline for prevention of SSI in 2016. In this study we have compared the NCDC, India, guideline with WHO (World health organization) and American Society of Health System Pharmacists (ASHP) guidelines. The timing of antimicrobial agent administration is the only parameter which is included in all the three guidelines. As per NCDC and ASHP it should be within 60 minutes of incision while as per WHO it is within 120 minutes of incision. Material and Methods This was a prospective observational study—104 patients undergoing surgery in general surgical ward between January 2016 and June 2017 were included in this study. The NCDC guideline was compared with WHO and ASHP guidelines. Real data comparison was done for those parameters which were included in all the three guidelines. Statistical Analysis Data were analyzed using descriptive methods and chi-square test. Results None of the patients in our study received SAP within 60 minutes of incision. In 70% cases it was administered within 2 hours of incision and in the remaining 30% it was administered after more than 2 hours. There was no significant difference in the incidence of SSI among these two groups. Conclusion NCDC SAP guideline helps in rational use of antimicrobials. Increasing the duration for SAP may be added in the NCDC guidelines. Inclusion of certain additional parameters like weight-based doses and consideration for other comorbidities will help in patient- and procedure-specific SAP. Antimicrobial stewardship should be encouraged in all the hospitals and should follow local antimicrobial resistance pattern. This will assist in therapy decision, policy making, and evidence-based treatment.

Upaya Memutus Rantai Infeksi Melalui Edukasi Good Hand Hygiene pada Keluarga Penunggu Pasien yang dirawat di Rumah Sakit Dr. Slamet Garut

Health Care Associated Infection (HAIs) adalah infeksi yang terjadi pada pasien rawat inap di pelayanan kesehatan. HAIs merupakan masalah yang umum ditemukan di berbagai rumah sakit, baik dalam negeri maupun luar negeri. HAIs berdampak pada penurunan kualitas layanan rumah sakit dan merugikan pada pasiennya sendiri. Oleh karena itu diperlukan pencegahan untuk mmutus rantai infeksi. Salah satu upaya pencegahan untuk memutus rantai infeksi yaitu dengan cara melakukan edukasi pada penunggu pasien untuk meningkatkan perilaku yang baik dalam memutus rantai infeksi. Tujuan dari kegiatan ini adalah untuk memberikan pengetahuan kepada keluarga penunggu pasien tentang pentingnya mencuci tangan dan mengetahui bagaimna langkah mencuci tangan. Metode yang digunakan adalah penyuluhan langsung bertatap muka dengan keluarga penunggu pasien melalui media power point dan leaflet serta evaluasi berupa instrument pengetahuan tentang cuci tangan yang berjumlah 10 pertanyaan. Hasil yang didapatkan menunjukkan bahwa, dari 20 peserta kegiatan, setelah dilakukan edukasi hand hygiene, 15 peserta menunjukkan pengetahuan yang baik (75%) dan 5 orang (25%) dalam kategori pengetahuan cukup. Diperlukan program edukasi yang berkesinambungan kepada setiap pengunjung rumah sakit.

Knowledge and Expressed Practice Related to Hand Hygiene among Student Nurses - A Selected College of New Delhi, India

Introduction: Hand hygiene is an important healthcare issue globally and is a single most cost-effective and practical measure to reduce the incidence of health care associated infection across all setting-from advanced healthcare systems to primary healthcare centres. The objectives of the present study were to assess the knowledge and expressed practice related to hand hygiene among the student nurses in a selected college of Nursing, New Delhi. Materials and Methods: Quantitative research approach with descriptive research design were adopted for this study. Structured questionnaire was used to assess the knowledge and expressed practice checklist was used to assess the expressed practice related to hand hygiene among student nurses. Total 102 student nurses were selected through convenient sampling technique from DGNM 1st year and DGNM 2nd year of Rufaida College of Nursing, Jamia Hamdard, New Delhi, India. Data were collected in the month of September 2020. Descriptive statistics were used to analyse the data. Result: The findings of present study revealed that out of 102 samples, 90 (88.24%) have inadequate knowledge whereas only 12 (11.76%) have adequate knowledge on hand hygiene and 78 (76.47%) have good expressed practice while 16 (15.69%) have satisfactory expressed practice and 8 (7.84%) have poor expressed practice on hand hygiene. Conclusion: It was concluded that more observational studies should be conducted on hand hygiene as majority of samples have good expressed practice on hand hygiene whereas very few samples have adequate knowledge on hand hygiene.