Role of Pre-Operative Blood Transfusion and Subcutaneous Fat Thickness as Risk Factors for Surgical Site Infection after Posterior Thoracic Spine Stabilization

2015 ◽  
Vol 16 (3) ◽  
pp. 333-337 ◽  
Author(s):  
Georg Osterhoff ◽  
Laurin Burla ◽  
Clément M.L. Werner ◽  
Thorsten Jentzsch ◽  
Guido A. Wanner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Surgical Site Infection ◽  
Thoracic Spine ◽  
Subcutaneous Fat ◽  
Site Infection ◽  
Spine Stabilization ◽  
Subcutaneous Fat Thickness ◽  
Fat Thickness

scholarly journals Subcutaneous Fat Thickness and the Risk of Superficial Incisional Surgical Site Infection Following Open Appendectomy

2021 ◽  
Vol 23 (1) ◽  
pp. 1-5
Author(s):  
Subash Rai ◽  
P Poudel ◽  
A Chalise ◽  
M Nepal ◽  
M Shrestha
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Subcutaneous Fat ◽  
Site Infection ◽  
Female Population ◽  
Wound Site ◽  
Incisional Surgical Site Infection ◽  
Subcutaneous Fat Thickness ◽  
Fat Thickness

Obesity is a known risk factor for surgical site infection (SSI). Recent studies have demonstrated that fat burden at the incisional site rather than body mass index (BMI) is a more precise and sensitive measure to predict the risk of SSI. The purpose of the study was to evaluate the correlation between subcutaneous fat thickness (SCFT) at the level of Mc Burney’s point and the occurrence of superficial incisional SSI among the patients undergoing open appendectomy. A total of 120 patients who underwent open appendectomy were included in the study. SCFT was measured preoperatively with ultrasonography (USG). The occurrence of superficial incisional SSI was evaluated in relation to SCFT. Previously identified well established risk factors for the development of SSI were also considered by the study. Statistical analysis was performed using SPSS version 17. Overall, superficial incisional SSI was observed in 27 (22.5%) participants. Mean SCFT at the level of Mc Burney’s point among male and female population was 2.26 cm ± 0.74 (SD) and 2.02 cm ± 0.83 (SD) respectively. Patients with superficial incisional SSI had a mean fat thickness of 2.80 cm and those without SSI had mean fat thickness of 1.97 cm. The difference in SCFT was statistically significant (p=.001). More interestingly, the area under the ROC curve was more for SCFT, in comparison to BMI among the patients who developed superficial incisional SSI (81% vs. 73%). Furthermore, we analysed the occurrence of superficial incisional SSI with SCFT cut off at 2.80 cm, which was statistically significant. As majority of the study population were young adults, risk factors like smoking, diabetes mellitus and nutritional status failed to demonstrate significant correlation with post appendectomy wound site complications. The study demonstrated that the thickness of subcutaneous fat at the site of inci sion is a good predictor of superficial incisional SSI following open appendectomy and the risk of superficial wound site infection increases as the thickness of subcutaneous fat at the site of incision increases.

scholarly journals Correlation Between Subcutaneous Fat Thickness And Superficial Surgical Site Infection In Patients Undergoing Open Appendectomy

2020 ◽  
Vol 8 (02) ◽  
pp. 7-10
Author(s):  
Naveen Mahaseth ◽  
Santosh Shah ◽  
Kritendra Raj Sharma
Keyword(s):  
Surgical Site Infection ◽  
Prospective Observational Study ◽  
Open Appendectomy ◽  
Subcutaneous Fat ◽  
Obese Group ◽  
Site Infection ◽  
Medical Sciences ◽  
Delayed Wound Healing ◽  
Subcutaneous Fat Thickness ◽  
Fat Thickness

INTRODUCTION Surgical site infection (SSI) is a commonly encountered complication in any surgery and is commonly associated with appendicitis. Obesity has been associated with delayed wound healing and risk of infections and this research aims to validate the fact. MATERIAL AND METHODS Prospective observational study was carried out in Universal College of Medical Sciences, Bhairahawa, Nepal, from September 2017 to December 2018 on all cases of appendectomy meeting the inclusion criteria. RESULTS Of total 100 cases of acute Appendicitis, 35% cases developed superficial surgical site infection (SSSI). The development of SSSI in patients with subcutaneous fat thickness (SCFT) of greater that 2.5 cm, between 1.5 cm to 2.5 cm and less than 1.5 cm were 62.5%, 41.9% and 6.1% respectively. Similarly, 40% of patients in grade I obesity group, 63.6% of patients in pre-obese group and 31.1% of patients in normal BMI group developed SSSI.  On comparison between SCFT and BMI on a ROC curve, SCFT (0.785) has more AUC than BMI (0.762). CONCLUSION It has been observed that patients with increasing amount of SCFT at incision site had higher chances of developing SSSI. It could also be concluded that though both increased BMI and SCFT had increased frequency of occurrence SSSI, SCFT was more reliable in predicting the chances of SSSI as significant number of cases of SSSI were occurring in normal BMI and pre- obese group.

scholarly journals Developing a Risk Stratification Model for Surgical Site Infection after Abdominal Hysterectomy

2009 ◽  
Vol 30 (11) ◽  
pp. 1077-1083 ◽  
Author(s):  
Margaret A. Olsen ◽  
James Higham-Kessler ◽  
Deborah S. Yokoe ◽  
Anne M. Butler ◽  
Johanna Vostok ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Blood Transfusion ◽  
Risk Stratification ◽  
Surgical Site Infection ◽  
Private Health Insurance ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
Independent Risk Factors ◽  
Duration Of Operation

Objective.The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy.Methods.Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression.Results.There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30–35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI.Conclusions.Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.

scholarly journals Liberal and Restrictive Blood Transfusion Strategies in Orthopedic Surgery: Risk Factors for Surgical Site Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s313-s314
Author(s):  
Hoberdan Pereira ◽  
Marcelo Perucci ◽  
Lucas de Lima ◽  
Daniel Bodour ◽  
Laura Vieira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Blood Transfusions ◽  
Site Infection ◽  
Lower Limb Fractures ◽  
Limb Fractures

Background: The identification of risk factors for infections in surgical patients with lower-limb fractures and blood transfusions has increased in recent years. Surgical site infections (SSIs) increase hospitalization, care costs, and patient suffering. Correction surgery for lower-limb fractures and blood transfusion is quite common between surgical procedures. The aim of this study was to describe the relationship between blood transfusion and SSI in patients undergoing orthopedic surgery on lower limbs. Methods: We conducted a prospective cohort study to identify risk factors for SSI in blood transfused patients undergoing fracture repair in lower-limb surgeries between February 2017 and May 2019 in 2 reference tertiary-care hospitals in Belo Horizonte, a city of 3 million people in Brazil. Data regarding patient characteristics, surgical procedures, blood transfusions, and surgical infections were collected. Patient characterization was performed by calculating the absolute and relative frequencies of categorical variables and calculating mean, median, minimum, maximum, standard deviation, and coefficient of variation for quantitative variables. The incidence of surgical site infection, the risk of postoperative hospital death, and the total length of hospital stay were calculated by point estimates and 95% confidence intervals identified by statistical tests of bilateral hypotheses, considering the level of significance of 5%. A multivariate analysis (logistic regression) was performed to identify SSI risk factors. Results: Patients who had an indication for blood transfusion (n = 38) but who did not receive blood (n = 4) had significantly lower hemoglobin, comparing discharge with admission, than the group who received blood. Intraoperative transfusion was a risk factor for SSI (OR, 4.7) (Fig. 1). Among the 205 patients with no indication for transfusion, 98 received blood even without the indication: there was no difference in hemoglobin outcome when discharge and admission were compared, and the 98 patients were exposed to unnecessary risk. Regarding restrictive versus liberal transfusion strategies, there were differences in the variables, age (P = .000), duration of surgery (P = .003), number of comorbidities (P = .000), body mass index (BMI) (P = .027), previous hemoglobin (P = .000), and high hemoglobin (P = .000), considering the transfusion practice employed (Fig. 2). Conclusions: The indications for and definition of protocols and careful evaluation of blood transfusion are critical to avoid infectious complications in orthopedic patients with lower-limb fractures.Funding: NoneDisclosures: None

THE RELATION OF BODY BUILD TO THE EXCRETION OF 17-KETOSTEROIDS AND 17-KETOGENIC STEROIDS IN HEALTHY YOUNG MEN

1959 ◽  
Vol 19 (1) ◽  
pp. 87-101 ◽  
Author(s):  
J. M. TANNER ◽  
M. J. R. HEALY ◽  
R. H. WHITEHOUSE ◽  
A. C. EDGSON
Keyword(s):  
Subcutaneous Fat ◽  
Urine Volume ◽  
Young Men ◽  
Multiple Correlation ◽  
Body Build ◽  
Limb Bones ◽  
Penis Size ◽  
Subcutaneous Fat Thickness ◽  
Fat Thickness

SUMMARY 1. The 24 hr excretions of 17-ketosteroids (17-KS), 17-ketogenic steroids (17-KGS) and creatinine of 101 healthy young men have been measured on two occasions several weeks apart to determine what, if any, relationship these bore to the subjects' body build. 2. Body build was assessed by anthropometric measurements, somatotyping, and a new method detailing the limb widths of fat, muscle and bone. 3. The week-to-week personal constancy coefficient of each of these excretions has been calculated. It is highest for 17-KS (0·83), and slightly lower for 17-KGS (0·73) and creatinine (0·72). 4. Correlations have been calculated both for between-persons relationships ('stable' or 'habitual'individuals' values) and within-persons relationships (daily individual co-fluctuations). The stable values of 17-KS and 17-KGS excretions are inversely related, individuals habitually high in one being habitually low in the other. This relationship becomes more marked when allowances are made for surface area and urine volume differences. 5. Excretion of 17-KS is significantly related to body weight and to mesomorphy. The multiple correlation with muscle width and weight was 0·56. 6. Excretion of 17-KGS is significantly related to weight and height. This is due to a positive relation with width and length of the limb bones (multiple correlation 0·55). There is no relation with muscle mass or subcutaneous fat thickness. 7. On the basis of these findings speculations are made on the possible role of 17-KS in maintaining muscle bulk and of corticosteroids in maintaining the contents of the medulla of the limb bones. 8. There is a significant, though quantitatively small, correlation between general body hirsutism, muscle bulk and 17-KS output. There is a similar-sized but inverse relation between penis size and amount of subcutaneous fat. 9. Recent findings on the relation of physique to resistance to tuberculosis are discussed in the light of the above findings. These point to the conclusion that more bodily measurements than simple weight and height must be taken if useful information as to causes of the physique-disease relationship is to be obtained.

scholarly journals Surgical Site Infection in Spine Surgery: Who Is at Risk?

2018 ◽  
Vol 8 (4_suppl) ◽  
pp. 5S-30S ◽  
Author(s):  
Reina Yao ◽  
Hanbing Zhou ◽  
Theodore J. Choma ◽  
Brian K. Kwon ◽  
John Street
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Surgical Site Infection ◽  
Spine Surgery ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Preoperative Radiation ◽  
Site Infection ◽  
Postoperative Blood Transfusion ◽  
Duration Of Surgery

Study Design: Retrospective literature review of spine surgical site infection (SSI). Objective: To perform a review of SSI risk factors and more specifically, categorize them into patient and surgical factors. Methods: A review of published literature on SSI risk factors in adult spine surgery was performed. We included studies that reported risk factors for SSI in adult spinal surgery. Excluded are pediatric patient populations, systematic reviews, and meta-analyses. Overall, we identified 72 cohort studies, 1 controlled-cohort study, 1 matched-cohort study, 1 matched-paired cohort study, 12 case-controlled studies (CCS), 6 case series, and 1 cross-sectional study. Results: Patient-associated risk factors—diabetes mellitus, obesity (body mass index >35 kg/m2), subcutaneous fat thickness, multiple medical comorbidities, current smoker, and malnutrition were associated with SSI. Surgical associated factors—preoperative radiation/postoperative blood transfusion, combined anterior/posterior approach, surgical invasiveness, or levels of instrumentation were associated with increased SSI. There is mixed evidence of age, duration of surgery, surgical team, intraoperative blood loss, dural tear, and urinary tract infection/urinary catheter in association with SSI. Conclusion: SSIs are associated with many risk factors that can be patient or surgically related. Our review was able to identify important modifiable and nonmodifiable risk factors that can be essential in surgical planning and discussion with patients.

Statewide Collaboration to Evaluate the Effects of Blood Loss and Transfusion on Surgical Site Infection after Hysterectomy

2012 ◽  
Vol 33 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Heather Young ◽  
Crystal Berumen ◽  
Bryan Knepper ◽  
Amber Miller ◽  
Morgan Silverman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Surgical Site Infection ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Abdominal Hysterectomy ◽  
Public Reporting ◽  
Site Infection

We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL.Infect Control Hosp Epidemiol 2012;33(1):90-93

Risk factors for surgical site infection after cardiac surgery: The role of endogenous flora

Heart & Lung ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 108-114 ◽  
Author(s):  
Janet P. Haas ◽  
Ann M. Evans ◽  
Karen E. Preston ◽  
Elaine L. Larson
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Surgical Site Infection ◽  
Site Infection
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