scholarly journals Postoperative Management Strategy of Surgical Site Infection following Lumbar Dynesys Dynamic Internal Fixation

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Liehua Liu ◽  
Lei Luo ◽  
Chen Zhao ◽  
Qiang Zhou
Keyword(s):  
Surgical Site Infection ◽  
Internal Fixation ◽  
Management Strategy ◽  
Implant Removal ◽  
Early Infection ◽  
Site Infection ◽  
Infection Site ◽  
Delayed Infection ◽  
Group A ◽  
Group B

Aim. To research the incidence of surgical site infection (SSI) following lumbar Dynesys dynamic internal fixation and its management strategy. Methods. We retrospectively analyzed all cases of lumbar Dynesys dynamic internal fixation performed from January 2010 to December 2019, and the data from patients with SSI were collected. The observational indicators included the incidence of SSI, general information of the patients, surgical details, inflammatory indicators, pathogenic bacteria, and treatment. SSI was defined as both early infection and delayed infection, and the cases were divided into Groups A and B, respectively. The relevant indicators and treatment were compared between the two groups. Results. A total of 1125 cases of lumbar Dynesys dynamic internal fixation were followed up. Twenty-five cases of SSI occurred, and the incidence of SSI was 2.22% (25/1125). There were 14 cases of early infection (1.24%) and 11 cases of delayed infection (0.98%). Fourteen cases of early infection occurred 12.3 ± 8.3 days postoperatively (3–30), and 11 cases of delayed infection occurred 33.3 ± 18.9 months postoperatively (3–62). The inflammatory indicators of Group A were significantly higher than those of Group B (all P < 0.05 ), except for procalcitonin. The main infection site in Group A was located on the skin and subcutaneous tissue and around the internal instrument, while the main infection site in Group B was around the internal instrument. The main treatment for Group A was debridement and implant replacement, and the main treatment for Group B was implant removal. Summary. The incidence of SSI following lumbar Dynesys dynamic internal fixation was 2.22%, the incidence of early SSI was 1.24%, and the incidence of delayed SSI was 0.98%. If the main infection site of early infection is in the incision, debridement should be the main treatment method; if the infection site is around the internal fixation, implant replacement is recommended on the basis of debridement. Once delayed infection is diagnosed, implant removal is suggested.

scholarly journals Management of surgical site infection post-open reduction and internal fixation for tibial plateau fractures

2021 ◽  
Vol 10 (7) ◽  
pp. 380-387
Author(s):  
Jie Shen ◽  
Dong Sun ◽  
Jingshu Fu ◽  
Shulin Wang ◽  
Xiaohua Wang ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Site Infection ◽  
Induced Membrane ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Group A ◽  
Group B

Aims In contrast to operations performed for other fractures, there is a high incidence rate of surgical site infection (SSI) post-open reduction and internal fixation (ORIF) done for tibial plateau fractures (TPFs). This study investigates the effect of induced membrane technique combined with internal fixation for managing SSI in TPF patients who underwent ORIF. Methods From April 2013 to May 2017, 46 consecutive patients with SSI post-ORIF for TPFs were managed in our centre with an induced membrane technique. Of these, 35 patients were included for this study, with data analyzed in a retrospective manner. Results All participants were monitored for a mean of 36 months (24 to 62). None were subjected to amputations. A total of 21 patients underwent two-stage surgeries (Group A), with 14 patients who did not receive second-stage surgery (Group B). Group A did not experience infection recurrence, and no implant or cement spacer loosening was noted in Group B for at least 24 months of follow-up. No significant difference was noted in the Lower Extremity Functional Scale (LEFS) and the Hospital for Special Surgery Knee Score (HSS) between the two groups. The clinical healing time was significantly shorter in Group B (p＜0.001). Those with longer duration of infection had poorer functional status (p＜0.001). Conclusion Management of SSI post-ORIF for TPF with induced membrane technique combined with internal fixation represents a feasible mode of treatment with satisfactory outcomes in terms of infection control and functional recovery. Cite this article: Bone Joint Res 2021;10(7):380–387.

scholarly journals Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial

2018 ◽  
Vol 5 (4) ◽  
pp. 1438
Author(s):  
Aditya N. Patil ◽  
Veerendra M. Uppin
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Intravenous Route ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Open Appendicectomy ◽  
Group A ◽  
Group B

Background: Surgical site infection (SSI) is one of the most common postoperative complications following abdominal surgeries. Whilst the use of prophylactic antibiotics has been shown to reduce postoperative wound infection, controversy still remains as to the optimum route of administration and the duration of treatment. This study aims to compare the efficacy of a preoperative single dose of a cephalosporin antibiotic (cefotaxime) administered intraincisionally versus that administered intravenously, in preventing postoperative surgical site infections following appendicectomy.Methods: Sixty consecutive cases diagnosed as uncomplicated appendicitis who consented for open appendicectomy at a tertiary care institute were included in the study. Cases were randomized to 2 comparable groups of 30 patients each. Preoperatively, patients in Group A received a single dose of Inj. Cefotaxime 1g intraincisionally while those in Group B received the same intravenously. Incision sites were examined every alternative day starting on postoperative day 3 until removal of sutures. Signs of surgical site infection, if any, were recorded and outcomes were statistically tested for significance.Results: One patient in Group A (3.3%) and 4 patients in Group B (13.3%) showed signs of postoperative surgical site infection (p >0.05) during the follow up period which prolonged their hospital stay.Conclusions: This study showed that a single dose preoperative intraincisional administration of cefotaxime was as effective as intravenous administration for prevention of postoperative surgical site infection after open appendicectomy. Although the difference was not statistically significant, there was a reduced incidence of SSI in individuals who received intraincisional antibiotic. These results are encouraging for a way forward in reducing unnecessary burdening of systemic antibiotics in patients undergoing abdominal surgeries. 

scholarly journals Abdominal Wound Closure in Gynaecological or Obstetrical Surgery with Vicryl® (Polyglactin910) Versus Vicryl Plus® (Polyglactin910 with Triclosan Added): A Comparative Study

2019 ◽  
Vol 17 (1) ◽  
pp. 10-12
Author(s):  
Binod Kumar Mahaseth
Keyword(s):  
Surgical Site Infection ◽  
Surgical Complication ◽  
College Teaching ◽  
Controlled Study ◽  
Skin Closure ◽  
Site Infection ◽  
Comparative Efficacy ◽  
Group A ◽  
Group B ◽  
Johnson Company

Background: Surgical site infection is the most common post-surgical complication in surgical patients. The incidence of surgical site infection varies from 3-20% (or even more) in different part of the world. To date, the best method and material for skin closure has not been recommended by anybody. Triclosan is an antiseptic agent used for coating a suture material to prevent the infections. This case-controlled study was carried out to determine the comparative efficacy of sutures; Objective: This case-controlled study was carried out to determine the comparative efficacy of sutures: vicryl® and vicryl plus® (triclosan, an antiseptic incorporated with suture), in reducing surgical site infection in laparotomy for clean Gyn/Obs operations. Material and method: This case-controlled study was carried out in Dept. Of Gynae/Obs at Nepalgunj Medical College Teaching Hospital, Kohalpur. The period of the study was from Jan 2018 to January 2019. A total of 50 participants were enrolled in the study, who met the inclusion criteria. The patients were divided into two groups A and B, each consisting of 25 patients. The patients were allocated in the groups alternately to remove bias. The Group A consisted of patients where Vicrylplus® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 with triclosan) was used and Group B consisted of patients where vicryl ® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 alone) was used. Patients whose abdominal wounds were found infected, pus swab for culture were taken and sent for aerobic culture and sensitivity. All patients received ceftriaxone and metronidazole single dose before operations prophylactically. Result: Surgical site infection ingroup A was 3 cases out of 25 (12%) and in group B it was 6 cases out of 25(24%). Triclosan added polyglactin910 suture found to be statistically non significant concerning prevention of SSI as compared to polyglactin910 (p=0.472). The mean age of the study population was in group A was (29.76±7.47) and in group B was (27.12±7.42).

scholarly journals Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study

2019 ◽  
Vol 6 (1) ◽  
pp. 106
Author(s):  
M. Bharath ◽  
J. R. Galagali ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
E. Nikhilesh
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Prophylactic Use ◽  
Group B ◽  
Clean Contaminated

<p class="abstract"><strong>Background:</strong> Many clinicians continue to use antibiotic prophylaxis routinely in all surgical procedures, ignoring the guidelines issued by policy makers. In this prospective study we compared the rate of surgical site infection (SSI) in patients who received prophylactic antibiotics as a routine; with the rate of SSI in patients getting antibiotics strictly as per SIGN 104 Guidelines, for clean and clean contaminated procedures.</p><p class="abstract"><strong>Methods:</strong> The study population comprised 235 patients. Group A consisted of 119 patients having 77 (65%) males and 42 (35%) females while Group B had 116 patients - 71 (61%) males and 45 (39%) females. Group A received routine antibiotic prophylaxis in all cases, while Group B received antibiotic prophylaxis as per SIGN 104 guidelines only. Both the groups were followed up for one month post-operatively for SSI and complications.</p><p class="abstract"><strong>Results:</strong> SSI occurred in 2 patients (1.68%) in Group A and in 3 (2.59%) patients in Group B. There was no significant difference in the rate of SSI between the two groups (p=0.68). Procedure wise maximum SSI occurred in tympanoplasty and laryngectomy. Due to infection one case of tympanoplasty had graft failure and one case of laryngectomy had delayed wound healing. No major complications related to infection or antibiotic use occurred in either group.</p><p class="abstract"><strong>Conclusions:</strong> Selective use of antibiotic prophylaxis as per SIGN 104 Guidelines does not lead to increase in SSI in clean and clean contaminated ENT procedures.</p>

scholarly journals A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 253 ◽  
Author(s):  
Pramod Singh ◽  
Sumit Kumar Gupta ◽  
Mukesh Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
City Hospital ◽  
Site Infection ◽  
First Choice ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.

scholarly journals SURGICAL SITE INFECTION;

2017 ◽  
Vol 24 (12) ◽  
pp. 1770-1774
Author(s):  
Syed Muhammad Asar Hussain ◽  
Saadat Ali Janjua ◽  
Amna Fareed ◽  
Asrar Ahmad ◽  
Irum Saleem
Keyword(s):  
Surgical Site Infection ◽  
Study Design ◽  
Primary Closure ◽  
Military Hospital ◽  
Site Infection ◽  
Trial Duration ◽  
Primary Wound Closure ◽  
Delayed Primary Closure ◽  
Group A ◽  
Group B

Objectives: To compare the frequency of surgical site infection after primaryand delayed primary wound closure in dirty abdominal wounds. Study Design: Randomizedcontrolled trial. Duration and Setting: This study was carried out over a period of six monthsfrom 07-02-2014 to 06-08-2014 in the department of surgery combined military hospital Quetta.Methodology: A total of 190 patients were included in this study. wound was observed fordevelopment of surgical site infection post operatively within seven days by the assignedinvestigator who was unaware of the wound study design. surgical site infection was assessedusing Southampton wound grading. Results: Mean age of the patients was 30.89±10.38 and32.74±9.52 in group A and B, respectively. in group-A, 73 patients (76.8%) and in group-B 66patients (69.5%) were male while 22 patients (23.2%) of group-A and 29 patients (30.5%) ingroup-B were female.in group-A surgical site infection was observed in 29 patients (30.5%)and in group-B 12 patients (12.6%) were having surgical site infection. statistically significantdifference was found between two groups (p=0.003). Conclusion: The frequency of surgicalsite infection was significantly lower after delayed primary closure of dirty wounds as comparedto primary closure.

Surgical Site Infections in Abdominal Surgeries - A Clinicopathological Prospective Study

2021 ◽  
Vol 8 (02) ◽  
pp. 69-74
Author(s):  
Biswaranjan Mohapatra ◽  
Dipesh Kumar Padhihari ◽  
Mrutynjay Das ◽  
Sai Barath Sunkara ◽  
Saikh Kasif Sahajada
Keyword(s):  
Prospective Study ◽  
Surgical Site Infection ◽  
Medical Science ◽  
Operating Time ◽  
Surgical Techniques ◽  
Surgical Site Infections ◽  
Purulent Discharge ◽  
Site Infection ◽  
Group A ◽  
Group B

BACKGROUND Surgical site infection still remains a nightmare for most surgeons even in these times despite many advances in medical science, surgical techniques & better operating room environment. Surgical site infection (SSI) is defined as ‘an infection occurring within 30 days of a surgery (or within 1 year if an implant is left in place after procedure) and affecting either incision or deep tissues at the operation site. METHODS A single observer, cross sectional, prospective study was carried out in the Dept. of General Surgery, in collaboration with Microbiology & Pathology Departments of Hi-tech Medical College and Hospital, Bhubaneswar, Odisha. The study included all patients who underwent laparotomy during the period of study, patients of all age groups except neonates and patients with post-operative surgical site infections. RESULTS The prospective study involved culture and sensitivity of 114 patients undergoing clean-contaminated surgeries (group A), contaminated-surgeries (group B) in the Department of Surgery at our institute. The study shows that the maximum number of cases were between 21 to 60 yrs. of age. (78 %) and the mean age in the group A was 39.2 years while in group B, it was 39.8 years. There was a total of 90 patients between 21 - 60 yrs. of age. Mean hospital stay in group A was 5.7 days and group B was 8.9 days. The sex ratio is quite evenly matched, 63 male patients and 51 female patients out of 114 cases. Amongst the 114 subjects, group A comprised of 58.77 % (67) while group B consisted of 41.22 % (47.13) patients. Out of 67, 13 from group A came back as sterile, in group B sterile samples were 10. CONCLUSIONS This study concludes that age, sex, class of wound, peri-operative management, operating time and co-morbidities of the patient, all have a significant effect on the incidence of surgical site infections. KEYWORDS Surgical Site Infection, Laparotomy, Purulent Discharge, Drain

scholarly journals Intraoperative Disinfection by Pulse Irrigation with Povidone-Iodine Solution in Spine Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Vincenzo De Luna ◽  
Federico Mancini ◽  
Fernando De Maio ◽  
Gabriele Bernardi ◽  
Ernesto Ippolito ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Spine Surgery ◽  
Povidone Iodine ◽  
Site Infection ◽  
Iodine Solution ◽  
Deep Wound ◽  
Group A ◽  
Group B ◽  
Povidone Iodine Solution

Background. Deep wound infection in spine surgery is a debilitating complication for patients and increases costs. The objective of this prospective study was to evaluate the efficacy of wound pulse irrigation with a dilute povidone-iodine solution in the prevention of surgical site infection.Methods. 50 patients undergoing spinal surgery were randomly divided into two groups (A and B) of 25 patients each. In group A, wounds were irrigated with dilute (3%) povidone-iodine solution through a low-pressure pulsatile device. In group B, wounds were irrigated with saline solution through a bulb syringe. In both groups, specimens for bacterial culture were harvested from surgical site before and after irrigation.Results. In group A, no surgical site infection occurred; in group B, deep wound infection was observed in 3 patients. In both groups, before irrigation some cultures have been found positive for bacterial contamination.Conclusion. Our study seems to support the idea that low-pressure pulsating lavage of surgical wounds with povidone-iodine diluted to a nontoxic concentration of 3% is an effective therapeutic adjunct measure to prevent surgical site infection in spine surgery. However, the number of the enrolled patients is small and a significant statistical analysis is not practicable. This trial is registered withNCT03249363.

scholarly journals Predictive Factors of Surgical Site Infection in Prosthetic Joint Surgery. A Prospective Study on 760 Arthroplasties.

2021 ◽  
Author(s):  
Martina Maritati ◽  
Alessandro Trentini ◽  
Davide Chemello ◽  
Elisa Mazzoni ◽  
Gustavo Zanoli ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Site Infection ◽  
Surgical Suture ◽  
Group A ◽  
Group B

Abstract Purpose: Surgical site infection (SSI) is a debilitating complication of total joint arthroplasty (TJA) with significant morbidity and increased costs. Aim of our study was to identify potential risk factors for SSIs in a population of patients undergoing TJA. Methods: TJA were prospectively recruited at Santa Maria Maddalena Hospital from February 2019 to April 2020. Age, sex, major comorbidities, American Society of Anesthesiologists (ASA) class, length of surgery, type of surgical suture, total hospital length of stay and clinical laboratory data were collected. The study population was then divided into two groups: Group A, normal post-operative course, and Group B, patients who developed SSI at follow-up (17-25 days).Results: 25/760 (3.3%) patients developed SSIs at follow-up. Clinical and demographic parameters were not different between the two groups. Total leucocyte and neutrophil values at discharge resulted to be significatively higher in Group B compared to Group A (p=0.025 and p=0.016, respectively). Values of 7860/mL for total leucocyte, and 5185/mL for neutrophil count at discharge significantly predicted the future development of SSI (AUC 0.623 and AUC 0.641, respectively; p<0.05) independently from confounding factors (total leukocytes: O.R.=3,69 [95% C.I. 1,63-8,32]; neutrophils: O.R.=3,98 [95% C.I. 1,76-8,97. Deep SSIs has been diagnosed significantly before superficial SSIs (p=0,008), with a median advance of 9 days. Conclusion: Total leukocytes and neutrophils at discharge seem useful to identify a population at risk for the development of SSIs following TJA. Further studies on larger populations are needed to develop a predictive SSIs risk score that should include those variables.

scholarly journals A prospective study in peritonitis patients to compare the impact of subcutaneous negative suction closure, conventional primary closure of skin and subcutaneous tissue and open skin technique following laparotomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3293
Author(s):  
Mano Zac Mathews ◽  
Sriram Gopalakrishnaiah Subramanyam ◽  
Nivedita Mitta
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Abdominal Wall ◽  
Subcutaneous Tissue ◽  
Site Infection ◽  
Abdominal Wall Closure ◽  
Suction Drain ◽  
Group A ◽  
Group B ◽  
Negative Suction

Background: Abdominal wall closure in the presence of sepsis presents a challenge to the surgeon. The objective of this study is to determine the advantages and disadvantages of each method to individualise the techniques based on patient profile about surgical site infection, duration of hospitalisation and morbidity.Methods: A prospective comparative study was conducted among 102 operated patients of peritonitis in the Department of General Surgery at St John’s Medical College and Hospital. The patients were divided into three groups, group A, group B and group C. In group A, skin and subcutaneous tissue was closed after draining the subcutaneous space by a negative-suction drain. In group B, the patient’s skin and subcutaneous tissues were closed primarily with continuous sutures without negative suction drain. In group C, the laparotomy wound was closed and the skin was left open. And the outcome compared in the form of wound infection, hospital stay and morbidity. Patients on immunosuppressive therapy and paediatric patients were excluded. Demographic and clinical variables were recorded at the time of admission. SPSS version 18 was used for analysis.Results: The study showed male preponderance and the mean age was 43.2 years. Duodenal perforation was the commonest cause of peritonitis in this study (38.2%). Incidence of surgical site infection was less in Group A (20.6%) compared to group B (52.9%) and group C (29.4%). Duration of hospital stay was also less in Group A patients (9.3±3.6 days) compared to other two groups. 37 patients who were included in the study were diabetic, out of which 25 patients (67.6%) developed surgical site infection.Conclusions: It can be concluded from this study that abdominal wall closure using a sub cutaneous negative suction drain in peritonitis cases reduces the incidence of surgical site infection, duration of hospital stays, subsequent surgeries related to wound dehiscence and its associated morbidity.  

Sign in / Sign up

Export Citation Format

Share Document