scholarly journals Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis

2020 ◽  
Vol 36 (1) ◽  
pp. 30-34
Author(s):  
Tae Gyeong Lee ◽  
Soomin Nam ◽  
Hyung Soon Lee ◽  
Jin Ho Lee ◽  
Young Ki Hong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Postoperative Complication ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Multiple Logistic Regression Analysis ◽  
Operation Time ◽  
Site Infection ◽  
Uncomplicated Acute Appendicitis

Purpose: To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.Methods: Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.Results: A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.Conclusion: There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Impact of wound irrigation during laparoscopic appendectomy on surgical site infection in acute appendicitis: a multicenter retrospective analysis

2020 ◽  
Author(s):  
Soomin Nam ◽  
Youn Young Park ◽  
Yun Tae Jung ◽  
Chinock Cheong
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Laparoscopic Appendectomy ◽  
Perforated Appendicitis ◽  
Operation Time ◽  
Skin Closure ◽  
Site Infection ◽  
Wound Irrigation ◽  
Saline Irrigation ◽  
Postoperative Fever

Abstract Background Surgical site infection (SSI) is one of the major complications after appendectomy. Among the many efforts to reduce variable risk factors, subcutaneous wound irrigation has been reported in some abdominal surgeries. However, there are no relevant literatures regarding patients who underwent laparoscopic appendectomy. This study aimed to determine the effect of wound irrigation before skin closure when performing laparoscopic appendectomy. Methods We included patients who had undergone laparoscopic appendectomy due to acute appendicitis from March 2017 to October 2019 from three hospitals. Clinical data of 333 patients were retrospectively collected, and we divided 333 patients into three groups according to the method of wound irrigation: no irrigation (n = 93), saline irrigation (n = 144), and povidone-iodine (PI) (n = 96) groups. Results A total of 15 patients (4.5%) were diagnosed with SSI within postoperative 30 days. There was no difference in the SSI rates (4.3% vs. 5.1% vs. 4.5%, p = 0.953). None of the factors were associated with SSI among the variables (sex, age, ASA, perforated appendicitis, preoperative WBC and hemoglobin levels, operation time, wound irrigation, type of wound closure material, and preoperative and postoperative fever). Conclusions Wound irrigation did not affect the SSI rate in patients who underwent laparoscopic appendectomy.

scholarly journals Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rui Ma ◽  
Jie He ◽  
Biao Xu ◽  
Changsong Zhao ◽  
Yao Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Orthopedic Surgery ◽  
Operating Characteristic ◽  
Multiple Logistic Regression Analysis ◽  
Hiv Positive ◽  
Cutoff Score ◽  
Site Infection ◽  
Erythrocyte Sedimentation ◽  
Immunodeficiency Virus

Abstract Background Surgical site infection (SSI) is a devastating complication of orthopedic surgery, related with increased morbidity and mortality. This study was performed with the aim to compare the SSI rate in human immunodeficiency virus HIV-positive patients, to identify other risk factors for SSI and to establish a nomogram model to predict the risk of SSI. Methods A total of 101 HIV-positive individuals following orthopedic surgery patients admitted to Beijing Ditan Hospital. Their characteristics were gathered. The univariate and multiple logistic regression analysis were performed to explore the risk factors of SSI. And the Nomogram prediction model was constructed and verified. Results The independent predictive factors of SSI included CD4 (Odds ratio [OR], 0.041; P = 0.040), erythrocyte sedimentation rate (ESR) (OR, 89.773; P = 0.030), and procalcitonin (PCT) (OR, 220.746; P = 0.006). The scoring nomogram model was as follows: Logit (SSI) = − 2.63589–0.00314*CD4 < 430.75 = 1) + 0.04695*(ESR < 17.46 = 1) + 2.93694*(PCT < 0.22 = 1). The area under the Receiver Operating Characteristic (ROC) curve was 0.946. The cutoff score was − 2.1026 with a sensitivity of 93.33% and a specificity of 84.88%. Conclusions CD4, ESR, PCT might affect the occurrence of SSI after orthopedic surgery. The nomogram model constructed in this study is helpful for predicting the probability of SSI.

scholarly journals Risk Factors Associated With 55 1 In Elective Gastrointestinal Surgery: A Prospective Study In A Specialized Surgical Centre

2019 ◽  
Vol 16 (2) ◽  
pp. 71-75
Author(s):  
Aminul Islam Joarder ◽  
Mohammad Salahuddin Faruque ◽  
M Nur E Elahi ◽  
Ishrat Jahan ◽  
Omar Siddiqui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Smoking Habit ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Operation Time ◽  
Drain Tube ◽  
Site Infection ◽  
A Prospective Study ◽  
Surgery Department

Background: Understanding SSI and providing feedback to the surgical team has been shown to reduce the incidence of surgical site infection and the cost incurred due to it. Objective: To assess the risk factors of surgical site infection (SSI) in elective gastrointestinal surgery. Methods: prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 0 to July 201 2. All preoperative risk factors were evaluated .Patients operated were followed in the post operative period and if any wound infection noted, swab from the site of infection was sent for culture and sensitivity and antibiotics were given accordingly. Results: The incidence of SSI was 1 83(1 6.31 %).Out of this 1 83 cases 65.6% had BMI <25. Anaemia was present in 45.90% cases, bronchopulomnary disease was present in 1 1 .5% cases and DM & jaundice was present in 8.1 9% and 28.9% cases accordingly. 69(37.7%) cases were habitual smoker.SSI rate progressively increased with rate of contamination and maximum infection occurred in lower GIT surgery which was 144(1 7.84%). SSI developed more, in 1 02 (55.74 %) cases when duration of peration was more th ;1 1 1;1.2 hours. In 73.8% cases of SSI drain tube was used. Statistically significant risk factors for SS were found to be smoking habit, BMI <25, preoperative anaemia and duration of operation more than two hours. Conclusion: Specific optimization of the patients' preoperative condition is essential to reduce the risk of SSI following elective gastrointestinal surgery. Surveillance should be conducted and maintained in all hospitals to promote better surgical outcomes. Cessation of smoking, optimization of nutritional status, correction of anaemia and reduction of operation time should be associated with a lower incidence of SSI. Journal of Surgical Sciences (2012) Vol. 16 (2) : 71-75

scholarly journals Study on Risk Factors and Microorganisms for Surgical Site Infection following Caesarean Section among 100 Patients in a Tertiary Hospital in Bangladesh

2019 ◽  
Vol 9 (2) ◽  
pp. 90-96
Author(s):  
Sayma Afroz ◽  
Maliha Rashid
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Mode Of Delivery ◽  
Operation Time ◽  
Site Infection ◽  
College Hospital ◽  
Bacteriological Study ◽  
E Coli

Background: Lower uterine caesarean section is a common mode of delivery now and surgical site infection is one of the most common and dreaded complication of surgery. It is associated with significant morbidity and delayed recovery and it lengthens hospital stay and costs. Identifying risk factors for surgical site infection in caesarean wound and modifying them can be beneficial for patient management during surgery and optimizing good clinical outcome. Identifying microorganisms with their sensitivity has epidemiological as well as therapeutic implications. Objective: To identify risk factors for surgical site infection in caesarean section wound and find out microorganisms responsible for such infection. Materials and Methods: In this study 100 women with surgical site infection after caesarean section were included. They were selected randomly from four maternity units of Dhaka Medical College Hospital. Each patient of caesarean section was followed strictly up to discharge from hospital and also for 30 days postoperatively for any evidence of infection. Wound swab was sent in each case for microbiological study. Data were collected in structured questionnaire and analysed by computer using spreadsheet. Results: Among 100 women studied, 73% had inadequate or no antenatal check-up, 52% had duration of labour pain >12 hours, 52% had duration of ruptured membrane >12 hours, 94% women underwent emergency caesarean section, 62% had operation time >1 hour, 61% had haemoglobin level <60%, 46% women had intervention by untrained birth attendant, and 43% women had >500 mL blood loss during operation. In bacteriological study, microorganisms were identified in 55% cases, among them Staphylococcus aureus (20%), E. coli (11%), Acinetobacter (7%), Pseudomonas (6%) and Proteus (5%). During sensitivity test Staphylococcus aureus was mostly sensitive to ceftriaxone (50%) and amikacin (33%) and E. coli to amikacin (80%). In four cases (2 proteus and 2 pseudomonas) out of 55 organisms were resistant to all antibiotics. Conclusion: Most of the risk factors for surgical site infection during caesarean section identified in this study can be modified through intervention. However, the microorganisms detected from our patients showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Enam Med Col 2019; 9(2): 90-96

scholarly journals Thirty-Day Readmission After Elective Colorectal Surgery for Colon Cancer: A Single-Center Cohort Study

2020 ◽  
Vol 36 (3) ◽  
pp. 186-191
Author(s):  
Jun Seong Chung ◽  
Han Deok Kwak ◽  
Jae Kyun Ju
Keyword(s):  
Risk Factors ◽  
Colon Cancer ◽  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
Disease Free Survival ◽  
Operation Time ◽  
Site Infection ◽  
Elective Colorectal Surgery ◽  
Factors Associated ◽  
Physical Status Classification

Purpose: There is a concern that enhanced recovery after surgery may affect other proposed quality measures, including the rate of readmission due to early discharge. We examine the 30-day readmission rate, risk factors associated with readmission after elective colorectal surgery for colon cancer, causes of readmission, disease-free survival (DFS), and overall survival (OS) in a single institution.Methods: We retrospectively investigated 292 patients who underwent elective colorectal surgery for colon cancer between 2010 and 2015. Baseline data including age, sex, body mass index, American Society of Anesthesiologists physical status classification, preoperative comorbidities, previous operation history, TNM stage, surgical approach, operation time, gas passage time, and length of hospital stay were obtained. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with 30-day readmission.Results: A total of 229 patients who underwent elective colorectal surgery were enrolled. Twenty-four patients were readmitted 30 days after discharge. The most common readmission diagnoses were wound bleeding or surgical site infection. Multivariate analysis indicated that patients who had preoperative hepatic disease were at the highest risk of readmission (odds ratio [OR], 8.98; 95% confidence interval [CI], 7.35–10.61). Survival outcomes were significantly better in the nonreadmitted group (OS, P=0.00; DFS, P=0.04).Conclusion: This study identified that preoperative comorbidities including hepatic and pulmonary diseases were associated with higher readmission rates after elective colorectal surgery. Moreover, the most common cause of readmission in patients who underwent elective colorectal surgery was wound bleeding or surgical site infection.

scholarly journals A comparative study on surgical site infection in cases of open and laparoscopic appendicectomy

2018 ◽  
Vol 5 (10) ◽  
pp. 3309
Author(s):  
Priyansh Pandey ◽  
Manish M. Swarnkar ◽  
S. C. Jain
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Surgical Site Infection ◽  
Clinical Features ◽  
White Blood Cell ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Appendicectomy ◽  
Open Approach ◽  
Site Infection

Background: Diagnosis of acute appendicitis is mostly based on clinical features pointing towards appendicitis. Several biochemical parameters, such as the white blood cell (WBC) count, and neutrophil percentage, are currently used to aid clinical diagnosis.  Without immediate surgery, appendicitis may progress to perforation of the appendix. This study was carried out to determine rate of SSI in open versus laparoscopic appendicectomy for acute appendicitis and to identify independent risk factors for SSI.Methods: Appendicitis is a common cause of pain in right iliac fossa worldwide. The present study was carried out in the Department of General Surgery, Acharya Vinoba Bhave Rural Hospital, affiliated to Jawaharlal Nehru Medical College, Sawangi, Wardha, from August 2015 to July 2017. This study was conducted after the due clearance from Institutional Ethical committee. Total 132 patients admitted to the surgery ward with acute lower abdominal pain with clinical features of acute appendicitis on clinical examination, were studied prospectively.Results: In the present study, maximum patients were seen in less than 20 years of age and next commonest age group of presentation was 21-30 years. The male to female sex ratio was 1:1.3 in the laparoscopic appendectomy group while in the open appendectomy group was 1.81:1. The incidence of complicated intra-operative findings and mean white blood cell count was more in the open appendectomy group. The mean operative time, days for use of analgesics, time taken to return to soft diet and length of hospital stay for laparoscopic appendectomy group was less than the open appendectomy group. There were more cases of surgical site infection in the patients operated by open approach than laparoscopic approach.Conclusions: Wound class II versus III and NNIS index were found to be significantly associated with surgical site infection.

scholarly journals Surgical site infection in benign abdominal gynaecological surgeries

2021 ◽  
Vol 10 (10) ◽  
pp. 3870
Author(s):  
Haritha Kizhakke Kodiyath ◽  
Kunnath Ramakrishnan ◽  
Kadaviparambil Jacob
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Prospective Observational Study ◽  
Operative Time ◽  
Causative Organism ◽  
Site Infection ◽  
Medical College ◽  
Duration Of Surgery ◽  
Host Defense System ◽  
Old Evidence

Background: Surgical site infection is the commonest complication after gynecological surgeries. Limited studies have been done in India to know the magnitude of the problem. This study aims to know the incidence of surgical site infection, analyze the risk factors and identify the causative organisms.Methods: A prospective observational study .All women who underwent abdominal surgeries for benign pathologies in department of obstetrics and gynecology, Government medical college, Thrissur from April 2016 to March 2017, were included in the study women more than 80 years old, evidence of infection preoperative or within 48 hours of surgery, laparoscopy procedures unless combined with open surgeries and emergency surgeries were excluded.Results: The incidence of SSI was found to be 7.9%. Re suturing had to be done in 24 patients. The risk factors found to be significant were age more than 50 years ,patients with education <7th std, diabetes, BMI>30,pre hospital stay >10 days, ASA score >3, duration of surgery >2 hours and peri-operative blood transfusion. Staphylococcus aureus was the most common causative organism and was sensitive to amikacin, vancomycin, cloxacillin and its combinations.Conclusions: SSI pose a significant problem in the post operative period that can affect recovery. It was associated with multiple predisposing factors which could be prevented if these risk factors are identified early and appropriate measures are adopted to support host defense system in the peri operative time. 

Compare the Outcomes of Laparoscopic and Open Appendectomy

2021 ◽  
Vol 15 (7) ◽  
pp. 1742-1744
Author(s):  
Aqeel Ahmad ◽  
Muhammad Hammad Muzaffar ◽  
Mumtaz Ahmad Khan ◽  
Arshid Mahmood
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Site Infection ◽  
Time Duration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Aim: The aim of this study is to compare the surgical site infection, hospital stay and time duration of procedure in patients undergoing laparoscopic and open appendectomy. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Pak Red Crescent Medical and Dental college, Dina Nath, during from Jan 2020 to March 2021. Methods: In this study 240 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients demographic including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 120 patients and received laparoscopic appendectomy and Group II with 120 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. P-value <0.05 was set as significant. Results: There were 140 (58.3%) patients (70 Group I, 70 Group II) were male with mean age 25.7+6.54 years while 100 (41.7%) patients (50 Group I, 50 Group II) were females with mean age 26.9+3.12 years. No significant difference regarding BMI between both groups p=>0.05. There was a significant difference in term of surgery time duration between both groups 48.24+9.59 minutes Vs 35.74+6.86 minutes; P=0.001. No significant difference observed in term of hospital stay (p=0.345). 11 (9.2%) patients in Group II in which 5.83% had Superficial SSI and 3.7% had Deep SSI. 9 (7.5%) patients 5% superficial and 2.5% Deep SSI in Group I had developed surgical site infection with no significant difference (p=0.41). Conclusion: We concluded in this study that open appendectomy is better in term of operative time as compared to laparoscopic appendectomy. We found no significant difference regarding surgical site infection and hospital stay. Keywords: Acute appendicitis, Appendectomy, Laparoscopic, Open, Outcomes

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