scholarly journals Surgical site infection incidence and risk factors in thoracic surgical procedures: A 12-year prospective cohort study

2019 ◽  
Vol 13 (03) ◽  
pp. 212-218
Author(s):  
Vlado S Cvijanovic ◽  
Aleksandar S Ristanović ◽  
Nebojsa T Maric ◽  
Natasa V Vesovic ◽  
Vanja V Kostovski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thoracic Surgery ◽  
Surgical Procedures ◽  
Surgical Site Infections ◽  
Thoracic Surgical Procedures ◽  
Wound Contamination ◽  
Surgical Site Infection Incidence ◽  
Independent Risk Factors ◽  
American Society ◽  
Duration Of Operation

Introduction: Surgical site infections (SSI) continue to be a major problem for thoracic surgery patients. We aimed to determine incidence rate (IR) and risk factors for SSI in patients with thoracic surgical procedures. Methodology: During 12 years of hospital surveillance of patients with thoracic surgical procedures, we prospectively identified SSI. Patients with SSI were compared with patients without SSI. Results: We operated 3,370 patients and 205 (6.1%) developed SSI postoperatively. We detected 190 SSI among open thoracic surgical procedures (IR 7.1%) and 15 SSI after video-assisted thoracic surgery (IR 2.1%). Five independent risk factors for SSI were identified: wound contamination (p = 0.013; relative risk (RR) 2.496; 95%, confidence interval (CI): 1.208-5.156), American Society of Anesthesiologist (ASA) score (p = 0.012; RR: 1.795; 95% CI: 1.136-2.834), duration of drainage (p < 0.001; RR: 1.117; 95% CI: 1.085-1.150), age (p = 0.036; RR: 1.018; 95% CI: 1.001-1.035) and duration of operation (p < 0.001; RR:1.005; 95% CI:1.002-1.008). Conclusion: The results are valuable in documenting risk factors for SSI in patients undergoing thoracic surgery. The knowledge and prevention of controllable risk factors is necessary in order to reduce the incidence of SSI.

Risk factors associated with surgical site infections following vascular surgery at a German university hospital

2012 ◽  
Vol 141 (6) ◽  
pp. 1207-1213 ◽  
Author(s):  
E. OTT ◽  
F.-Ch. BANGE ◽  
D. SOHR ◽  
O. TEEBKEN ◽  
F. MATTNER
Keyword(s):  
Risk Factors ◽  
Vascular Surgery ◽  
Infection Prevention ◽  
Protective Factor ◽  
Surgical Site Infections ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
Postoperative Drainage ◽  
Independent Risk Factors ◽  
Duration Of Operation

SUMMARYSurgical site infection (SSI) after vascular surgery is a serious complication increasing morbidity, mortality, and costs for healthcare systems. A 4-year retrospective cohort study was performed in a university hospital with patients who had undergone arterial vascular surgery below the aortic arch. Investigated variables included demographics and clinical data. Forty-four of 756 patients experienced SSI, 29 of which were superficial, five were deep, and 10 had organ/space infections. Coagulase-negative staphylococci (22%), enterococci (20%), and Staphylococcus aureus (18%) were the most common pathogens. Independent risk factors for SSIs were femoral grafting [odds ratio (OR) 6·7], peripheral atherosclerotic disease, Fontaine stages III–IV (OR 4·1), postoperative drainage >5 days (OR 3·6), immunosuppression (OR 2·8), duration of operation >214 min (OR 2·8), and body mass index >29 (OR 2·6). The application of perioperative antibiotic prophylaxis was an independent protective factor (OR 0·2). Patients with certain risk factors for SSIs warrant special attention for infection prevention.

scholarly journals The Effectiveness of Sterile Wound Drapes in the Prevention of Surgical Site Infection in Thoracic Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kemal Karapınar ◽  
Celalettin İbrahim Kocatürk
Keyword(s):  
Thoracic Surgery ◽  
Surgical Site Infection ◽  
Operation Time ◽  
Surgical Site Infections ◽  
Control Group ◽  
Site Infection ◽  
Wound Debridement ◽  
Thoracic Surgical Procedures ◽  
Hospitalization Costs ◽  
The Cost

Background. The rate of surgical site infections (SSIs) has decreased in parallel to advances in sterilization techniques. Such infections increase morbidity and hospitalization costs. The use of iodine-impregnated sterile wound drapes (SWDs) is recommended to prevent or reduce the incidence of these infections. However, there is a paucity of data regarding their use in thoracic surgical procedures. The aim of the present study was to evaluate the effectiveness of sterile wound drapes in the prevention of these infections and the effects on hospitalization costs. Methods. Perioperative iodine-impregnated SWDs have been used since January 2015 in the Thoracic Surgery Clinic of our hospital. A retrospective evaluation was made of patients who underwent anatomic pulmonary resection via thoracotomy with SWD in the period January 2015–2017, compared with a control group who underwent the same surgery without SWD in the 2-year period before January 2015. Factors that may have increased the risk of surgical site infection were documented and the occurrence of SSI was recorded from postoperative follow-up data. The cost analysis was performed as an important criterion to investigate the benefits of SWD. Results. Evaluation was made of 654 patients in the study group (n:380) using SWD, the operation time was significantly longer, and perioperative blood transfusion was significantly higher, whereas treatment costs (p=0.0001) and wound culture positivity (p=0.004) were significantly lower and less surgical wound debridement was performed (p=0.002). Conclusion. The findings suggest that the use of sterile wound draping in thoracic surgery procedures reduces surgical site infections and hospitalization costs.

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.

Surgical Site Infections in Major Head and Neck Surgeries Involving Pedicled Flap Reconstruction

2016 ◽  
Vol 126 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Neerav Goyal ◽  
Bharat B. Yarlagadda ◽  
Daniel G. Deschler ◽  
Kevin S. Emerick ◽  
Derrick T. Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck ◽  
Free Flap ◽  
Operating Time ◽  
Surgical Site Infections ◽  
Free Flaps ◽  
Neck Surgery ◽  
Pedicled Flap ◽  
American Society ◽  
Clean Contaminated

Objective: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. Methods: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. Results: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%). Most (72%) cases were clean-contaminated and American Society of Anesthesiologists classification 3 or higher (73%); 63% of patients had prior radiation. The SSIs occurred in 9.1% and were associated with a longer length of stay ( P = .004) but no particular risk factors. Seventeen patients developed a fistula (11 without SSI). The SSI rates were not significantly different between pedicled and free flaps, but pedicled flap patients were older, more likely to have had prior surgery and/or radiation, and be methicillin-resistant Staphylococcus aureus positive. In the combined population, multivariate analysis demonstrated clean-contaminated wound classification ( P = .03), longer operating time ( P = .03), and clindamycin prophylaxis ( P = .009) as SSI risk factors. Conclusions: The SSI rate following pedicled flap surgeries was low and similar to free flap surgeries despite a significantly different population. No specific risk factors were associated with developing a pedicled flap SSI.

Thoracic anaesthesia

2014 ◽  
Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin
Keyword(s):  
Thoracic Surgery ◽  
Surgical Procedures ◽  
Lung Ventilation ◽  
Chest Drain ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Thoracic Surgical Procedures ◽  
Hypoxic Vasoconstriction ◽  
Thoracic Anaesthesia ◽  
Drain Management

Pre-assessment of patients for thoracic surgery with prediction of postoperative dyspnoea is important and may determine ‘operability’ of malignancy. Anaesthetic conduct for common thoracic surgical procedures such as thoracotomy, video-assisted thorascopic surgery, mediastinal surgery, and bronchoscopic techniques are described. Techniques for providing one-lung ventilation using double-lumen tubes or endobronchial blockers are discussed along with the physiology of one-lung ventilation, hypoxic vasoconstriction, and techniques to improve oxygenation. Thoracic postoperative care such as pain and chest drain management is included

scholarly journals Risk of surgical site infection in patients undergoing orthopedic surgery

2011 ◽  
Vol 19 (6) ◽  
pp. 1362-1368 ◽  
Author(s):  
Flávia Falci Ercole ◽  
Lúcia Maciel Castro Franco ◽  
Tamara Gonçalves Rezende Macieira ◽  
Luísa Cristina Crespo Wenceslau ◽  
Helena Isabel Nascimento de Resende ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Descriptive Analysis ◽  
Surgical Site Infections ◽  
Incidence Rates ◽  
Site Infection ◽  
Chi Square ◽  
Historical Cohort ◽  
Surgical Site Infection Incidence ◽  
Chi Square Test

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

scholarly journals Risk factors for postoperative meningitis after microsurgery for vestibular schwannoma

2019 ◽  
Author(s):  
Bowen Huang ◽  
Yanming Ren ◽  
Chenghong Wang ◽  
Zhigang Lan ◽  
Xuhui Hui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vestibular Schwannoma ◽  
Univariate Analysis ◽  
High Morbidity ◽  
Intraoperative Bleeding ◽  
Bleeding Volume ◽  
Independent Risk Factors ◽  
Postoperative Meningitis ◽  
Prolonged Hospital ◽  
Duration Of Operation

AbstractOBJECTIVEMeningitis after microsurgery for vestibular schwannoma (VS) is a severe complication and result in high morbidity. But few studies have focused on meningitis after VS surgery alone. The purpose of this study was to identify the risk factors for meningitis after VS surgery.METHODSWe undertook a retrospective analysis of all VS patients, who underwent microsurgery of VS and at least live for 7 days after surgery, between 1st June 2015 and 30st November 2018 at West China Hospital of Sichuan University. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis (POM).RESULTSWe collected 410 patients, 27 of whom had POM. Through univariate analysis, hydrocephalus (p=0. 018), Koos grade IV (p=0.04), The operative duration (> 3 hours p=0.03) and intraoperative bleeding volume (≥ 400ml p=0. 02) were significantly correlated to POM. Multivariate analysis showed that Koos grade IV (p=0.04; OR=3.19; 95% CI 1.032-3.190), operation duration (> 3 hours p=0.03 OR= 7.927; 95% CI 1.043-60.265), and intraoperative bleeding volume (≥ 400ml p=0.02; OR=2.551; 95% CI 1.112-5.850) are the independent influencing factors of POM.CONCLUSIONSKoos grade IV, the duration of operation, and the amount of bleeding were identified as independent risk factors for POM after microsurgery of VS. POM caused a prolonged hospital stay.

Incidence of Surgical-Site Infections and the Validity of the National Nosocomial Infections Surveillance System Risk Index in a General Surgical Ward in Santa Cruz, Bolivia

2003 ◽  
Vol 24 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Lorena Soleto ◽  
Marianne Pirard ◽  
Marleen Boelaert ◽  
Remberto Peredo ◽  
Reinerio Vargas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Nosocomial Infections ◽  
Risk Index ◽  
Surgical Site Infections ◽  
Santa Cruz ◽  
Surgical Ward ◽  
System Risk ◽  
Local Risk

AbstractObjectives:To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country.Design:A prospective study with patient follow-up until the 30th postoperative day.Setting:A general surgical ward of a public hospital in Santa Cruz, Bolivia.Patients:Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed.Results:Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a “local” risk index constructed with the above cut-off points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3.Conclusions:SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

scholarly journals Incidence and Risk Factors for Surgical Site Infections Following Oromaxillofacial Oncologic Surgery in Dogs

2021 ◽  
Vol 8 ◽  
Author(s):  
Brittney E. Rigby ◽  
Kevin Malott ◽  
Scott J. Hetzel ◽  
Jason W. Soukup
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Bacterial Infections ◽  
Critical Evaluation ◽  
Surgical Site Infections ◽  
Tumor Type ◽  
Site Infection ◽  
Oncologic Surgery

Antibiotic stewardship in veterinary medicine is essential to help prevent resistant bacterial infections. Critical evaluation into the benefits of prophylactic use of antibiotics during veterinary surgical procedures is under reported and additional investigation is warranted. The objectives of this paper were to determine the incidence of surgical site infection in dogs that underwent oromaxillofacial oncologic surgery and to identify risk factors for the development of surgical site infection. In this retrospective cohort study including 226 dogs surgically treated for oromaxillofacial tumors between January 1, 1997 and December 31, 2018, the incidence of surgical site infection was determined to be 7.5%. Univariable logistical regression models were used to evaluate potential risk factors for development of surgical site infections including signalment, tumor type, antibiotic protocol, time under anesthesia, location of surgical procedure (dental suite vs. sterile operating room), specific comorbidities, and surgical margins obtained. Anesthetic events lasting greater than 6 h were significantly associated with development of infection. Signalment, comorbidities, administration of anti-inflammatory and immunosuppressive medications, tumor type, histological margin evaluation, surgical procedure location, and antibiotic protocols were not significant contributors to development of infection. Use of antibiotic therapy in this cohort was not protective against development of infection and may not be routinely indicated for all oromaxillofacial oncologic surgeries despite common promotion of its use and the contaminated nature of the oral cavity. Anesthetic time significantly contributed towards the development of infection and use of perioperative antibiotics for surgical procedures lasting &gt;6 h may be routinely warranted.

Sign in / Sign up

Export Citation Format

Share Document