scholarly journals Infections and antibiotic therapy in patients after spine surgery in a 5-year follow-up study

2021 ◽  
Author(s):  
Joanna Baranowska ◽  
Alicja Baranowska ◽  
Paweł Baranowski ◽  
Tadeusz Płusa ◽  
Wojciech Białowąs ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Infection Rate ◽  
Surgical Procedures ◽  
Spinal Surgery ◽  
Surgical Site Infections ◽  
Retrospective Data ◽  
Follow Up Study ◽  
Leading Position ◽  
Extent Of Surgery

IntroductionInfections after spinal surgery are sporadic and depend on the patient's condition and the type and extent of surgery. The incidence of surgical site infections in European centers ranges from 0% to 18%. The aim of the study was to determine the frequency of infections in patients after spinal surgery.Material and methodsThe analysis covered 6067 patients who underwent spinal surgery in the Department of Neuroorthopedics between 2015-2019, taking into account the number of microbiological tests and the number of detected infections, the number of surgical procedures and the rate of SSI infections, the number of readmissions and reoperations, and the use of antibiotics. The analysis was based on retrospective data of patients hospitalized in the analyzed period.ResultsThe number of operated patients remained at a similar level in the analyzed annual periods, from 1136 to 1269 patients, while the infection rate of the operated site ranged from 0,33% to 1,04%, and the percentage of infections was between 0,58% and 3,29 %. In turn, the analysis of reoperations performed due to infection of the operated site in 2018 and 2019 was 0,56% and 0,07%, respectively, which places the center in the leading position in the European ranking. During the analyzed five years, the use of antibiotics was reduced by 2/3.ConclusionsThe analysis of infections in patients after spinal surgery over a 5-year period showed that the SSI rate did not exceed 1,04%, which is comparable with data from recognized European centers. Infections caused by alarm pathogens have been detected occasionally.

scholarly journals Relevance of Modified Debridement-Irrigation, Antibiotic Therapy and Implant Retention Protocol for the Management of Surgical Site Infections: A Series of 1694 Instrumented Spinal Surgery

2018 ◽  
Vol 3 (5) ◽  
pp. 266-272 ◽  
Author(s):  
Romain Manet ◽  
Tristan Ferry ◽  
Jean-Etienne Castelain ◽  
Gilda Pardey Bracho ◽  
Eurico Freitas-Olim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Antibiotic Therapy ◽  
Success Rate ◽  
Surgical Procedures ◽  
Spinal Surgery ◽  
Surgical Site Infections ◽  
Second Look ◽  
Implant Retention ◽  
New Surgery

Abstract. Introduction: Management of surgical site infections (SSI) after instrumented spinal surgery remains controversial. The debridement-irrigation, antibiotic therapy and implant retention protocol (DAIR protocol) is safe and effective to treat deep SSI occurring within the 3 months after instrumented spinal surgery.Methods: This retrospective study describes the outcomes of patients treated over a period of 42 months for deep SSI after instrumented spinal surgery according to a modified DAIR protocol.Results: Among 1694 instrumented surgical procedures, deep SSI occurred in 46 patients (2.7%): 41 patients (89%) experienced early SSI (< 1 month), 3 (7%) delayed SSI (from 1 to 3 months), and 2 (4%) late SSI (> 3months). A total of 37 patients had a minimum 1 year of follow-up; among these the modified DAIR protocol was effective in 28 patients (76%) and failed (need for new surgery for persistent signs of SSI beyond 7 days) in 9 patients (24%). Early second-look surgery (≤ 7days) for iterative debridement was performed in 3 patients, who were included in the cured group. Among the 9 patients in whom the modified DAIR protocol failed, none had early second-look surgery; 3 (33%) recovered and were cured at 1 year follow-up, and 6 (66%) relapsed. Overall, among patients with SSI and a minimum 1 year follow-up, the modified DAIR protocol led to healing in 31/37 (84%) patients.Conclusions: The present study supports the effectiveness of a modified DAIR protocol in deep SSI occurring within the 3 months after instrumented spinal surgery. An early second-look surgery for iterative debridement could increase the success rate of this treatment.

scholarly journals Effect of Influenza Vaccination of Children on Infection Rate in Hutterite Communities: Follow-Up Study of a Randomized Trial

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0167281 ◽  
Author(s):  
Biao Wang ◽  
Margaret L. Russell ◽  
Lorraine Moss ◽  
Kevin Fonseca ◽  
David J. D. Earn ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Randomized Trial ◽  
Infection Rate ◽  
Follow Up Study

scholarly journals Impact of Postdischarge Surveillance on Surgical Site Infection Rates for Several Surgical Procedures Results From the Nosocomial Surveillance Network in The Netherlands

2006 ◽  
Vol 27 (08) ◽  
pp. 809-816 ◽  
Author(s):  
Judith Manniën ◽  
Jan C. Wille ◽  
Ruud L. M. M. Snoeren ◽  
Susan van den Hof
Keyword(s):  
Medical Record ◽  
Surgical Procedures ◽  
Clinical Symptoms ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
Surveillance Network ◽  
Femorotibial Bypass ◽  
Registration Card

Objective. To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. Design. Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical symptoms and whether a patient developed an SSI according to the definitions; an alternative method is examination of the outpatient medical record. Setting. Hospitals participating in the Dutch national nosocomial surveillance network between 1996 and 2004. Results. We collected data on 131,798 surgical procedures performed in 64 of the 98 Dutch hospitals. PDS was performed according to one of the recommended methods for 31,134 operations (24%) and according to another active method for 32,589 operations (25%), and passive PDS was performed for 68,075 operations (52%). Relatively more SSIs were recorded after discharge for cases in which PDS was performed according to a recommended method (43%), compared with cases in which another active PDS method was used (30%) and cases in which passive PDS was used (25%). The highest rate of SSI after discharge was found for appendectomy (79% of operations), followed by knee prosthesis surgery (64%), mastectomy (61%), femoropopliteal or femorotibial bypass (53%), and abdominal hysterectomy (53%). Conclusions. For certain surgical procedures, most SSIs develop after discharge. SSI rates will be underestimated if no PDS is performed. We believe we have found a feasible and sensitive method for PDS that, if patients routinely return to the hospital for a postdischarge follow-up visit, might be suitable for use internationally.

scholarly journals Changes in hospitalisation and surgical procedures among the oldest-old: a follow-up study of the entire Danish 1895 and 1905 cohorts from ages 85 to 99 years

2013 ◽  
Vol 42 (4) ◽  
pp. 476-481 ◽  
Author(s):  
A. Oksuzyan ◽  
B. Jeune ◽  
K. Juel ◽  
J. W. Vaupel ◽  
K. Christensen
Keyword(s):  
Surgical Procedures ◽  
Oldest Old ◽  
Follow Up Study

scholarly journals Impact of Postdischarge Surveillance on Surgical Site Infection Rates for Several Surgical Procedures Results From the Nosocomial Surveillance Network in The Netherlands

2006 ◽  
Vol 27 (8) ◽  
pp. 809-816 ◽  
Author(s):  
Judith Manniën ◽  
Jan C. Wille ◽  
Ruud L. M. M. Snoeren ◽  
Susan van den Hof
Keyword(s):  
Medical Record ◽  
Surgical Procedures ◽  
Clinical Symptoms ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Abdominal Hysterectomy ◽  
Surveillance Network ◽  
Femorotibial Bypass ◽  
Registration Card

Objective.To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important.Design.Prospective SSI surveillance with voluntary PDS. Recommended methods for PDS in the Dutch national nosocomial surveillance network are addition of a special registration card to the outpatient medical record, on which the surgeon notes clinical symptoms and whether a patient developed an SSI according to the definitions; an alternative method is examination of the outpatient medical record.Setting.Hospitals participating in the Dutch national nosocomial surveillance network between 1996 and 2004.Results.We collected data on 131,798 surgical procedures performed in 64 of the 98 Dutch hospitals. PDS was performed according to one of the recommended methods for 31,134 operations (24%) and according to another active method for 32,589 operations (25%), and passive PDS was performed for 68,075 operations (52%). Relatively more SSIs were recorded after discharge for cases in which PDS was performed according to a recommended method (43%), compared with cases in which another active PDS method was used (30%) and cases in which passive PDS was used (25%). The highest rate of SSI after discharge was found for appendectomy (79% of operations), followed by knee prosthesis surgery (64%), mastectomy (61%), femoropopliteal or femorotibial bypass (53%), and abdominal hysterectomy (53%).Conclusions.For certain surgical procedures, most SSIs develop after discharge. SSI rates will be underestimated if no PDS is performed. We believe we have found a feasible and sensitive method for PDS that, if patients routinely return to the hospital for a postdischarge follow-up visit, might be suitable for use internationally.

scholarly journals A Study on Role of Follow up in Minor Surgical Procedures

2019 ◽  
Vol 2 (1) ◽  
pp. 34-39
Author(s):  
Shankar Raut ◽  
Yogendra Man Shakya ◽  
Yagya Laxmi Shakya ◽  
Tirtha Man Shrestha ◽  
Ram Prasad Neupane
Keyword(s):  
Infection Rate ◽  
Surgical Procedures ◽  
P Value ◽  
Medical Illness ◽  
Daily Routine ◽  
Age Group ◽  
Cross Sectional ◽  
Minor Surgical Procedures ◽  
Duration Of Surgery

Background: Minor surgical procedures are surgeries that can be performed in the clinic under local anesthesia and doesn’t require preoperative and postoperative admission. In most of the institutions in our country, we advised patients to follow up within 7 to 10 days following minor surgical procedures. Unnecessary follow up increases stress to the patients in terms of not being able to manage daily routine work and would be costly as well. As a General Practitioner, majority of the cases done are the minor surgical procedures. Methods: The study was a prospective cross sectional study conducted in General Surgery Department at United Mission Hospital, Palpa from Dec 2013 to May 2013. 228 patients were divided in two groups of “No follow up” group and “Follow-up” group. No Follow-up Group was asked pre-formed questionnaires by telephone where as Follow-up group were asked to follow up routinely on day 7 to 10 days of surgery and asked the same questions. Statistical analysis was done using SPSS program and Microsoft excel. P value of <0.05 was considered statistically significant. P-value was determined by using Chi Square test. Result: The overall wound infection among 228 patients was found to be 14.5 percent with infection rate of 16.4 percent in No Follow up group and 12.7 percent in Follow-up group. The infection rate was found to be higher among the older age group of patient maximum being 36.4% in the age group of 50-59 years with p value of 0.053. Other risk factors like age, sex, residence, duration of surgery, socio economic status, history of medical illness and BMI didn’t have significant association with rate of infection following minor surgical procedure. Conclusion: The routine postoperative follow up in minor surgery is unnecessary unless there are any signs suggestive of infection.

Radiofrequency volumetric reduction of the palate: An extended follow-up study

2000 ◽  
Vol 122 (3) ◽  
pp. 410-414 ◽  
Author(s):  
Kasey K. Li ◽  
Nelson B. Powell ◽  
Robert W. Riley ◽  
Robert J. Troell ◽  
Christian Guilleminault
Keyword(s):  
Adverse Effect ◽  
Clinical Examination ◽  
Surgical Procedures ◽  
Patient Acceptance ◽  
Minimal Invasiveness ◽  
Follow Up Study ◽  
Visual Analog Scales

OBJECTIVE The goal was to evaluate the effect of radiofrequency (RF) of the palate on speech, swallowing, taste, sleep, and snoring 12 to 18 months after treatment. METHODS Twenty-two patients were evaluated by clinical examination, questionnaires, and visual analog scales. The patients with relapse of snoring were offered further RF treatment. RESULTS After a mean follow-up of 14 months, no adverse effect was reported. Subjective snoring scores relapsed by 29% overall. Nine patients (41%) noted relapse of snoring from 2.1 ± 1.1 to 5.7 ± 2.7 ( P < 0.001). Eight of the patients underwent further RF treatment with a reduction of snoring from 5.8 ± 2.9 to 3.3 ± 3.1 ( P = 0.01). CONCLUSION The success of RF volumetric reduction of the palate diminishes with time, as with other surgical procedures of the palate. However, the minimal invasiveness of the RF provided a high patient acceptance for retreatment, and relapse of snoring can be improved.

scholarly journals Stunting Among Children in Rural Area of Indonesia: Five-Year Follow-Up Study

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 187-187
Author(s):  
Dini Suciyanti ◽  
Grace Wangge ◽  
Umi Fahmida ◽  
Taniawati Supali
Keyword(s):  
Rural Area ◽  
Infection Rate ◽  
Serum Zinc ◽  
Structured Interview ◽  
Hemoglobin Level ◽  
Wilcoxon Test ◽  
Household Food Security ◽  
Follow Up Study ◽  
Household Food

Abstract Objectives To follow-up the situation of stunting among children in Nangapanda, a subdistrict in East Nusa Tenggara, Indonesia after 5 years. Methods The design was 5-year follow-up study in rural area of Indonesia. A total of 89 children aged 6–9 years were included. Structured interview, nutritional assessment, blood and stool collection were performed to the subjects who had the same measurement in 2014. Socio-demography characteristics, weight, height, hemoglobin level, serum ferritin, serum zinc, CRP, worm infection and household food security were collected. To compare the baseline and 5-year follow-up data wilcoxon test, paired t-test, and Mc-Nemar test were used. Results After 5 years, stunting prevalence dropped considerably from 49.4% to 21.3%. There were 34.1% children remain stunted after 5 years. Among the stunted children, 80% remained underweight, 33.3% remained anemia, and 16.7% still had worm infection. According to sociodemographic data, those who remain stunted had low mother's education (66%), lived with 5–8 household members (53.3%), experienced household food insecurity (53.3%), and consumed unsafe drinking water (46.7%). Compared to their nutritional status in 2014, there are improvements in their HAZ-score and hemoglobin level (P &lt; 0.0001). In addition, worm infection rate reduced although the reduction was not significant (P = 0.077). Children whose HAZ-score improved were comparable in their sociodemographic status with those children who remained stunted children. Conclusions Within five year period, there was reduction in stunting prevalence which was accompanied by increase in HAZ-score, hemoglobin level and reduction in worm infection rate. No difference was found in characteristics of children who recovered and remained stunted. Funding Sources Pintermidi Grant from Universitas Indonesia with contract number 1908/UN2.R3.1/HKP.05.00/2019.

Artificial disc replacement and adjacent-segment pathology: 10-year outcomes of a randomized trial

2021 ◽  
pp. 1-9
Keyword(s):  
Surgical Procedures ◽  
Disc Replacement ◽  
Adjacent Segment ◽  
Artificial Disc ◽  
Anterior Decompression ◽  
Fusion Surgery ◽  
Follow Up Study ◽  
Artificial Disc Replacement ◽  
Flexion Extension

OBJECTIVE Artificial disc replacement (ADR) is designed to preserve motion and thus protect against adjacent-segment pathology (ASP) and act as an alternative treatment to fusion surgery. The question remains, how well do ADR devices perform after 10 years of follow-up compared with fusion surgery in terms of patient satisfaction, sustainability, and protection against ASP? METHODS This was the 10-year follow-up study of 153 participants who underwent ADR or fusion surgery after anterior decompression due to cervical degenerative radiculopathy (ISRCTN registration no. 44347115). Scores on the Neck Disability Index (NDI), EQ-5D, and visual analog scale for neck and arm pain were obtained from the Swedish Spine Registry and analyzed using ANCOVA. Information about secondary surgical procedures was collected from medical records and presented as Kaplan-Meier curves. MRI and flexion-extension radiography were performed, and ASP was graded according to the Miyazaki classification system. RESULTS Ten participants were lost to follow-up, which left 143 participants (80 underwent ADR and 65 underwent anterior cervical discectomy and fusion). There were no differences between groups in terms of patient-reported outcome measures (10-year difference in NDI scores 1.7 points, 95% CI −5.1 to 8.5, p = 0.61). Nineteen (24%) participants in the ADR group compared with 9 (14%) in the fusion group underwent secondary surgical procedures. The higher reoperation rate of the ADR group was mainly due to 11 female participants with device loosening. The rates of reoperation due to ASP were similar between groups, which was confirmed with MRI assessment of ASP that also showed no differences between the groups (p = 0.21). CONCLUSIONS This was the first 10-year follow-up study to compare ADR with fusion surgery and to provide MRI information for the assessment of ASP. The authors found no benefit of ADR over fusion surgery after anterior decompression for cervical degenerative radiculopathy.

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