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At least 217 records · Page 12Linked to original sources
PubMed1987

Assessing operative site infection in surgical patients.

We evaluated the contribution of altered host defense to the risk of developing an operative site infection. In part 1 of this study, we measured the following variables in 404 preoperative patients: cutaneous delayed-type hypersensitivity, age, serum albumin level, contamination status at the time of surgery, and the duration of surgery. Patients were examined daily postoperatively for the presence of an operative site infection (culture-positive drainage or infected tissue; overall rate, 17.3%). The above variables, plus previously defined risk factors, were examined by logistic regression analysis using the development of an operative site infection as the dependent variable. An equation to calculate the probability of developing a postoperative wound infection was thus derived. In part 2 of the study, a separate, matched group of 404 preoperative patients was used to test the validity of this predictive equation. A good fit of the model was obtained, with 70.3 wound infections predicted and 67 obtained (chi 2 = 0.8; not significant, ie, no difference between expected and observed wound infections at all probability deciles). We conclude that there are three determinants of an operative site infection, host defense (delayed-type hypersensitivity), acute and chronic physiologic derangement (albumin and age) and bacterial contamination risk at surgery (contamination status and duration of surgery).

Adult↗
PubMed1986

[Quality assurance in general surgery by prospective patient documentation. A comparison over 5 years].

All patients who had undergone general surgery in three different periods of time were prospectively recorded. Results were found to have been improving with significance owing to peri-operative antibiotic prophylaxis, mechanical suturing (for gastro-intestinal anastomoses), and introduction of a system of regular documentation. Rates of postoperative complications were also affected by the individual surgeon's efficiency and techniques.

Anti-Bacterial Agents↗
PubMed2003

Risk factors for surgical site infection in the patient with spinal injury.

STUDY DESIGN: A retrospective chart review of 1561 patients with spinal injury was conducted over a 4-year period. OBJECTIVES: To determine the rate of surgical site infection in the spinal trauma population, to compare infection rates after spinal operations for elective and traumatic indications, and to identify risk factors for postoperative wound infections in the traumatic subpopulation. SUMMARY OF BACKGROUND DATA: Surgical site infection after spinal operations is a dreaded complication. Risk factors have been investigated previously, but the subset of patients with acute traumatic spinal injury may be distinct. METHODS: The hospital's infection control program was used to identify surgical site infections after spinal operations, and infection rates were calculated. Data including patient characteristics, severity of injury indicators, surgical factors, and perioperative management factors were collected for the patients presenting with acute spinal injury over a 4-year period. RESULTS: Postoperative wound infections developed in 24 of 256 patients. This infection rate of 9.4% was significantly (P < 0.001) higher than for elective spinal operations during the same period (3.7%). Risk factors found to be independently significant included delay until operation, increased postoperative intensive care unit stay, single (neurosurgical or orthopedic) versus combined operative team. CONCLUSIONS: Risk factors for surgical site infection in the acute trauma setting are identified. Two surgical teams may be involved without causing a higher rate of infection.

Acute Disease↗
PubMed1982

Povidone-iodine irrigation of the subcutaneous tissue to prevent surgical wound infections.

In a prospective randomized trial, the influence of irrigation of the subcutaneous tissue using povidone-iodine solution upon the development of postoperative wound infection was examined in 592 patients undergoing general surgical operative procedures. No beneficial effect of irrigation with povidone-iodine solution could be demonstrated, nor could it be demonstrated in the group as a whole or in the subgroups according to bacterial contamination.

Abdomen↗
PubMed1991

Surgery for chronic ear disease in a non-university hospital: open cavity, obliteration and intact canal wall techniques.

The long-term results of surgery for chronic suppurative middle ear disease at a non-university ENT-clinic (Vasa Central Hospital, Finland) are reported. The material consisted of 273 ears, 65 of which had been operated on by open cavity techniques, 178 by the original Palva obliteration method, and 30 by the intact canal wall method. Post-operative cholesteatoma occurred equally frequently with the two canal wall down methods (7.7 and 7.3%, respectively) but was more frequent after intact canal wall surgery (23.3%). Hearing was better and the infection rate lower with obliteration than with open cavity techniques. Post-operative infection was the least frequent and the hearing result best in the intact canal wall ears, but compared to the other two groups the extent of disease found at surgery was considerably less in this group. The obliteration operation proved to be a safe method in the hands of a practising otologist outside university clinics.

Adolescent↗
PubMed1976

A new sutureless technique for skin closure.

A sutureless wound-closure device was used in 150 patients. The average time spent to effect skin closure was reduced; removal was easy; skin apposition was satisfactory; and patient response was favorable. Sutureless tape closures eliminate the disadvantages of invasive skin closures. The device described provides secure tape adhesion to the skin and does not cover the wound. It can be easily applied, adjusted, and removed, in addition to serving as a protective splint to the healing wound. This method can reduce operative time of skin closure with highly satisfactory cosmetic results.

Adolescent↗
PubMed1996

General surgery with a special interest in vascular surgery: changing patterns of workload.

Prospective surveys of workload were carried out during 1989, 1990 and 1995. Analysis of outpatient referrals, inpatients and operations performed over periods of 3 months was undertaken and the changing patterns of general surgical and vascular surgical workload noted. The number of outpatient referrals rose throughout the study period because of a significant increase in the number of patients with both varicose veins and other vascular problems. There was an increase in the number of emergency admissions for vascular disease. The number of patients having general surgical operations fell; there was a corresponding increase in the number for arterial and venous disease. The general surgical component of a general surgical unit with a vascular interest is gradually declining, as increased numbers of patients with vascular problems are being referred and managed.

Ambulatory Surgical Procedures↗
PubMed1976

Multiple sclerosis and surgery.

Five patients with multiple sclerosis showed deterioration following operation and anaesthesia. In every case the change was associated with pyrexis due to infection. No correlation was found between aggravation and any anaesthetic agent used.

Adult↗
PubMed1980

[Postoperative mortality rates in a general surgical unit].

In a 10 years period (1970 to 1979) 25,578 patients were operated upon, 433 patients died postoperatively. The causes of death were analysed according to Petrén and the autopsy results. The most frequent causes of death were cardiac failure, peritonitis, malignant tumours, pneumonia and pulmonary embolism.

Adolescent↗
PubMed1975

A controlled clinical trial of three different methods of perineal wound management following excision of the rectum.

Three methods of perineal wound closure were studied in a randomized prospective clinical trial in 106 patients undergoing excision of the rectum for inflammatory or malignant disease. In method 2 the perineal wound was managed by open drainage. In both methods 2 and 3 the perineal wound was closed by primary suture, suprapubic suction drains being left down to the presacral space, but in method 2 the pelvic peritoneal floor was reconstituted, whilst in method 3 it was left unsutured. Topical and systemic antibiotics were administered to all patients submitted to primary closure of the perineal wound but not routinely to those whose perineal wound was left open. The overall operative mortality was 8-5 per cent but no deaths could be definitely attributed to perineal wound complications. The incidence of primary wound healing after methods 2 and 3 was 45-2 and 42-9 per cent respectively. Operative contamination of the perineal wound had an adverse effect on perineal wound healing. The incidence of persistent wound sinuses and unhealed wounds at 3 and 6 months after primary wound closure was rather less than that encountered after open drainage. It was concluded that primary closure of the perineal wound is the treatment of choice following excision of the rectum, except in cases in which contamination of the perineal wound has occurred during operation or the final state of haemostasis in the pelvis with diathermy and suture at the conclusion of the dissection was deemed to be unsatisfactory.

Ampicillin↗
PubMed1984

Hospital costs of surgical complications.

Fifteen patients who had a general or gynecologic abdominal operation were operated on a second time for a complication of the first operation. There were three deaths. Extra costs attributable to the complications amounted to +211,503, of which one third was uncollectible. One half of the extra hospital days for surviving patients were spent in the intensive care unit.

Abdomen↗