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Results for “Prophylactic Surgical Procedures”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 595 records · Page 33Linked to original sources
PubMed1998

Evaluation of perioperative antibiotics at the time of dialysis catheter placement.

The effect of prophylactic antibiotics on the occurrence of peritonitis in the 14 days following surgical peritoneal dialysis catheter placement was evaluated. Medical records from 73 pediatric patients who had 89 Tenckhoff catheters inserted over 6 years were reviewed. Twelve catheter procedures were excluded for rapid catheter loss, unavailable charts, eosinophilic peritonitis, and antibiotic administration > 3 h postoperatively. Chi-squared analysis for non-continuous variables compared factors at the time of catheter placement with outcome (peritonitis). Thirteen patients developed postoperative peritonitis when 77 catheter insertions were analyzed (17%). Peritonitis was significantly more common in patients who did not receive perioperative antibiotics (7 of 16 catheter placements) (chi(2) = 12.48, P < or = 0.001). The reduced incidence of peritonitis was not specific to any one antibiotic class. Using step-wise logistic regression analysis, no association was found between peritonitis incidence and nephrotic syndrome, immunosuppression, recent surgery (< 14 days), acute versus chronic use, year of catheter placement, surgeon, or patient age. Catheter type, implantation technique, exit site care, and operative wound care did not vary. These results indicate that perioperative peritonitis episodes can be significantly reduced by the use of prophylactic antibiotics prior to or at the time of surgery.

Adolescent↗
PubMed2004

[Vitreoretinal secondary procedures following elective macular surgery].

OBJECTIVE: The spectrum of reoperations after macular surgery was investigated retrospectively in a large group of patients. All secondary surgical procedures except for cataract surgery were considered. METHODS: Between July 1995 and June 2001 353 eyes underwent macular surgery (218 due to macular pucker, 135 due to macular hole) with a pars-plana vitrectomy (PPV), creation of vitreous detachment, membrane peeling and SF(6)/air-instillation. The vitrectomies were performed by 4 different surgeons. In all patients a preoperative circular peripheral cryoretinopexy was performed 3-4 weeks before macular surgery. The follow-up was 20.9 months on average. The number of revitrectomies as well as the postoperative retinal detachment rate were investigated. RESULTS: In 33 cases (9.3%) a second vitrectomy had to be performed due to an unsatisfying postoperative macular finding: 17/218 (7.8%) after macular pucker surgery with a recurrent pucker and 16/135 (11.8%) after macular hole surgery with persistent or recurrent macular hole. In 7/353 (2.0%) a postoperative rhegmatogenous retinal detachment was observed and in 2/353 (0.6%) a postoperative endophthalmitis had to be treated. CONCLUSION: In 9.3% of our patients a second PPV due to an unsatisfying macular finding became necessary. The rate of postoperative retinal detachment of 2.0% is considerably lower than in most other studies. Therefore, a possible prophylactic effect of the preoperative circular peripheral cryoretinopexy is suggested to reduce the risk of postoperative retinal detachment.

Elective Surgical Procedures↗
PubMedDate not supplied

Surgical antimicrobial prophylaxis: principles and guidelines.

Antimicrobial prophylaxis for surgical procedures is an area that is recognized as being subject to individual clinical variations. This review gives practitioners some basic principles of rational prophylaxis as defined by the medical literature. In addition, this literature is evaluated and condensed to provide clinicians with guidelines for particular procedures: obstetric, gynecologic, gastric, biliary, colonic, urologic, cardiac, thoracic, vascular, orthopedic and head and neck. Each section concludes with recommendations for the clinically most accepted prophylactic regimens. Antibiotics discussed include not only the older agents, but where good information exists, the newer cephalosporins. The suggested regimens consider efficacy, safety and cost as determinants in rational prescribing. Although research into even shorter, and perhaps more cost-effective, regimens continues, this compilation lists state-of-the-art recommendations.

Anti-Bacterial Agents↗
PubMed2006

Prospective study of use of perioperative antimicrobial therapy in general surgery.

BACKGROUND: Perioperative antimicrobial therapy has demonstrated efficacy in reducing the rate of surgical site infections in clinical trials. With the emergence of antibiotic resistance, the risk of reaction, and the inevitable financial repercussions, use of prophylactic antibiotics is not a panacea, and their misuse may have considerable implications. The aim of this study was to assess the use of antibiotics in the perioperative period in both general and vascular surgery procedures. METHODS: A prospective study was undertaken of 131 patients with a mean age of 43 years (range one month-88 years), of whom 68 (51%) were male, who underwent twenty-seven different general or vascular surgery procedures over a four-week period. Each patient was evaluated from the time of antibiotic commencement through their operative procedure until the treatment was discontinued. RESULTS: A total of 73 patients (54%) received ten antibiotics, with 71 (97%) of these uses being prophylactic. Of the 15 appendectomies performed for uncomplicated appendicitis, the mean number of prophylactic antibiotic doses was 5.3 (range 1-12). Where they were documented, written postoperative directives were not adhered to in 18/27 prescriptions (66%). CONCLUSION: This study has demonstrated a lack of adherence to guidelines in the perioperative administration of antimicrobial agents. In addition, it calls attention to the economic implications of unnecessary prophylaxis.

Adolescent↗
PubMed1989

[Plasma and tissue concentrations of cefamandole during cardiac surgery].

This study aimed to determine plasma (CPC) and tissue concentrations of cefamandole during cardiac surgery, so as to compare them with the minimal inhibitory concentration (MIC) for staphylococci (0.25 - 1 microgram.ml-1 for S. aureus; 2 micrograms.ml-1 for S. epidermidis). Cefamandole was given prophylactically to 8 consecutive patients as a single intravenous dose of 60 mg.kg-1. Tissue concentrations were measured in presternal subcutaneous loose tissue and sternal marrow. Average CPC was 233.75 +/- 58 micrograms.ml-1, 15 min after drug administration, 187 +/- 6.4 micrograms.ml-1 at the time of sternotomy, 57.9 +/- 36.5 micrograms.ml-1 10 min after the start of bypass and 36.4 +/- 18.4 micrograms.ml-1 at its end, and 15.5 +/- 5.9 micrograms.ml-1 at the end of the procedure. Sternal subcutaneous tissue and marrow concentrations were respectively 24.4 +/- 13.3 micrograms.g-1 and 31 +/- 5.6 micrograms.g-1 at the time of sternotomy, and 9.4 +/- 5.5 micrograms.g-1 and 9.2 +/- 3.5 micrograms.g-1 at the end of the procedure. Giving a high dose of cefamandole preoperatively appeared to have an effective prophylactic antibiotic action, as the plasma and tissue concentrations were always higher than the MIC for staphylococci.

Aged↗
PubMed2003

Primary total hip arthroplasty.

TOTAL HIP ARTHROPLASTY (THA) has been proven to decrease a patient's pain and improve function and quality of life. This procedure has been performed in the United States since 1960. Follow-up data suggest long-term success with a decreasing rate of complications and low rate of revision. MORE THAN 168,000 THA procedures are performed in the United States every year. There is an 80% chance these hip replacements will last at least 20 years. CURRENT IMPROVEMENTS in hip designs, surgical techniques, fixation methods, prophylactic therapies, preadmission education, and rehabilitation have contributed to improved patient outcomes.

Aged↗
PubMed1995

Early complications of abdominal and vaginal hysterectomy.

In 1982, the Collaborative Review of Sterilization (CREST) study was published, reviewing the complications accompanying and following both abdominal and vaginal hysterectomy. This review was undertaken to see how these rates have changed in the ensuing years. All large series of abdominal and vaginal hysterectomy complications published subsequent to the CREST study were reviewed. Additionally, other studies that focused on specific complications were reviewed. It is concluded that the following changes related to hysterectomy morbidity have occurred since the publication of the CREST study: 1) the use of blood transfusion has diminished due to concern regarding human immunodeficiency virus contamination; 2) the rate of urinary tract infection has decreased primarily due to routine use of prophylactic antibiotics; and 3) inadvertent injury to the bladder has been noted more frequently at a rate of 1 to 2 percent. A particularly important category of complication is "unintended major surgical procedures which accompany or follow hysterectomy." This has been shown to occur at a rate of approximately 4 percent on general gynecology services. Finally, risk factors that add to the morbidity of hysterectomy are discussed.

Female↗
PubMedDate not supplied

Management of the patient with a total joint replacement: the primary care practitioner's role.

The primary care practitioner assumes chief responsibility for patients with arthritis. More than 40 million Americans experience some form of arthritis. Management of the patient with arthritis may include a referral to an orthopedic surgeon for surgical intervention. As estimated, up to 500,000 total joint replacement procedures are performed by orthopedic surgeons each year in the United States. Presurgical evaluation for a total joint replacement is imperative to ensure that the patient can safely undergo this surgical procedure. Postsurgical care of a patient with total joint replacement involves coordinating care with the physical therapist and orthopedic surgeon to ensure adequate follow-through with the recommended rehabilitation program, prophylactic antibiotic coverage, and observation for any complications including infection, deep-vein thrombosis, or loosening of the total-joint prosthesis.

Arthritis, Rheumatoid↗
PubMed1979

[Progress of technical medicine within the field of gerontoneurology (author's transl)].

1938 respectively 1978 are dates for progress of technical medicine concerning gerontoneurology. Following the discussion of the development in technical (apparatus), chemical and immunological diagnostic activities in neurology the applicability in elderly people should be described. On principle there are no methods of investigations which cannot be used in geriatric causes. Main point of interest is the correct indication. Non invasive methods can be used without somatic risk; one has to observe only the fact of psychological stress for the patient; indications of invasive methods (merely angiography of vessels within the brain) must be focused on special diagnosis of the illness. Suspicious facts of space occupying intracranial process almost everytime ask for angiography following EEG and cranial computertomography. In cases of arteriosclerosis in aged people with typical changes within the vessel system of the brain one should only use angiographical investigations if clinical findings (based on noninvasive methods) show indications for surgical treatment in extracranial regions of the brain vessels. It might be the same procedure if shunt-operation between carotis externa and interna circulation system can be expected as curative or prophylactic influence within the neurological condition. In these cases risk of selective angiography of the vessels within the brain (outgoing from arteria femoralis) are much less dangerous than in direct charges. First of all neurological status, general condition and age will be decive for medical indication. One should not use the full range of diagnostic features in gerontoneurology only to satisfy diagnostic appeasement.

Aged↗
PubMed1993

Hard tissue regeneration for implant success.

The inevitable loss of alveolar bone following tooth loss deserves a prophylactic approach from the dental profession. By preserving bone through regenerative procedures, the patient option and likelihood of successful future dental implant treatment are enhanced. The use of fascia lata similarly extends surgical and restorative options to patients who otherwise might not be candidates for dental implants. A variety of materials is available for these procedures, but whichever are selected, it is imperative that the dental implant professional operate as a member of a team of interrelated disciplines if the results of dental implant treatment are to be optimized.

Alveolar Bone Loss↗