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The Bacteriological Profile of Su.gical Site Infections in Orthopaedic Implant Su.geries in Sou.h-East Nigeria

Jou.nal of Biosciences and Medicines 2019年第9期7卷 19-27页

作者： Kelechu.wu.A. Okoro Osita Ede Emmanu.l C. Iyidobi ugochukwu u. enweani Cajetan u. Nwadinigwe Gabriel O. Eyichu.wu.u.o E. Anyaehie Francis N. Ahaotu.Richard C. Ezeh Department of Orthopaedics and Trau.a National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Backgrou.d: Knowledge of the common bacteria that cau.e su.gical site infection (SSI) and their antibiotic sensitivity is mandatory if treatment of su.gical infection is to be su.cessfu.. The threat of the emergence of resistant strains of bacteria is ever-present. Hence, a sensitivity directed therapy is paramou.t for the su.cessfu. eradication of organisms with minimal risk of development of antibiotic resistance. Aim: The aim is to identify the common bacteria that cau.e SSI in orthopaedic implant su.geries in ou. hospital. Method: This is a prospective longitu.inal stu.y that inclu.es all orthopaedic su.geries involving the u.e of implants within one year. Patients that had major orthopaedic su.geries involving implant were followed u. and their wou.ds inspected for signs of SSI on postoperative days 3, 7, 14, 42 and 90. Wou.d swab was taken for microscopy, cu.tu.e and sensitivity analysis from those who had wou.d infection, based on the CDC gu.delines. Resu.ts: One-hu.dred and sixteen patients met ou. inclu.ion criteria and were inclu.ed in the analysis. There were 62 males and 54 females. The mean age of the participant was 39.62 years (SD = 15.02 years). Fractu.e fixation with plates and screws was the most common implant su.gery done. The incidence of SSI was 2.6%, and Escherichia coli was the most common isolated pathogen. All the SSIs were su.erficial incisional type, and the infection was monomicrobial in 67% of cases and polymicrobial in 33%. All of the isolated pathogens were sensitive to Imipenem and Gentamycin. Conclu.ion: Su.erficial incisional SSI is the most common type of SSI in this stu.y. Escherichia coli is the most frequ.nt pathogen in SSI affecting implant su.geries in ou. hospital. Gentamycin and Imipenem shou.d be u.ed for the prophylaxis of SSI in ou. environment.

关键词： SSI Bacteriology Orthopaedic Implant Nigeria

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The Antiseptic Efficacy of Povidone-Iodine in Redu.ing Early Su.gical Site Infections in Orthopaedic Implant Su.geries

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Jou.nal of Biosciences and Medicines 2019年第9期7卷 9-18页

作者： Kelechu.wu.A. Okoro Osita Ede ugochukwu u. enweani Emmanu.l C. Iyidobi Cajetan u. Nwadinigwe Gabriel O. Eyichu.wu.u.o E. Anyaehie Francis N. Ahaotu.Richard C. Ezeh Department of Orthopaedics and Trau.a National Orthopaedic Hospital Enugu Nigeria City Clinics Enugu Nigeria

Backgrou.d: Su.gical site infection (SSI) is a dreaded nightmare for the Orthopaedic su.geon. Preoperative skin cleaning with antiseptics has been shown to redu.e the microbial bu.den of the skin and resu.ts in redu.ed incidence of SSI. However, the ideal skin cleaning agent remains to be established. Aim: To compare the efficacy of Povidone-Iodine/Povidone-Iodine (PI-PI) combination with that of Chlorhexidine-Glu.onate/Alcohol (CG-A) combination in re-du.ing SSI in Orthopaedic su.geries. Methods: This was a prospective, randomized, dou.le-blinded, controlled stu.y. Su.jects that met the selection criteria and gave consent were randomized into PI-PI grou. (test grou.) and the CG-A grou. (control grou.). Both the patients and the assessors for SSI were blinded to the grou. a participant belongs. Blocking was done on the type of su.gery to cancel the confou.ding effect of su.gery type on SSI. Standard perioperative protocols were applied to both grou.s. Assessment for featu.es of SSI was done on the 3rd day, 7th day, 14th day, 6th week and 12th-week postoperative period. The diagnosis of SSI was made based on the Centers for Disease and Control (CDC) gu.delines. Resu.ts: We recru.ted 124 patients for this stu.y, 62 males and 54 females. The mean age of the su.jects was 37.5 years (SD = 14.7 years). Sixty-two su.jects were randomized into each grou.. There was no significant difference in the distribu.ion of the genders in the stu.y arms. Other possible confou.ders su.h as du.ation of hospital stay, u.e of drains, the su.geon involved and age were evenly distribu.ed in the two grou.s. Eight patients did not complete the stu.y. The overall incidence of SSI in the stu.y was 2.6%. Su.jects in the control grou. had an SSI of 3.4% while those in the PI-PI grou. had a rate of 1.8%;however, this was not significant, p = 0.579. Conclu.ion: Both CG-A and PI-PI combinations are equ.lly efficaciou. as preoperative skin antiseptic in Orthopaedic implant su.geries.

关键词： SSI Orthopaedic Implant Su.geries Chlorhexidine Glu.onate-Alcohol Povidone Iodine

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Epidemiological Pattern of Closed Femoral Shaft Fractu.es in a Regional Tertiary Hospital in Enu.u. Nigeria

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Jou.nal of Biosciences and Medicines 2019年第5期7卷 180-188页

作者： E. C. Iyidobi R. T. Ekwu.ife u. M. enweani C. u. Nwadinigwe I. C. Okwesili H. C. Ekwedigwe National Orthopedic Hospital Enugu Nigeria City Specialist Hospital Enugu Nigeria College of Medicine University of Nigeria Eungu Campus Enu.u.State u.iversity Teaching Hospital Parklane Enugu Nigeria

Backgrou.d: The femu. is the longest and strongest tu.u.ar bone in the hu.an body. The femoral shaft is the portion of the bone between 5 cm distal to the lesser trochanter and 6 cm proximal to the most distal point of the medial femoral condyle. Femoral shaft fractu.es often resu.t from high energy forces. These fractu.es occu. mostly among you.g adu.ts. Objective: This was to determine the epidemiological pattern of closed femoral shaft fractu.es in a regional tertiary hospital in Enu.u. Nigeria. Method: The stu.y was a prospective stu.y over a 12 month period (Ju.e 2015-May 2016) at National Orthopaedic Hospital, Enu.u. Following ethical approval and written informed consent, patients were consecu.ively recru.ted. The patients were clinically and radiographically evalu.ted at presentation. The diagnosis of closed femoral shaft fractu.es were made from the physical examination finding of absent open wou.d commu.icating with the fractu.e hematoma in the thigh and anteroposterior (AP) and lateral x-rays of the affected thigh confirming the fractu.e pattern. The data collected inclu.ed patients’ demographics, the cau.e of inju.y, the side of inju.y and anatomic site of the inju.y among other parameters. The data were collected u.ing well designed and stru.tu.ed proforma. Resu.ts: A total of 52 femoral shaft fractu.es in 50 patients were inclu.ed and analyzed u.ing SPSS version 20.0. The age range of the patients is 18 - 85 years with a median age of 39.1 ± 14.9 years. The most commonly affected age grou. is 21 - 30 years. There was male preponderance with a male to female ratio of 2.3:1. Majority of the fractu.es (76.9%) resu.ted from road traffic crashes most commonly following motor vehicu.ar accident (36.5%). Majority of the fractu.es (92.3%) are u.ilateral with right side to left side ratio of 1.2:1. Majority of the patients (51.9%) had Winqu.st Hansen grade III type of fractu.e. The most common associated inju.y is fractu.es of tibia/fibu.a followed by fractu.e

关键词： Epidemiology Closed Femoral Shaft Fractu.e

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