检索结果-南通市图书馆

The Impact of an Evidence-Based Bundle on Cesarean Section-Related surgical site infections:A Randomized Clinical Trial

引用

Maternal-Fetal Medicine 2024年第2期6卷 70-77页

作者： Aditya Gan Romana Khursheed Mahadevi Savanur Anita Dalal Arif Maldar Department of Obstetrics and Gynecology Jawaharlal Nehru Medical CollegeKLE Academy of Higher Education and ResearchBelagaviKarnataka 590009India Department of Medicine Jawaharlal Nehru Medical CollegeKLE Academy of Higher Education and ResearchBelagavi 590010India.

Objective To compare the effectiveness of an evidence-based bundle in minimizing cesarean section(CS)-related surgical site infections(SSIs)with that of standard routine care.Methods This was a single-center,parallel,and randomized clinical trial conducted at KAHER’s Dr.Prabhakar Kore Charitable Hospital,Belagavi,India,from January 2021 to December 31,2021.Three hundred twenty women undergoing CS delivery were selected and allocated into two groups(1:1)using simple randomization with fixed allocation.An evidence-based surgical bundle(a combination of more than three perioperative interventions)was used for the intervention group,whereas the control group received routine standard perioperative care.The primary outcome was the incidence of SSI(superficial,deep,and organ or space SSIs)within 6 weeks postpartum in both groups.Categorical and continuous data were analyzed using appropriate statistical tests with a significance threshold set at P<0.05.Results In this study,16 and 17 participants each from the control and intervention groups,respectively,were lost to follow-up,resulting in a total of 144 and 143 study participants included in the respective groups.Twenty-eight(19.4%)and 14(9.8%)women developed SSI in the control and intervention groups,respectively(P=0.02).Methicillin-resistant Staphylococcus aureus was the most common cause of SSI in both groups(63.6%(7/11)and 100%(3/3)in the control and intervention groups,respectively).Conclusion The use of the evidence-based bundle for CS-related SSI prevention effectively decreased the incidence of SSI by half compared to standard routine practice.Implementing the use of this bundle in routine perioperative care will reduce the cost of CS and improve health outcomes in CS.

关键词： Cesarean section Bundle approach Infection prevention bundle surgical site infections Evidence-based bundle

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery:A systematic review and metaanalysis

引用

World Journal of Gastrointestinal Surgery 2023年第12期15卷 2879-2889页

作者： Tomohiro Ishinuki Hiroji Shinkawa Keita Kouzu Seiichi Shinji Erika Goda Toshio Ohyanagi Masahiro Kobayashi Motomu Kobayashi Katsunori Suzuki Yuichi Kitagawa Chizuru Yamashita Yasuhiko Mohri Junzo Shimizu Motoi Uchino Seiji Haji Masahiro Yoshida Hiroki Ohge Toshihiko Mayumi Toru Mizuguchi Department of Nursing Surgical SciencesSapporo Medical UniversitySapporo 060-8556HokkaidoJapan Department of Hepatobiliary-Pancreatic Surgery Osaka Metropolitan University Graduate School of MedicineAbeno-Ku 545-0051Japan Department of Surgery National Defense Medical CollegeTokorozawa 359-8513Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 113-8602Japan Department of Nursing Japan Health Care UniversitySapporo 062-0053Japan Department of Liberal Arts and Sciences Center for Medical EducationSapporo Medical UniversitySapporo 060-8556Japan Department of Clinical Pharmacokinetics Research and Education Center for Clinical PharmacyKitasato UniversityTokyo 108-8641Japan Department of Anesthesiology Hokushinkai Megumino HospitalEniwa 061-1395Japan Department of Infectious Disease Medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Gastrointestinal Surgery National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Anesthesiology and Critical Care Medicine Fujita Health UniversityToyoake 470-1192Japan Department of Gastrointestinal Surgery Mie Prefectural General Medical CenterYokkaich 510-8561Japan Department of Surgery Toyonaka Municipal HospitalToyonaka 560-8565Japan Department of Gastroenterological Surgery Hyogo Medical UniversityNishinomiya 663-8501Japan Department of Surgery Soseikai General HospitalKyoto 612-8473Japan Department of Hepato-Biliary-Pancreatic&Gastrointestinal Surgery International University of Health and WelfareIchikawa 272-0827Japan Department of Infectious Disease Hiroshima University HospitalHiroshima 734-8551Japan Department of Intensive Care Unit Chukyo HospitalJapan Community Health Care OrganizationNagoya 457-8510Japan

BACKGROUND surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.

关键词： Abdominal surgery Mortality Seroma formation Subcutaneous drain surgical site infections

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effect of weight-adjusted antimicrobial antibiotic prophylaxis on postoperative dosage and surgical site infection incidence in total joint arthroplasty

引用

World Journal of Orthopedics 2024年第4期15卷 318-320页

作者： Ashim Gupta Vijay Kumar Jain Department of Orthopaedics and Regenerative Medicine Future BiologicsLawrencevilleGA 30043United States Department of Orthopaedics South Texas Orthopaedic Research Institute(STORI Inc.)LaredoTX 78045United States Department of Regenerative Medicine BioIntegrateLawrencevilleGA 30043United States Department of Orthopaedics and Regenerative Medicine Regenerative OrthopaedicsNoida 201301India Department of Orthopaedics Atal Bihari Vajpayee Institute of Medical SciencesDr Ram Manohar Lohia HospitalNew Delhi 110001India

surgical site infections(SSI)following total joint arthroplasty pose a significant concern for both providers and patients across the globe.Currently,administration of antimicrobial antibiotic prophylaxis is used throughout the world to reduce the incidence of SSI.However,the correct dosage and frequency of administration remains debatable.In this editorial,we emphasized the determination of the effect of administration of weight-adjusted antimicrobial antibiotic prophylaxis regime on the incidence of SSI and postoperative dosage reduction compared to the conventionally used regime during total joint arthroplasty.The results demonstrated similar efficacy between both regimes with respect to the incidence of SSI.In addition,weight-adjustment led to reduced postoperative dosage and has the potential to reduce chances of achieving lower therapeutic concentration,drug resistance,drug toxicity,and costs.

关键词： Antibiotics Antimicrobial prophylaxis Weight-adjusted surgical site infections Total joint arthroplasty Knee arthroplasty Hip arthroplasty

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Antibiotic Prescribing Patterns and Prevalence of surgical site infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia

引用

Pharmacology & Pharmacy 2022年第8期13卷 313-330页

作者： Maisa Kasanga Misheck Chileshe Steward Mudenda Raphael Mukosha Maika Kasanga Victor Daka Tobela Mudenda Maureen Chisembele John Musuku Benjamin Bisesa Solochi Jian Wu College of Public Health Zhengzhou University Zhengzhou China Department of Pathology and Microbiology University Teaching Hospitals Lusaka Zambia Mary Begg Health Services Ndola Zambia Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Disease Control School of Veterinary Medicine University of Zambia Lusaka Zambia Laboratory Department Levy Mwanawasa University Teaching Hospital Lusaka Zambia Department of Pharmacy University Teaching Hospitals Lusaka Zambia Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Department of Pathology Ndola Teaching Hospital Ndola Zambia Department of Obstetrics and Gynaecology University of Zambia-School of Medicine Lusaka Zambia Women and Newborn Hospital University Teaching Hospitals Lusaka Zambia Levy Mwanawasa University Teaching Hospital Lusaka Zambia

Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.

关键词： Antibiotic Prescribing Patterns Caesarean Section Post-Operative Antibiotics Prophylactic Antibiotics surgical site infections

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Role of ablation therapy in conjunction with surgical resection for neuroendocrine tumors involving the liver

引用

World Journal of Gastrointestinal Surgery 2024年第3期16卷 768-776页

作者： Alexander Ostapenko Stephanie Stroever Lud Eyasu Minha Kim Krist Aploks Xiang Da Dong Ramanathan Seshadri Department of General Surgery Danbury HospitalDanburyCT 06810United States Department of Research and Innovation Nuvance HealthDanburyCT 06810United States Division of surgical Oncology/Hepato-Pancreato-Biliary Surgery Danbury HospitalDanburyCT 06810United States

BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.

关键词： Hepatectomy Neuroendocrine tumor Ablation Bile leaks Bleeding surgical site infections

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

How to identify early complications in patients undergoing distal gastrectomy?

引用

World Journal of Gastrointestinal Surgery 2024年第4期16卷 974-981页

作者： Giuseppe Tropeano Maria Michela Chiarello Valeria Fico Giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Department of Medical and surgical Sciences UniversitàCattolica del Sacro CuoreRome 00168Italy

In this editorial we comment on the article by Zhang et al published in a recent issue of the World Journal of Gastrointestinal Surgery.Gastrectomy with appropriate lymph node dissection is still standard curative treatment in locally advanced gastric cancer.Several studies point out that gastric cancer surgery is a complex procedure that leads to a high risk of morbidity and mortality.Many factors can contribute to the onset of complications with consequent effects on prognosis and increased mortality.The complications can be divided in complications related to anastomosis,to motility and to surgical site infection.The study presented by Zhang B et al represent an interesting analysis on the possibility to prevent postoperative morbidity.The study was performed on 131 patients with distal gastric cancer who underwent gastrectomy with D2 lymph node dissection.Of these patients,16%developed early postoperative complications.The univariate analysis showed that prealbumin level,hypertension,diabetes,history of abdominal surgery,R0 resection,and blood transfusion were factors influencing early postoperative complications after distal gastrectomy.Moreover,the inclusion of the above significant variables in the logistic regression analysis revealed that hypertension,diabetes,a history of abdominal surgery,and blood transfusion were independent predictors of postoperative complications.In conclusion,preoperative and intraoperative factors can be used to establish an early postoperative nomogram model.The results of the study presented by Zhang et al suggest that the prediction model can be used to guide the detection of postoperative complications and has clinical reference value.

关键词： Gastric cancer Gastrectomy Lymph node dissection Morbidity Mortality surgical site infections

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Wound irrigation for preventing surgical site infections

引用

World Journal of Methodology 2021年第4期11卷 222-227页

作者： Marios Papadakis Department of Surgery II University of Witten-HerdeckeWuppertal 42283Germany

Wound irrigation(i.***.washing out a wound before wound closure)aims to reduce the microbial burden by removing tissue debris,metabolic waste,and tissue exudate from the surgical field before site closure.Although it is a popular procedure in every day surgical practice,the lack of procedure standardization,leads to studies with high heterogeneity and often controversial results.Thus,there are studies that advocate its use,while others discourage its implementation in clinical practice to reduce the risk of surgical site infection.The present article reviews the current literature on wound irrigation for preventing surgical site infections.Several irrigants are presented.Chlorexidine is generally considered to be less effective than povidone-iodine,while antibiotics are not that common nowadays,as they require prolonged exposure with the target to act.Hydrogen peroxide has several potential complications,which eliminate its use.Any differences in the incidence of surgical site infections between different irrigants,especially between antibacterial and non-bacterial ones,should be viewed sceptically.More randomized controlled studies are needed to provide better quality of evidence regarding the irrigants'effectiveness and safety.

关键词： Wound irrigation surgical site infections Antiseptics Antibiotics Patient Safety

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

The Place of Nursing Theory in the Management of Post-Operative infections in a Hospital Environment: Case of Cibitoke District Hospital

引用

Open Journal of Nursing 2024年第5期14卷 225-238页

作者： Onésime Nduwimana Le Béni Bugingo Arlette Ntigura Ishimwe Abias Nibaruta Faculty of Health Sciences Hope Africa University Bujumbura Burundi Faculty of Health Sciences Integrated Polytechnic University Cibitoke Burundi

Introduction: Post-operative infections, such as surgical site infections (SSIs), are a significant concern in healthcare settings. Nurses play a crucial role in the prevention and management of these infections. The use of nursing theory could contribute to the prevention of SSIs. The aim of this study was to evaluate the role of nursing theory in the management of surgical site infections (SSIs) in a hospital environment. Method: A cross-sectional study was conducted using descriptive and analytical methods to assess the role of nursing theory in the management of Post-operative infections (POI) in a hospital setting in October 2023. The study population consisted of nurses working in the Surgery, Emergency, and Maternity units at Cibitoke District Hospital. A sample size of 71 nurses working full or part time in the Surgery were invited to participate in this study. A questionnaire was used to collect the data, and SPSS version 21.0 software was used for analysis. Results: The study found that nursing theory did not have any statistically significant place in the management of POI (p-value = 0.523). However, the results showed that experience was the only significant factor influencing the management of POI (p-value = 0.004). This is explained by the analysis of the net effects of the explanatory variable where we noticed that those who had more experience were more likely to manage post-operative infections. The participants’ knowledge regarding nursing theory in the management was poor as they scored less than 30% in all the variables used to measure their knowledge. Conclusion: The study revealed that nurses’ knowledge of nursing theories and their applications in the management of SSIs was poor. Continuing professional development, curriculum review, and in-service training were highly recommended.

关键词： Nurses Postoperative Infection surgical site infections Management Nursing Theory

来源：

维普期刊数据库博看期刊评论

在线全文

学校读者我要写书评

暂无评论

Risk factors and prediction model for inpatient surgical site infection after elective abdominal surgery

引用

World Journal of Gastrointestinal Surgery 2023年第3期15卷 387-397页

作者： Jin Zhang Fei Xue Si-Da Liu Dong Liu Yun-Hua Wu Dan Zhao Zhou-Ming Liu Wen-Xing Ma Ruo-Lin Han Liang Shan Xiang-Long Duan Second Department of General Surgery Shaanxi Provincial People's HospitalXi’an 710068Shaanxi ProvinceChina Institute of Medical Research Northwestern Polytechnical UniversityXi’an 710072Shaanxi ProvinceChina Second Department of General Surgery Third Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710068Shaanxi ProvinceChina Computer Science School Universiti Sains MalaysiaPenang 11800Malaysia Medical Service Shaanxi Provincial People's HospitalXi’an 710068Shaanxi ProvinceChina

BACKGROUND surgical site infections(SSIs) are the commonest healthcare-associated infection. In addition to increasing mortality, it also lengthens the hospital stay and raises healthcare expenses. SSIs are challenging to predict, with most models having poor predictability. Therefore, we developed a prediction model for SSI after elective abdominal surgery by identifying risk factors.AIM To analyse the data on inpatients undergoing elective abdominal surgery to identify risk factors and develop predictive models that will help clinicians assess patients preoperatively.METHODS We retrospectively analysed the inpatient records of Shaanxi Provincial People’s Hospital from January 1, 2018 to January 1, 2021. We included the demographic data of the patients and their haematological test results in our analysis. The attending physicians provided the Nutritional Risk Screening 2002(NRS 2002)scores. The surgeons and anaesthesiologists manually calculated the National Nosocomial infections Surveillance(NNIS) scores. Inpatient SSI risk factors were evaluated using univariate analysis and multivariate logistic regression. Nomograms were used in the predictive models. The receiver operating characteristic and area under the curve values were used to measure the specificity and accuracy of the model.RESULTS A total of 3018 patients met the inclusion criteria. The surgical sites included the uterus(42.2%), the liver(27.6%), the gastrointestinal tract(19.1%), the appendix(5.9%), the kidney(3.7%), and the groin area(1.4%). SSI occurred in 5% of the patients(n = 150). The risk factors associated with SSI were as follows: Age;gender;marital status;place of residence;history of diabetes;surgical season;surgical site;NRS 2002 score;preoperative white blood cell, procalcitonin(PCT), albumin, and low-density lipoprotein cholesterol(LDL) levels;preoperative antibiotic use;anaesthesia method;incision grade;NNIS score;intraoperative blood loss;intraoperative drainage tube placement;surgical operation items. Multivariate logistic regress

关键词： surgical site infections Risk factors Abdominal surgery Prediction model

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Antimicrobial approach of abdominal post-surgical infections

引用

World Journal of Gastrointestinal Surgery 2023年第12期15卷 2674-2692页

作者： Marco Fiore Antonio Corrente Sveva Di Franco Aniello Alfieri Maria Caterina Pace Francesca Martora Stephen Petrou Claudio Mauriello Sebastiano Leone Department of Women Child and General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy Unit of Virology and Microbiology “Umberto I”HospitalNocera Inferiore 84018Italy Department of Emergency Medicine University of California San FranciscoSan FranciscoCA 94143United States Department of General Surgery “Santa Maria delle Grazie”HospitalPozzuoli 80078Italy Division of Infectious Diseases “San Giuseppe Moscati”HospitalAvellino 83100Italy

Abdominal surgical site infections(SSIs)are infections that occur after abdominal surgery.They can be superficial,involving the skin tissue only,or more profound,involving deeper skin tissues including organs and implanted materials.Currently,SSIs are large global health problem with an incidence that varies significantly depending on the United Nations’Human Development Index.The purpose of this review is to provide a practical update on the latest available literature on SSIs,focusing on causative pathogens and treatment with an overview of the ongoing studies of new therapeutic strategies.

关键词： surgical site infections Multidrug resistance Carbapenem-resistant Enterobacterales Carbapenem-resistant Klebsiella Abdominal post-operative complications Post-surgical infections

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：