Reducing Postsurgical Wound Complications: A Critical Review (original) (raw)
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Surgical Site Infection, Prevalence, Management and Prevention
2020
Background: Postoperative wound infection or Surgical Site Infection (SSI) is defined as wound infection occurring within 30 days of the operative procedure or within one year if the implant is left in place and the infection is considered to be secondary to the operation. SSIs can range from a relatively trivial wound discharge to a life-threatening condition without any other complications. SSI is one of the most common health-care-associated infections and may occur in 5-20% after surgery. Aim: In this review, we will look into epidemiology, risk factors, management and prevention of surgical site infection. Conclusion: There is a profound effect of SSIs on both patients and healthcare organizations; hence efforts should be focused on implementing complex multidisciplinary prevention strategies. Knowledge of the important consequences of SSI for patient safety and treatment costs is of prime importance to any surgeon and tracking one's own activities in the operating room in relation to existing literature is an essential step in preventing infection and optimizing beneficial outcomes.
Awareness and wound assesment decrease surgical site infections
2021
Objective: Various surveillance methods have been described for surveillance of surgical site infections (SSI). The aim of this study was to examine practicality of SSI risk assessment methods (SENIC and NNIS) with a postoperative wound monitoring scale (ASEPSIS) as an outcome assessment measure and evaluation of the contribution of wound assesment to the reduction of wound infection. Material and Methods: Patients were followed with a prospective data chart through four year. Correlation of SENIC and NNIS together with ASEPSIS were performed. Results: During the study period, 275 SSI occurred. SSIs were determined within the 21 days-period after operations. Correlation between SENIC with ASEPSIS (rs= 0.41, p< 0.001) was found better than that for NNIS with ASEPSIS (rs= 0.37, p< 0.001). Type of operation (emergency vs. elective), body mass index, operation class and American Society of Anesthesiologists scores were found independently predictive factors for SSI. The forth year SSI rate was found to be significantly lower than the other years (p< 0.001). Conclusion: This study indicates weak but significant correlation between preoperative risk assessment methods for SSI and ASEPSIS method. In addition, surgical wound assesment and awarness of the wound infection rates, have decreased the SSI rates over the years.
Updates in Surgery
Surgical site infections represent a considerable burden for healthcare systems. To obtain a consensus on the impact and future clinical and economic needs regarding SSI management in an era of multidrug resistance. A modified Delphi method was used to obtain consensus among experts from five European countries. The Delphi questionnaire was assembled by a steering committee, verified by a panel of experts and administered to 90 experts in 8 different surgical specialities (Abdominal, Cancer, Cardiac, General surgery, Orthopaedic, Thoracic, Transplant and Vascular and three other specialities (infectious disease, internal medicine microbiology). Respondents (n = 52) reached consensus on 62/73 items including that resistant pathogens are an increasing matter of concern and increase both treatment complexity and the length of hospital stay. There was strong positive consensus on the cost-effectiveness of early discharge (ED) programs, improvement of quality of life with ED and associat...
Risk Factors and Key Principles for Prevention of Surgical Site Infections
Surgical Infections [Working Title]
Surgical site infections are one of the most important causes of healthcareassociated infections (HCAIs). They are associated with morbidity and possibly in part as a factor in associated postoperative mortality if present. Thus, it is important to recognize different SSIs and that they can vary from trivial wounds to a life-threatening condition. There are multiple risk factors contributing to the development of SSIs and guidelines to combat and decrease the possibility of the occurrence of such events through proper implementation.
International Surgery Journal
Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay incre...
Surgical Perspective of Wound Site Infection at a Tertiary Care Hospital
JMS SKIMS
Background: Surgical wound infection is a common postoperative complication and causes significant postoperative morbidity and mortality, prolongs hospital stay, and adds to hospital costs. Aims and objectives: This study was designed and carried out in the Department of General surgery SKIMS Srinagar in order to find infection rate after clean and clean-contaminated surgery in our hospital, to study the clinical profile of patients with surgical site infections (SSI), to find out the common organisms involved in different wound infections and to study the risk factors for postoperative wound Infections. Methods: This study was carried out prospectively in the Department of General and Minimal Access Surgery SKIMS, Srinagar from February 2012 to January 2014 on 117 cases that underwent clean and clean-contaminated surgery. Results: In our study, the frequency of Surgical Site Infection was 13%. The incidence amongst clean surgical cases was 6.5% and amongst clean-contaminated case...
for the Healthcare Infection Control Practices Advisory Committee IMPORTANCE The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies.
Surgical site infections – an updated review of guidelines in the light of new scientific data
Journal of Education, Health and Sport
Surgical site infections are important and still more growing burden in 2023. WHO estimated that SSIs are one of the most common and frequent healthcare associated infections (HAI), and in the world’s perspective, it can occur up to 10% after surgeries [1]. The knowledge about preliminary and novel ways of diagnosis and treatment and prevention of this disease are important in improving outcomes. Reducing the amount of complications after surgeries is crucial in helping with the recovery and it is an outcome of both proper prehabilitation and safe surgical protocols . Especially focus on the preventive measures for SSI, early diagnosis and aggressive treatment can really improve overall survival, lower the incidence of further complications (including sepsis), and improve patients recovery. This paper summarizes the current guidelines indications as well as their reflection in novel published data.
Trials, 2011
Background: Surgical site infection (SSI) is a common complication following abdominal surgery. It is associated with considerable morbidity and mortality, and its management results in significant cost to health services within both primary and secondary care. Some surgeons believe that the use of a wound-edge protection device may reduce the incidence of SSI. Whilst there is some encouraging evidence showing that such devices may lead to a reduction in SSI, there are no controlled trials of sufficient size or quality to support their routine use. Methods/Design: 750 patients will be recruited from around 20 surgical units within the United Kingdom. Patients undergoing laparotomy through any major abdominal incision for any indication, elective or emergency, are eligible. Patients under the age of 18, those undergoing a laparoscopic assisted procedure or who have undergone laparotomy within the previous 3 months, and those who are unable to give informed consent will be excluded. Patients will be randomised (1:1 ratio) to the use of a wound-edge protection device or no wound-edge protection device during surgery. Follow up will consist of blinded clinical wound reviews at 5-7 days and 30-33 days postoperatively with a selfcompleted questionnaire covering the intervening period. Quality of life questionnaires will be completed prior to surgery and at the subsequent wound review points and information on resource usage will also be captured. The primary outcome measure is SSI within 30 days of surgery. Secondary outcomes include the impact of the degree of wound contamination, patient comorbidity, and operative characteristics on the efficacy of a woundedge protection device in reducing SSI and whether the use of a wound-edge protection device has an effect on health-related quality of life or length of hospital stay and is cost-effective.