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Wound Infection

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181. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system correlates with cost of care for diabetic foot ulcers treated in a multidisciplinary setting. (PubMed)

The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system correlates with cost of care for diabetic foot ulcers treated in a multidisciplinary setting. We have previously demonstrated that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing time in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Our aim was to assess whether the charges and costs (...) associated with DFU care increase with higher WIfI stages.All patients presenting to our multidisciplinary diabetic limb preservation service from June 2012 to June 2016 were enrolled in a prospective database. Inpatient and outpatient charges, costs, and total revenue from initial visit until complete wound healing were compared for wounds stratified by WIfI classification.A total of 319 wound episodes in 248 patients were captured, including 31% WIfI stage 1, 16% stage 2, 30% stage 3, and 24% stage 4

2017 Journal of Vascular Surgery

182. Prophylactic negative pressure wound therapy after cesarean is associated with reduced risk of surgical site infection: a systematic review and meta-analysis. (PubMed)

Prophylactic negative pressure wound therapy after cesarean is associated with reduced risk of surgical site infection: a systematic review and meta-analysis. The objective of the study was to assess the effect of prophylactic negative-pressure wound therapy on surgical site infections and other wound complications in women after cesarean delivery.We searched Ovid Medline, Embase, SCOPUS, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov.We included randomized controlled trials (...) and observational studies comparing prophylactic negative-pressure wound therapy with standard wound dressing for cesarean delivery.The primary outcome was surgical site infection after cesarean delivery. Secondary outcomes were composite wound complications, wound dehiscence, wound seroma, endometritis, and hospital readmission. Heterogeneity was assessed using Higgin's I2. Relative risks with 95% confidence intervals were calculated using random-effects models.Six randomized controlled trials and 3 cohort

2017 American Journal of Obstetrics and Gynecology

183. Importance of postprocedural Wound, Ischemia, and foot Infection (WIfI) restaging in predicting limb salvage. (PubMed)

Importance of postprocedural Wound, Ischemia, and foot Infection (WIfI) restaging in predicting limb salvage. The Wound, Ischemia, and foot Infection (WIfI) classification system was created to encompass demographic changes and expanding techniques of revascularization to perform meaningful analyses of outcomes in the treatment of the threatened limb. The WIfI index is intended to be analogous to the TNM staging system for cancer, with restaging to be done after control of infection and after (...) postoperative wound and foot infection grades additionally correlated with AFS. WIfI restaging at 1 month and 6 months postoperatively may help identify a cohort that remains at higher risk for limb loss and may merit more expeditious reintervention.Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

2017 Journal of Vascular Surgery

184. In vitro and in vivo activity of fosfomycin alone and in combination with rifampin and tigecycline against Gram-positive cocci isolated from surgical wound infections. (PubMed)

In vitro and in vivo activity of fosfomycin alone and in combination with rifampin and tigecycline against Gram-positive cocci isolated from surgical wound infections. Complicated skin and soft tissue infections constitute a heterogeneous group of severe disorders, with surgical site infections being the most common hospital-acquired ones. The aim of our study was to investigate the synergistic and bactericidal activities of antimicrobial combinations of fosfomycin with rifampicin (...) and tigecycline against Enterococcus faecalis, Enterococcus faecium and methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates, and also to evaluate their in vivo effects in a mouse wound infection model. In in vitro studies, the combinations of fosfomycin with rifampicin and tigecycline were both synergistic. These synergies were confirmed in in vivo studies: the drug combinations showed the highest antimicrobial effects compared to monotherapy. In conclusion, the efficacy of fosfomycin

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2017 Journal of Medical Microbiology

185. Plastic wound protectors decreased surgical site infections following laparoscopic-assisted colectomy for colorectal cancer: A retrospective cohort study. (PubMed)

Plastic wound protectors decreased surgical site infections following laparoscopic-assisted colectomy for colorectal cancer: A retrospective cohort study. Laparoscopic surgery is widespread and safe for the management of patients with colorectal cancer (CRC). Although the use of standard surgical techniques can prevent perioperative wound infections, surgical site infections (SSIs) remain an unresolved complication in laparoscopic-assisted colectomy. The present study investigated the ability (...) of plastic wound protectors applied to the extraction incision during the externalized portion of the procedure to reduce the rate of infection in laparoscopic-assisted colectomy. We completed a retrospective review of the medical records of patients who underwent nonemergent laparoscopic-assisted between January 2015 and June 2016. Outcomes for patients with and without the use of a wound protector were compared. A total of 109 patients were included in this study. There was 1 patient in the wound

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2017 Medicine

186. Comparative Assessment of Tedizolid Pharmacokinetics and Tissue Penetration Between Diabetic Patients with Wound Infections and Healthy Volunteers via <i>In Vivo</i> Microdialysis. (PubMed)

Comparative Assessment of Tedizolid Pharmacokinetics and Tissue Penetration Between Diabetic Patients with Wound Infections and Healthy Volunteers via In Vivo Microdialysis. Herein, we present pharmacokinetic and tissue penetration data for oral tedizolid in hospitalized patients with diabetic foot infections (DFI) compared with healthy volunteers. Participants received oral tedizolid phosphate 200 mg every 24 h for 3 doses to achieve steady state. A microdialysis catheter was inserted (...) into the subcutaneous tissue near the margin of the wound for patients or into thigh tissue of volunteers. Following the third dose, 12 blood and 14 dialysate fluid samples were collected over 24 h to characterize tedizolid concentrations in plasma and interstitial extracellular fluid of soft tissue. Mean ± standard deviation (SD) tedizolid pharmacokinetic parameters in plasma for patients compared with volunteers, respectively, were as follows: maximum concentration (Cmax), 1.5 ± 0.5 versus 2.7 ± 1.1 mg/liter (P

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2017 Antimicrobial Agents and Chemotherapy

187. Caesarean section wound infections and antibiotic use: a retrospective case-series in a tertiary referral hospital in The Gambia. (PubMed)

Caesarean section wound infections and antibiotic use: a retrospective case-series in a tertiary referral hospital in The Gambia. Ours is the first published study to examine post-Caesarean section (CS) wound infections in The Gambia. We explored risk factors and clinical management retrospectively at a large referral hospital over a 12-month period. A total of 777 cases were identified and records for 682 (88%) were retrieved. The CS rate was 21.8% and the wound infection rate 13.2%. Risk (...) factors included: length of labour; decision-to-incision time and stillbirth. Only 7.4% of women received preoperative antibiotic prophylaxis, but all women received multiple-dose, postoperative antibiotics. The wound infection rate found is likely to be an underestimate owing to loss to follow-up. The adherence to international guidelines regarding preoperative antibiotic prophylaxis needs to be improved.

2017 Tropical Doctor

188. Electric Field Based Dressing Disrupts Mixed-Species Bacterial Biofilm Infection and Restores Functional Wound Healing. (PubMed)

Electric Field Based Dressing Disrupts Mixed-Species Bacterial Biofilm Infection and Restores Functional Wound Healing. This study was designed to employ electroceutical principles, as an alternative to pharmacological intervention, to manage wound biofilm infection. Mechanism of action of a United States Food and Drug Administration-cleared wireless electroceutical dressing (WED) was tested in an established porcine chronic wound polymicrobial biofilm infection model involving inoculation (...) dressing.WED dressing was applied within 2 hours of wound infection to test its ability to prevent biofilm formation. Alternatively, WED was applied after 7 days of infection to study disruption of established biofilm. Wounds were treated with placebo dressing or WED twice a week for 56 days.Scanning electron microscopy demonstrated that WED prevented and disrupted wound biofilm aggregates. WED accelerated functional wound closure by restoring skin barrier function. WED blunted biofilm-induced expression

2017 Annals of Surgery

189. Risk factors of wound infection after open reduction and internal fixation of calcaneal fractures. (PubMed)

Risk factors of wound infection after open reduction and internal fixation of calcaneal fractures. The aim of this study was to investigate the risk factors of wound infection after open reduction and internal fixation of calcaneal fractures.In all, 299 patients with 318 calcaneal fractures who underwent open reduction and internal fixation by a single surgeon were grouped according to different outcomes. We gathered the data on each patient including sex, age, injury mechanism, body mass index (...) (BMI), time to operation, fracture type, associated injuries, treatment course, tourniquet time, blood loss, bone graft (yes or no), diabetes (yes or no), smoking history, and complications. Univariate analysis and multivariable analysis were used to determine the association between risk factors and wound infection.Patients who met the entry criteria included 267 males and 32 females with a mean age of 38.6 years. Among them, 5.3% (n = 17) suffered wound infection, and all of the wounds healed

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2017 Medicine

190. Chronic lower extremity wound infection due to Kerstersia gyiorum in a patient with Buerger's disease: a case report. (PubMed)

Chronic lower extremity wound infection due to Kerstersia gyiorum in a patient with Buerger's disease: a case report. Kerstersia gyiorum is an extremely rare pathogen of human infection. It can cause chronic infection in patients with underlying conditions. It can easily be misdiagnosed if proper diagnostic methods are not used.A 47-year-old male patient with a history of Buerger's Disease for 28 years presented to our hospital with an infected chronic wound on foot. The wound was debrided (...) , surgical debridement, and skin grafting.This is the first case of wound infection due to K. gyiorum in a patient with Buerger's Disease. We made a brief review of K. gyiorum cases up to date. Also, this case is presented to draw attention to the use of new and advanced methods like MALDI-TOF MS and 16S rRNA gene sequencing for identification of rarely isolated species from clinical specimens of patients with chronic infections and with chronic underlying conditions.

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2017 BMC Infectious Diseases

191. Comparison of Wound Complications and Deep Infections With Direct Anterior and Posterior Approaches in Obese Hip Arthroplasty Patients. (PubMed)

Comparison of Wound Complications and Deep Infections With Direct Anterior and Posterior Approaches in Obese Hip Arthroplasty Patients. The purpose of this study was to compare the posterior approach (PA) with the direct anterior approach (DAA) among obese and nonobese total hip arthroplasty patients to determine if obese DAA patients have a higher risk of infection or wound complications compared with obese PA patients.We retrospectively evaluated 4651 primary total hip cases performed via (...) anterior approach or PA between 2009 and 2015. Patients were divided into 4 study groups based on approach and body mass index (BMI): (1) DAA <35 kg/m2, (2) DAA ≥35 kg/m2, (3) PA <35 kg/m2, and (4) PA ≥35 kg/m2. Infection rates and wound complications were compared.The rate of deep infection in groups 1 and 3 (nonobese anterior vs posterior) was 0.28% and 0.36%, respectively (P = .783); and in groups 2 and 4 (obese anterior vs posterior) was 2.35% and 2.7%, respectively (P = .80). The rate of wound

2017 Journal of Arthroplasty

192. The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large-Scale Cohort Study. (PubMed)

The Benefits of a Wound Protector in Preventing Incisional Surgical Site Infection in Elective Open Digestive Surgery: A Large-Scale Cohort Study. The objective of this study was to evaluate the benefits of wound protectors (WPs) in preventing incisional surgical site infection (I-SSI) in open elective digestive surgery using data from a large-scale, multi-institutional cohort study.Patients who had elective digestive surgery for malignant neoplasms between November 2009 and February 2011 were

2017 World Journal of Surgery

193. Effectiveness of topical application of Ostrich oil on the healing of Staphylococcus aureus and Pseudomonas aeruginosa-infected wounds. (PubMed)

Effectiveness of topical application of Ostrich oil on the healing of Staphylococcus aureus and Pseudomonas aeruginosa-infected wounds. Management of infected wounds is one of the major challenges that surgeons and nurses face. Several antimicrobial agents have been used, but the toxicity, drug resistance, and their effect on the healing process remain a matter of concern. The present study was designed to analyze the accelerative impact of topical application of ostrich oil on infected wounds (...) . The healing rate in the infected wound was assessed using wound area, histopathological characteristics, and expression of growth factors including vascular endothelial growth factor (VEGF), transforming growth factor beta 1 (TGF-β1), and fibroblast growth factor 2 (FGF-2).The wound area significantly decreased (p < 0.05) in the treated animals. There was a significant increase (p < 0.05) in new vessels, fibroblasts count, and collagen deposition in the ostrich oil-treated animals. Expression of VEGF, TGF

2017 Connective Tissue Research

194. Meta-analysis to assess the effectiveness of topically used vancomycin in reducing sternal wound infections after cardiac surgery. (PubMed)

Meta-analysis to assess the effectiveness of topically used vancomycin in reducing sternal wound infections after cardiac surgery. 28676184 2017 09 18 1097-685X 154 4 2017 Oct The Journal of thoracic and cardiovascular surgery J. Thorac. Cardiovasc. Surg. Meta-analysis to assess the effectiveness of topically used vancomycin in reducing sternal wound infections after cardiac surgery. 1320-1323.e3 S0022-5223(17)31170-4 10.1016/j.jtcvs.2017.06.004 Kowalewski Mariusz M Department of Cardiac

2017 The Journal of thoracic and cardiovascular surgery

195. Role of daptomycin on wound healing in a MRSA burn infected animal model. (PubMed)

Role of daptomycin on wound healing in a MRSA burn infected animal model. Prolonged hospitalization and antibiotic therapy are risk factors for the development of methicillin-resistant Staphylococcus aureus (MRSA) infections in thermal burn patients. We used a rat model to study the in vivo efficacy of daptomycin in the treatment of burn wound infections by S. aureus, and we evaluated the wound healing process through morphological and immunohistochemical analysis. A copper bar heated (...) , histological evaluation of tissue repair, and immunohistochemical expression of wound healing markers: epidermal growth factor receptor (EGFR) and fibroblast growth factor 2 (FGF-2). The highest inhibition of infection was achieved in the group that received daptomycin, which reduced the bacterial load from 107 CFU/ml to about 103 CFU/g (P < 0.01). The groups treated with daptomycin showed better overall healing with epithelialization and significantly higher collagen scores than the other groups

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2017 Antimicrobial Agents and Chemotherapy

196. Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis. (PubMed)

Association Between Obesity and Wound Infection Following Colorectal Surgery: Systematic Review and Meta-Analysis. The aim of this meta-analysis is to comprehensively review and quantify the excess risk of surgical site infections (SSI) in obese patients following colorectal surgery.A systematic electronic search of the MEDLINE and EMBASE databases identified studies that investigated the association of obesity, defined by body mass index (BMI) with SSI among colorectal surgery patients.Twelve

2017 Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

197. A survey of caesarean section surgical site infections with PICO™ Single Use Negative Pressure Wound Therapy System in high-risk patients in England and Ireland. (PubMed)

A survey of caesarean section surgical site infections with PICO™ Single Use Negative Pressure Wound Therapy System in high-risk patients in England and Ireland. This article reports audit data from the introduction of the PICO™ System for caesarean section patients with high body mass index (BMI) in four hospitals in the UK and Ireland. PICO was used on closed surgical incisions following caesarean section in 399 patients with BMI ≥35kg/m2. Thirty-six out of 399 patients (9.0%) developed signs (...) of surgical site infection (SSI), a rate lower than a previously reported incidence of 19.3% in a similar population. The readmission incidence was 0.8%. Therefore the use of PICO on closed surgical incisions may be associated with low incidence of SSI and readmission in this high-risk group.Copyright © 2017. Published by Elsevier Ltd.

2017 Journal of Hospital Infection

198. Factors influencing treatment success of negative pressure wound therapy in patients with postoperative infections after Osteosynthetic fracture fixation. (PubMed)

Factors influencing treatment success of negative pressure wound therapy in patients with postoperative infections after Osteosynthetic fracture fixation. Negative Pressure Wound Therapy (NPWT) is being increasingly used to treat postoperative infections after osteosynthetic fracture fixation. The aim of the present study was to analyze the influence of epidemiological and microbiological parameters on outcome.Infections following operative fracture fixation were registered in a comprehensive (...) [95% CI 1.41-17.92]) as did the presence of bacterial mixture (OR 5.0 [95% CI 1.41-17.92]) and open soft-tissue damage ≥ grade 3 (OR 10.2 [CI 1.88-55.28]). Wounds were less likely to heal in conjunction with high CRP blood levels (>20 mg/l) at the time of discharge (OR 3.6 [95% CI 1.31-10.08]) or following a change of the infecting bacterial species under therapy (OR 3.2 [95% CI, 1.13-8.99]).These results indicate that the delayed manifestation of infection, high CRP blood levels at discharge

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2017 BMC Musculoskeletal Disorders

199. Low yield of blood and wound cultures in patients with skin and soft-tissue infections. (PubMed)

Low yield of blood and wound cultures in patients with skin and soft-tissue infections. Current guidelines recommend blood cultures in skin and soft-tissue infection (SSTI) patients only with signs of systemic toxicity and wound cultures for severe purulent infections. Our objectives were to determine: 1) blood and wound culture yields in patients admitted with SSTIs; 2) whether injection drug users (IDUs) and febrile patients had higher blood culture yields; and 3) whether blood and wound (...) methicillin sensitive Staphylococcus aureus (MSSA) and 2 were methicillin resistant (MRSA). Of 29 febrile patients, 1 had a positive culture (yield=3.5%; 95% CI 0.6-17.2). Of 101 admitted IDU patients, 46 (46%) received blood cultures, and 4 had positive cultures (yield=8.7%; 95% CI 3.4-20.3). Of 89 patients with purulent wounds, 44 (49.4%) patients had ED wound cultures. Thirteen had positive cultures (yield=29.6%; 95% CI 18.2-44.2%). Most were MRSA, MSSA, and group A Streptococcus species - all

2017 American Journal of Emergency Medicine

200. Management of the extensive thoracic defects after deep sternal wound infection with the rectus abdominis myocutaneous flap: A retrospective case series. (PubMed)

Management of the extensive thoracic defects after deep sternal wound infection with the rectus abdominis myocutaneous flap: A retrospective case series. Deep sternal wound infection is a severe complication after open heart surgery. According to the different severity and dimensions of the deep sternal wound infection, the treatment method is different. In this study, we aimed to describe our experience with the rectus abdominis myocutaneous flap for large sternal wound management, especially (...) when 1 or 2 internal mammary arteries were absent.Between October 2010 and January 2016, a retrospective review of 9 patients who suffered from the extensive thoracic defects after deep sternal wound infection was conducted. All of these sternal defects encompassed almost the full length of the sternum after debridement. Defect reconstruction was achieved by covering with a rectus abdominis myocutaneous flap. When the ipsilateral or bilateral internal mammary artery had been harvested previously

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2017 Medicine

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