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Wound Infection

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28061. A prospective, randomized surveillance study of postoperative wound infections after plastic surgery: a study of incidence and surveillance methods. (PubMed)

A prospective, randomized surveillance study of postoperative wound infections after plastic surgery: a study of incidence and surveillance methods. In a postoperative wound infection study in plastic surgery, 315 patients were randomized to either outpatient wound control after 30 days (group I) or self-control by questionnaire (group II). We present a new definition of wound infection based on physiologic wound healing. The surveillance of postoperative wound infection showed follow-up rates (...) of 95 and 68 percent and infection rates of 16.3 and 17.1 percent for groups I and II, respectively. Of the 43 patients (16.7 percent) with postoperative wound infections, 31 (72 percent) were diagnosed after leaving the hospital, and only 12 (28 percent) were diagnosed during hospital stay. The monthly wound infection rate declined from 23.5 percent when the registration started to 12.2 percent at the end of the surveillance. The wound infection rate nearly tripled when duration of surgery was more

1995 Plastic and reconstructive surgery

28062. Antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies. (PubMed)

Antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies. A meta-analysis was conducted to determine whether prophylactic systemic antibiotics prevent infection in patients with nonbite wounds that are managed in the emergency department (ED). A literature search was performed to identify published, randomized trials of prophylactic antibiotics for nonbite wounds. Blinded review of trial methods was used to select trials that randomly assigned patients (...) with a penicillinase-resistant antibiotic (5 trials with 1,204 patients), there was no benefit from treatment; odds ratio 1.00 (95% CI 0.59 to 1.71). In conclusion, there is no evidence in published trials that prophylactic antibiotics offer protection against infection of nonbite wounds in patients treated in EDs.

1995 American Journal of Emergency Medicine

28063. Wound infection in head and neck surgery: prophylaxis, etiology and management. (PubMed)

Wound infection in head and neck surgery: prophylaxis, etiology and management. Antibiotic prophylaxis in clean-contaminated major head and neck surgery is mandatory. Many prospective, randomized and double blind studies have established the efficacy of antibiotics against a large spectrum of bacteria. Prophylaxis should be initiated prior to surgery, and prolonged administration of antibiotics beyond the first 24 hours following surgery is unnecessary. The experience of the Eye and Ear (...) Hospital of Pittsburgh is presented along with other studies concerning the effect of different regimens on wound outcome. The pathophysiology, bacteriology, evaluation and treatment of a postoperative infection are discussed, emphasizing the importance of gentle tissue handling and meticulous surgical technique.

1990 The Journal of otolaryngology

28064. Prophylactic mupirocin could reduce orthopedic wound infections. 1,044 patients treated with mupirocin compared with 1,260 historical controls. (PubMed)

Prophylactic mupirocin could reduce orthopedic wound infections. 1,044 patients treated with mupirocin compared with 1,260 historical controls. We analyzed the effect of perioperative elimination of nasal carriage of Staphylococcus aureus using mupirocin nasal ointment on the reduction of the postoperative wound infection rate in orthopedics. In an unblinded intervention trial, we compared 1,044 patients treated with mupirocin (intervention group) with 1,260 historical controls (control group (...) ). From each group a random sample of 50 patients was taken. Risk factors were analyzed in these random samples and we found it unlikely that different distributions of risk factors might have influenced the results. The wound infection rates were 14/1,044 in the intervention group and 34/1,260 in the control group (p = 0.02). The rates of wound infections caused by S. aureus were subsequently 7/1,044 and 14/1,260 (p = 0.3). On checking the data we found that prophylaxis had unintentionally not been

1998 Acta Orthopaedica Scandinavica

28065. Wound infection in open versus laparoscopic appendectomy. A meta-analysis. (PubMed)

Wound infection in open versus laparoscopic appendectomy. A meta-analysis. The authors performed a meta-analysis to determine whether open or laparoscopic appendectomy would reduce wound infection incidence in adult patients with acute appendicitis. The meta-analysis included nine of seven patients from eight randomized controlled trials. Data were analyzed using the fixed effect-model method of Mantel-Haenszel. Wound infection incidence was lower in the laparoscopic group.

1999 International journal of technology assessment in health care

28066. Prevention of wound infection in elective colorectal resections by preoperative cephazolin with and without metronidazole. (PubMed)

Prevention of wound infection in elective colorectal resections by preoperative cephazolin with and without metronidazole. Fifty patients were admitted to a prospective controlled double blind trial for assessment of the effect of preoperative intramuscular cephazolin with oral metronidazole or placebo on the incidence of wound infection in patients requiring treatment by elective large intestinal resection. All patients were operated upon by one surgeon. After exclusion of two patients who (...) died postoperatively 48 were analysed. No wound infection occurred in 22 patients receiving cephazolin with metronidazole. One (3.8%) infection developed in 26 patients receiving cephazolin with placebo. The difference did not attain statistical significance. Preoperative intramuscular cephazolin with or without metronidazole provides an effective and safe method of chemoprophylaxis for elective colorectal resection.

1981 The Australian and New Zealand journal of surgery

28067. Metronidazole prophylaxis against wound infection in patients undergoing appendicectomy. (PubMed)

Metronidazole prophylaxis against wound infection in patients undergoing appendicectomy. The effect of a preoperative single intravenous dose of metronidazole was studied in a prospective trial of 203 patients. 17.5% of the patients in the control group developed a wound infection compared with 3.4% of those receiving metronidazole (p less than 0.001). The average length of hospitalization and convalescence was significantly reduced in the metronidazole group. The use of metronidazole (...) in prevention of wound infection is recommended.

1981 Annales chirurgiae et gynaecologiae

28068. Risk of respiratory complications and wound infection in patients undergoing ambulatory surgery: smokers versus nonsmokers. (PubMed)

Risk of respiratory complications and wound infection in patients undergoing ambulatory surgery: smokers versus nonsmokers. Smoking is considered to be a risk factor for patients undergoing surgery and anesthesia, but it is unclear whether this is applicable to patients undergoing ambulatory surgery. The aim of this study was to determine the risk of respiratory complications and wound infection among smokers.The authors studied a random selection of 489 adult patients undergoing ambulatory (...) surgery. Smoking status was determined by self-report and confirmed with end-expired carbon monoxide analysis. The risk of respiratory complications (i.e., desaturation, cough, laryngospasm, bronchospasm, breath-holding, or apnea) and wound infection (i.e., wound redness or discharge +/- positive microbial culture, requiring antibiotic therapy) in smokers nonsmokers was ascertained. Odds ratios were estimated from multivariable logistic regression and adjusted for age, gender, body mass index

2002 Anesthesiology

28069. Antiseptic wick: does it reduce the incidence of wound infection following appendectomy? (PubMed)

Antiseptic wick: does it reduce the incidence of wound infection following appendectomy? The role of prophylactic antibiotics is well established for contaminated wounds, but the use of antiseptic wound wicks is controversial. The aim of this work was to study the potential use of wound wicks to reduce the rate of infection following appendectomy. This prospective randomized controlled clinical trial was conducted at a university hospital in the department of surgery. The subjects were patients (...) undergoing appendectomy for definite acute appendicitis. They were randomized by computer to primary subcuticular wound closure or use of an antiseptic wound wick. For the latter, ribbon gauze soaked in povidone-iodine was placed between interrupted nylon skin sutures. Wicks were soaked daily and removed on the fourth postoperative day. All patients received antibiotic prophylaxis. They were reviewed while in hospital and 4 weeks following operation for evidence of wound infection. The main outcome

2002 World Journal of Surgery

28070. Role of antibiotic prophylaxis for wound infection in percutaneous endoscopic gastrostomy (PEG): result of a prospective double-blind randomized trial. (PubMed)

Role of antibiotic prophylaxis for wound infection in percutaneous endoscopic gastrostomy (PEG): result of a prospective double-blind randomized trial. A randomized, double-blind, controlled trial was carried out to determine the value of antibiotic prophylaxis in the prevention of wound infection in percutaneous endoscopic gastrostomy (PEG) procedures. The wound was evaluated using ASEPSIS method and categorized as disturbance of healing, minor or major wound infection on the 7th day (...) and the 28th day. The rate of infection including major wound infection was lower in the prophylaxis group of patients at both seven and 28 days.Copyright 2002 The Hospital Infection Society.

2002 The Journal of hospital infection

28071. Post harvest wound infection and patient's perception: comparative study between radial artery and saphenous vein harvest sites. (PubMed)

Post harvest wound infection and patient's perception: comparative study between radial artery and saphenous vein harvest sites. Despite renewed clinical interest in radial artery grafts (RA) for coronary artery bypass grafting, there is a paucity of controlled prospective data on its efficacy. We report on the rate of harvest related complications from a randomized radial artery study.Two hundred eighty nine patients were divided into two groups. Group 1 received RA grafts (n=154 patients (...) ) and Group 2 (n=135 patients) received saphenous vein grafts (SVG). Postoperative wound problems were assessed using a questionnaire. Postoperative harvest site infections were also carefully documented.In group 1, 6 of 154 (3.9%) patients had harvest site wound infections. Five of them improved by antibiotic therapy alone. In group 2, 24 of 135 (17.8%) patients had harvest site wound infections (p=0.001 vs. group 1). Fifteen of these patients needed redressing due to discharge from the wound. One

2002 Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia

28072. Wound infection in elective biliary surgery: controlled trial using one dose cephamandole. (PubMed)

Wound infection in elective biliary surgery: controlled trial using one dose cephamandole. In a prospective randomized double-blind trial using a 1 g single dose of cephamandole versus placebo, given 1 h before surgery, the wound infection rate after elective surgery for gallbladder stones in 200 consecutive cases was 11%, being 15% in the placebo group and 7% in the cephamandole group (chi 2 = 4.03; P less than 0.05). The average hospital stay was 7.7 days in the absence of wound infection (...) and 13.6 days in the presence of wound infection. Contaminated bile was significantly positively related to wound infection, and cephamandole significantly protected the culture-positive group from wound infection.

1985 The Australian and New Zealand journal of surgery

28073. Preoperative intraincisional cefamandole reduces wound infection and postoperative inpatient stay in upper abdominal surgery. (Full text)

Preoperative intraincisional cefamandole reduces wound infection and postoperative inpatient stay in upper abdominal surgery. The use of preoperative intraincisional (POII) single dose antibiotic prophylaxis has the advantage of providing extremely high concentrations of antibiotic along all layers of the wound, whilst achieving adequate systemic concentrations throughout the operation. In a single blind controlled trial, 250 patients undergoing upper abdominal surgery were randomised (...) to receive POII cefamandole (2g) or to act as control. There was one wound infection in the POII group compared with 18 in the control group (P less than 0.001). Hospital stay was reduced by an average of one day (P less than 0.02) in the antibiotic treated group.

1985 Annals of the Royal College of Surgeons of England PubMed

28074. Peri-incisional mezlocillin versus rectal-metronidazole for wound infection prophylaxis. (PubMed)

Peri-incisional mezlocillin versus rectal-metronidazole for wound infection prophylaxis. One hundred and forty patients who underwent appendicectomy were included in a prospective randomized trial to compare the ability of preoperative rectal metronidazole and peri-incisional mezlocillin to prevent wound infection following appendicectomy. The results show that bactericidal local tissue levels of mezlocillin were uniformly achieved using the peri-incisional technique. The wound infection rate (...) for the metronidazole group was found to be 15.9% and did not significantly differ from the wound infection rate when mezlocillin was used (10.4%). Peri-incisional mezlocillin therefore appears to be a viable prophylactic technique against wound infection following appendicectomy and may offer a cheaper alternative to intravenous intra-operative metronidazole administration in cases when pre-operative metronidazole suppositories have been omitted. The peri-incisional mezlocillin technique is also suitable

1985 The Journal of hospital infection

28075. Prospective comparison of silver sulfadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent (Silvazine) and silver sulfadiazine 1 per cent (Flamazine) as prophylaxis against burn wound infection. (PubMed)

Prospective comparison of silver sulfadiazine 1 per cent plus chlorhexidine digluconate 0.2 per cent (Silvazine) and silver sulfadiazine 1 per cent (Flamazine) as prophylaxis against burn wound infection. Patients with fresh full-thickness burn wounds were randomly assigned to receive wound treatment with daily applications of either 1 per cent silver sulfadiazine plus 0.2 per cent chlorhexidine digluconate cream (Silvazine) or 1 per cent silver sulfadiazine (Flamazine). Fifty-four patients (...) treated with Silvazine were comparable to 67 treated with Flamazine with respect to extent and distribution of burn, age and all aspects of wound and associated treatment. Overall incidence of wound bacterial colonization was less in the Silvazine treated patients (65 per cent versus 88 per cent; P = 0.002). With Silvazine, wound colonization by Staphylococcus aureus was less (41 per cent versus 64 per cent; P = 0.01). Clinical wound infection with Staph, aureus developed in one Silvazine treated

1984 Burns, including thermal injury

28076. Wound infection following dog bite despite prophylactic penicillin. (PubMed)

Wound infection following dog bite despite prophylactic penicillin. Dog bite wounds of 39 children (ages one to 16 years) were cultured and irrigated. Cultures showed various organisms but were of no predictive value for development of infection. By using a table of random numbers, patients were assigned to either oral penicillin V-K (100,000 U/kg/day every 6 h) or placebo for two days. All patients were seen in follow-up in three to four days and again at seven to 10 days or earlier if signs (...) of inflammation occurred. The mean patient age, location and type of wound, and initial wound care were similar in the two treatment groups. Three of 39 (7.7%) children enrolled in the study developed infection at the bite site, including two of 19 in the penicillin group and one of 20 in the placebo group. In our study, prophylactic penicillin failed to prevent infection in dog bite wounds. Good local care on presentation seems to be the most important factor in determining future infection.

1986 Infection

28077. [Effectiveness of ofloxacin in the treatment of wound infections]. (PubMed)

[Effectiveness of ofloxacin in the treatment of wound infections]. Ofloxacin (OFX) and doxycycline (D) were compared in an open randomized study in the treatment of wound infections, including soft tissue, traumatic and postoperative wound infections caused by gram-positive as well as gram-negative pathogens. Doses were 2 X 200 mg/day of OFX (n = 21) and 2 X 100 mg/day of D (n = 20). In three cases from the OFX group, the daily dose was successfully increased to 2 X 300 mg. Clinical cure (...) was observed in 20 of 21 patients on OFX and in 12 of 20 patients on D. One patient who failed to respond clinically in the OFX group showed moderately severe gastric pain (possibly drug-related), but by the time this adverse effect became evident, the wound exudate had already cleared bacteriologically. In this study OFX proved to be highly effective in the treatment of wound infections, and it was also well tolerated. Not only did symptoms disappear more frequently under OFX than under D, but they also

1986 Infection

28078. A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection. (PubMed)

A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection. A prospective randomized clinical trial is in progress to compare the efficacy of teicoplanin with flucloxacillin and tobramycin in the prevention of endocarditis and wound infection following cardiac surgery. To date, 198 patients have completed the trial, of whom 95 have received (...) teicoplanin and 103 flucloxacillin and tobramycin. One patient developed prosthetic valve endocarditis 3 months after surgery covered by flucloxacillin and tobramycin. There was no significant difference in the incidence of sternal wound infection (P = 0.15). Severe sternal sepsis occurred in four patients in the teicoplanin group and two in the flucloxacillin/tobramycin group. There were more postoperative urinary tract infections among those given teicoplanin (15 of 95 patients compared to six of 103

1986 The Journal of hospital infection

28079. Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage. (Full text)

Single-dose antibiotic prophylaxis of abdominal surgical wound infection: a trial of preoperative latamoxef against peroperative tetracycline lavage. A randomized controlled clinical trial was undertaken in 542 consecutive emergency and elective abdominal operations, with one group of patients receiving tetracycline peritoneal and wound lavage and the other a single intravenous injection of 1 g latamoxef at induction of anaesthesia. Seventy-five patients were withdrawn because no potentially (...) contaminated hollow viscus was opened, and a further 36 because they could not be assessed for wound infection. Of the remaining 431 patients, 212 received latamoxef resulting in 5 major and 8 minor wound infections in hospital; another 4 minor infections occurred at home (total incidence 8.0%). In the tetracycline group (n = 219) there were 7 major and 19 minor wound infections in hospital and 10 minor infections later (total incidence 16.4%). This is significantly higher than the rate with latamoxef (P

1986 Journal of the Royal Society of Medicine PubMed

28080. The value of adjuvant systemic antibiotic therapy in localised wound infections among hospital patients: a comparative study. (PubMed)

The value of adjuvant systemic antibiotic therapy in localised wound infections among hospital patients: a comparative study. In a prospective randomised double-blind controlled trial that involved 73 patients with non-invasive wound infections receiving local wound treatment, the effect of adjuvant systemic antibiotic therapy was compared with that of a placebo. On inspection, more wounds were assessed as clinically clean after administration of an antibiotic than after the placebo was given (...) antibiotic therapy in the management of infected wounds promotes bacterial clearance and this may enhance healing of wounds.

1986 The Journal of infection

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