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Wound Infection

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61. Intrawound vancomycin powder increases post-operative wound complications and does not decrease periprosthetic joint infection in primary total and unicompartmental knee arthroplasties. (PubMed)

Intrawound vancomycin powder increases post-operative wound complications and does not decrease periprosthetic joint infection in primary total and unicompartmental knee arthroplasties. A frequent reason for revision surgery after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) is periprosthetic joint infection (PJI). The efficacy of intrawound VP in preventing PJI after primary TKA or UKA is rarely reported. The purpose of this study was to investigate the efficacy (...) and side effects of local high-dose VP application to the joint to prevent PJI in TKA and UKA.From 2010 to 2017, 166 consecutive patients that underwent primary TKA or UKA were enrolled. Seventy-five patients (92 knees) did not receive VP (control group), while 90 patients (110 knees, VP group) received VP (intrawound, 1 g) before capsule closure during TKA and UKA. Aseptic wound complications, such as skin erosion, wound dehiscence, and prolonged wound healing, were evaluated within 3 months post

2019 Knee Surgery, Sports Traumatology, Arthroscopy

62. Surgical wound infection following open humeral fracture caused by Mycobacterium houstonense: a case report. (PubMed)

Surgical wound infection following open humeral fracture caused by Mycobacterium houstonense: a case report. Historically Mycobacterium houstonense belongs to the unnamed third biovariant complex of the Mycobacterium fortuitum group, which are sorbitol positive. To date, there have been few reports of human infection induced by M. houstonense worldwide.We describe the case of a 68-year-old man with surgical wound infection, following an open humeral fracture, caused by M. houstonense (...) and Escherichia coli. An implant bone plate had been embedded for internal fixation during surgery on the humeral fracture previously. A week later E. coli was isolated from the skin wound secretions. Cefoperazone-sulbactam was used for treatment for two weeks but the infection was not controlled, with a subsequent risk of deep wound infection. External fixation of the fracture was then performed instead of internal fixation. Ten days later, M. houstonense was isolated from new wound secretions. M

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2019 BMC Infectious Diseases

63. Utility of skin perfusion pressure values with the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification system. (PubMed)

Utility of skin perfusion pressure values with the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification system. The addition of skin perfusion pressure (SPP) might enhance the predictive value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system. The purpose of the present study was to evaluate the SPP for each WIfI classification stage among patients with foot wounds by cross-referencing the results of prospectively (...) monitored limb outcomes and to derive the SPP criteria that could be combined with other measurements to grade ischemia for the WIfI classification.From July 2015 to June 2017, patients with foot wounds that met the WIfI classification criteria were prospectively enrolled. We assessed the limbs using the WIfI ischemia grade without measuring the transcutaneous oxygen pressure but measured the SPP. After monitoring for 1 year, the predictability of the WIfI stages was analyzed according to whether

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2019 Journal of Vascular Surgery

64. PICO negative pressure wound therapy for closed surgical incision wounds

wounds and to reduce surgical site complications such as surgical site infections. The inno innovativ vative aspects e aspects are that PICO is portable and disposable with no separate canister (for exudate collection) and has a proprietary dressing layer, which is designed to consistently deliver negative pressure across the incision and zone of injury. The intended place in ther place in therap apy y would be as an alternative to standard care for preventing surgical site complications in patients (...) a multisite dressing of up to 20 cm × 25 cm, which is used for awkward anatomical areas. PICO comes with 2 dressings, which between them can absorb up to 300 ml of exudate during 1 week of therapy. PICO can be used during MRI scans, if detached from the pump. PICO is promoted for a range of wound types. This briefing focuses on surgical incisions with low- to-moderate levels of exudate in people at increased risk of surgical site infections (SSIs). Innovations PICO differs from conventional NPWT systems

2018 National Institute for Health and Clinical Excellence - Advice

65. Antibiotic therapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in surgical wounds. (PubMed)

Antibiotic therapy for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in surgical wounds. Methicillin-resistant Staphylococcus aureus (MRSA) infection after surgery is usually rare, but incidence can be up to 33% in certain types of surgery. Postoperative MRSA infection can occur as surgical site infections (SSI), chest infections, or bloodstream infections (bacteraemia). The incidence of MRSA SSIs varies from 1% to 33% depending upon the type of surgery (...) performed and the carrier status of the individuals concerned. The optimal antibiotic regimen for the treatment of MRSA in surgical wounds is not known.To compare the benefits and harms of various antibiotic treatments in people with established surgical site infections (SSIs) caused by MRSA .In February 2013 we searched the following databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL); Database of Abstracts of Reviews of Effects (DARE

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2013 Cochrane

66. [Wound infections after surgery-effect of triclosan-coated sutures]

[Wound infections after surgery-effect of triclosan-coated sutures] Sårinfektioner efter kirurgi – effekt av triklosanbelagda suturer [Wound infections after surgery-effect of triclosan-coated sutures] Sårinfektioner efter kirurgi – effekt av triklosanbelagda suturer [Wound infections after surgery-effect of triclosan-coated sutures] Lennmarken C, Persson E Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation Lennmarken C, Persson E. Sårinfektioner efter kirurgi – effekt av triklosanbelagda suturer. [Wound infections after surgery-effect of triclosan-coated sutures] Stockholm: The HTA Center of the Stockholm County Council/Gotland. 2014:11. 2014 Authors' conclusions The conclusion of the assessment is that triclosan coated sutures had in various operations a limited beneficial effect with significantly lower incidence of superficial

2014 Health Technology Assessment (HTA) Database.

67. Surgical Site Infection Rate Drops to 0% Using a Vacuum-Assisted Closure in Contaminated/Dirty Infected Laparotomy Wounds. (PubMed)

Surgical Site Infection Rate Drops to 0% Using a Vacuum-Assisted Closure in Contaminated/Dirty Infected Laparotomy Wounds. Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/infected wounds. Eighty-one laparotomized patients with Class III or IV (...) surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G. C., & Plous, S., Version 4.0). Presence of infection was determined by a certified board physician according to Centers for Disease Control's Criteria for Defining a Surgical Site Infection. Twenty-seven patients received primary closure, 29 delayed primary closure, and 25 vacuum-assisted closure, with no exclusions for analysis. Surgical

2017 The American surgeon

68. Topical Opioids and Antimicrobials for the Management of Pain, Infection, and Infection-Related Odors in Malignant Wounds: A Systematic Review. (PubMed)

Topical Opioids and Antimicrobials for the Management of Pain, Infection, and Infection-Related Odors in Malignant Wounds: A Systematic Review. Patients with malignant wounds report pain, distress from odor and exudate, decreased self-esteem, and poor quality of life. This systematic review explores topical opioids, antimicrobials, and odor-reducing agents for preventing or managing malignant wound pain, infection, and odor.
.MEDLINE®, EMBASE, the Cochrane Library, CINAHL®, and reference lists (...) %-10% of tumors, particularly in breast cancer, sarcoma, and melanoma, are expected to fungate. Gaps in the literature exist for use of topical opioids and antimicrobials for managing pain, odor, and infection control in malignant wounds.
.Current recommendations for topical control of malignant wounds are based on case reports and observational studies in patients with breast cancer. Robust, controlled trials of topical opioid and antimicrobial use are warranted in patients with melanoma, breast

2017 Oncology nursing forum

69. Isolation and in vitro evaluation of bacteriophages against MDR-bacterial isolates from septic wound infections. (PubMed)

Isolation and in vitro evaluation of bacteriophages against MDR-bacterial isolates from septic wound infections. Multi-drug resistance has become a major problem for the treatment of pathogenic bacterial infections. The use of bacteriophages is an attractive approach to overcome the problem of drug resistance in several pathogens that cause fatal diseases. Our study aimed to isolate multi drug resistant bacteria from patients with septic wounds and then isolate and apply bacteriophages in vitro (...) that the most of the isolates detected had Pseudomonas aeruginosa as the predominant bacterium, followed by Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli. Our results suggested that gram-negative bacteria were more predominant than gram-positive bacteria in septic wounds; most of these isolates were resistant to ampicillin, amoxicillin, penicillin, vancomycin and tetracycline. All the gram-positive isolates (100%) were multi-drug resistant, whereas 86% of the gram-negative isolates had

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2017 PLoS ONE

70. Development, standardization and testing of a bacterial wound infection model based on ex vivo human skin. (PubMed)

Development, standardization and testing of a bacterial wound infection model based on ex vivo human skin. Current research on wound infections is primarily conducted on animal models, which limits direct transferability of these studies to humans. Some of these limitations can be overcome by using-otherwise discarded-skin from cosmetic surgeries. Superficial wounds are induced in fresh ex vivo skin, followed by intradermal injection of Pseudomonas aeruginosa under the wound. Subsequently (...) , the infected skin is incubated for 20 hours at 37°C and the CFU/wound are determined. Within 20 hours, the bacteria count increased from 107 to 109 bacteria per wound, while microscopy revealed a dense bacterial community in the collagen network of the upper wound layers as well as numerous bacteria scattered in the dermis. At the same time, IL-1alpha and IL-1beta amounts increased in all infected wounds, while-due to bacteria-induced cell lysis-the IL-6 and IL-8 concentrations rose only in the uninfected

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2017 PLoS ONE

71. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT. (PubMed)

Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT. Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound (...) complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing) and 46 women received standard care (Comfeel Plus(®) dressing). All women received the intended dressing following wound closure. The relative risk of SSI

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2016 Healthcare (Basel, Switzerland)

72. Coronary artery bypass surgery in diabetic patients – risk factors for sternal wound infections (PubMed)

Coronary artery bypass surgery in diabetic patients – risk factors for sternal wound infections The incidence of sternal wound infections (SWI) after coronary artery bypass surgery (CABG) as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG (...) concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity.

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2016 GMS Interdisciplinary plastic and reconstructive surgery DGPW

73. Hyperbaric Oxygen Therapy for Difficult Wounds

out. The main clinical outcomes of interest for diabetic foot ulcers were major amputation, minor amputation, 4 wound healing, and wound-size reduction. Other outcomes lacked robust evidence, but they included cost effectiveness, adverse events, resolution of infections, time to heal, length of stay, mortality, quality of life and transcutaneous oxygen tensions. The findings for these outcomes are updated below. HBOT to reduce major amputation in diabetic foot ulcers We identified ten systematic (...) Hyperbaric Oxygen Therapy for Difficult Wounds 2019 EVIDENCE UPDATE Hyperbaric Oxygen Therapy for Difficult Wound Healing 1 2019 Evidence Update: Hyperbaric Oxygen Therapy for Difficult Wound Healing in Newfoundland & Labrador Wendy Lasisi, Pablo Navarro 2019 EVIDENCE UPDATE Hyperbaric Oxygen Therapy for Difficult Wound Healing 2 Find CHRSP Reports Online All reports of the Contextualized Health Research Synthesis Program are available online: www.nlcahr.mun.ca/chrsp/ This Contextualized Health

2019 Newfoundland and Labrador Centre for Health Information

74. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI)

The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI) The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI) - Journal of Vascular Surgery Email/Username: Password: Remember me Search JVS Journals Search Terms Search within Search Access provided by Volume 59, Issue 1, Pages 220–234.e2 (...) The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI) x Joseph L. Mills Affiliations Division of Vascular and Endovascular Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona Health Sciences Center, Tucson, Ariz Correspondence Reprint requests: Joseph L. Mills, Sr, MD, Division of Vascular and Endovascular Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona Health

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2014 Society for Vascular Surgery

75. Negative pressure wound therapy for treating surgical wounds healing by secondary intention. (PubMed)

Negative pressure wound therapy for treating surgical wounds healing by secondary intention. Following surgery, incisions are usually closed by fixing the edges together with sutures (stitches), staples, adhesive glue or clips. This process helps the cut edges heal together and is called 'healing by primary intention'. However, not all incised wounds are closed in this way: where there is high risk of infection, or when there has been significant tissue loss, wounds may be left open to heal (...) authors independently performed study selection, risk of bias assessment and data extraction.We located two studies (69 participants) for inclusion in this review. One study compared NPWT with an alginate dressing in the treatment of open, infected groin wounds. and one study compared NPWT with a silicone dressing in the treatment of excised pilonidal sinus. The trials reported limited outcome data on healing, adverse events and resource use.There is currently no rigorous RCT evidence available

2015 Cochrane

76. Randomized Controlled Trial of Prophylactic Negative-Pressure Wound Therapy at Ostomy Closure for the Prevention of Delayed Wound Healing and Surgical Site Infection in Patients with Ulcerative Colitis. (PubMed)

Randomized Controlled Trial of Prophylactic Negative-Pressure Wound Therapy at Ostomy Closure for the Prevention of Delayed Wound Healing and Surgical Site Infection in Patients with Ulcerative Colitis. Although negative-pressure wound therapy (NPWT) is likely advantageous for wound healing, the efficacy and safety of its prophylactic use remain unclear for digestive surgery. We performed a prospective randomized controlled study to evaluate the efficacy and safety of this procedure during (...) ileostomy closure.We conducted a prospective, randomized study between November 2014 and September 2015. Patients with ulcerative colitis scheduled to undergo ileostomy closure with purse-string suture (PSS) were randomly divided into groups with or without NPWT. The primary endpoint was complete wound healing. The secondary endpoints were incidences of wound complications.A total of 31 patients with PSS alone and 28 patients with PSS + NPWT were enrolled. Wound infection was observed in 1 patient

2016 Digestive surgery

77. Effect of bag extraction to prevent wound infection on umbilical port site wound on elective laparoscopic cholecystectomy: a prospective randomised clinical trial. (PubMed)

Effect of bag extraction to prevent wound infection on umbilical port site wound on elective laparoscopic cholecystectomy: a prospective randomised clinical trial. Laparoscopic cholecystectomy is the gold standard treatment for gallbladder stones. Complications due to laparoscopic procedure are rare, but rate of wound infection in some studies is about 8 %. From January 2007 to December 2008, 320 laparoscopic cholecystectomies were performed at our hospital, and in 4.7 % of them, wound (...) infection of the umbilical trocar was identified. We believe that this infection rate could be lower and that it is necessary to implement a new technique to reduce the wound infection. The aim of the study was to evaluate the benefits of bag extraction of gallbladder to prevent the wound infection.Two-arm, parallel, 1:1, randomised controlled trial (ISRCTN38095251). All patients suffering from symptomatic gallbladder stones of low risk were enrolled for this study and were divided into two groups

2016 Surgical endoscopy

78. Closed-incision negative pressure therapy to reduce groin wound infections in vascular surgery: a randomised controlled trial. (PubMed)

Closed-incision negative pressure therapy to reduce groin wound infections in vascular surgery: a randomised controlled trial. Groin wound infections pose a major problem in vascular surgery. Closed-incision negative pressure therapy (ciNPT) was especially designed for the management of incisions at risk of surgical site infections. The aim of this study was to investigate whether ciNPT is able to reduce the incidence of wound infections after vascular surgery. Data on 132 consecutive patients (...) , scheduled for vascular surgery with a longitudinal femoral cutdown, were collected prospectively. All patients were randomised either to the ciNPT group (n = 64) or the control group (n = 68) with conventional dressing. In the ciNPT group, the foam dressing was applied intraoperatively and removed after 5 days. The control group received an absorbent dressing. All wounds were evaluated after 5 and 42 days. Infections were graded according the Szilagyi classification (I-III°). There were no significant

2018 International wound journal

79. [Pain Management, Local Infection, Satisfaction, Adverse Effects and Residual Pain after Major Open Abdominal Surgery: Epidural versus Continuous Wound Infusion (PAMA Trial)]. (PubMed)

[Pain Management, Local Infection, Satisfaction, Adverse Effects and Residual Pain after Major Open Abdominal Surgery: Epidural versus Continuous Wound Infusion (PAMA Trial)]. The Management of postoperative pain after abdominal surgery is a major challenge to the anesthesiologist. The optimization of postoperative analgesia improves prognosis contributing also to patient satisfaction and reducing morbidity and mortality. The aim of this randomized control study is to perform the comparative (...) analysis in terms of effectiveness of an unconventional and still poorly technique implemented, continuous wound infusion, and the currently most applied and gold standard technique, epidural analgesia, in the postoperative period after abdominal surgery.Fifty patients, previously subjected to abdominal surgery by median laparotomy with xifo-pubic incision were randomized to receive postoperative analgesia via epidural (n = 25) or via continuous wound infusion (n = 25) during 48 hours. The primary

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2018 Acta medica portuguesa

80. Characterization of Panton–Valentine leukocidin-positive Staphylococcus aureus from skin and soft tissue infections and wounds in Nigeria: a cross-sectional study (PubMed)

Characterization of Panton–Valentine leukocidin-positive Staphylococcus aureus from skin and soft tissue infections and wounds in Nigeria: a cross-sectional study Background:Staphylococcus aureus is a significant pathogen implicated in numerous nosocomial and community-acquired infections. The Panton-Valentine leukocidin (PVL) can be associated with severe necrotizing diseases such as pneumonia, skin and soft tissue infection (SSTI).  Methods: In total, 96 S. aureus isolates were obtained (...) from patients presenting with wounds (n=48) and soft tissue infections (SSTIs, n=48). These were characterized based on their antimicrobial susceptibility profile, the possession of virulence genes (e.g. capsular type, PVL), accessory gene regulator ( agr) type, and the staphylococcal protein A ( spa) type. The production of the PVL protein was assessed by western blotting. Results: All isolates were susceptible to methicillin. The resistance was highest to penicillin (97.9%), followed

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2018 F1000Research

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