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Wound Infection

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61. Using the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification to identify patients most likely to benefit from revascularization. Full Text available with Trip Pro

Using the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification to identify patients most likely to benefit from revascularization. The Society of Vascular Surgery Wound Ischemia foot Infection (WIfI) classification system for chronic limb-threatening ischemia was intended to predict 1-year major lower extremity amputation (LEA) risk and to identify which patients benefit most from revascularization. We aimed to identify which WIfI presentations benefited most from (...) : cluster 1, 4.4% (46/1038); cluster 2, 14.8% (66/447); cluster 3, 28.1% (36/128); and cluster 4, 51.2% (21/41). The between sum of squares/total sum of squares was 93.9%. Multiple linear regression revealed the wound grade most strongly predicted LEA (F-value, 17.25; P < .001). Ischemia (F-value, 6.51; P = .001) and infection (F-value, 5.7; P = .003) were similarly associated with LEA risk. Interaction terms between each component of the WIfI score were not statistically significant.WIfI can identify

2019 Journal of Vascular Surgery

62. Protocol for the development of a core indicator set for reporting burn wound infection in trials: ICon-B study. Full Text available with Trip Pro

Protocol for the development of a core indicator set for reporting burn wound infection in trials: ICon-B study. Systematic reviews of high-quality randomised controlled trials are necessary to identify effective interventions to impact burn wound infection (BWI) outcomes. Evidence synthesis requires that BWI is reported in a consistent manner. Cochrane reviews investigating interventions for burns report that the indicators used to diagnose BWI are variable or not described, indicating a need (...) to standardise reporting. BWI is complex and diagnosed by clinician judgement, informed by patient-reported symptoms, clinical signs, serum markers of inflammation and bacteria in the wound. Indicators for reporting BWI should be important for diagnosis, frequently observed in patients with BWI and assessed as part of routine healthcare. A minimum (core) set of indicators of BWI, reported consistently, will facilitate evidence synthesis and support clinical decision-making.The Infection Consensus in Burns

2019 BMJ open

63. Chronic wound assessment and infection detection method. Full Text available with Trip Pro

Chronic wound assessment and infection detection method. Numerous patients suffer from chronic wounds and wound infections nowadays. Until now, the care for wounds after surgery still remain a tedious and challenging work for the medical personnel and patients. As a result, with the help of the hand-held mobile devices, there is high demand for the development of a series of algorithms and related methods for wound infection early detection and wound self monitoring.This research proposed (...) an automated way to perform (1) wound image segmentation and (2) wound infection assessment after surgical operations. The first part describes an edge-based self-adaptive threshold detection image segmentation method to exclude nonwounded areas from the original images. The second part describes a wound infection assessment method based on machine learning approach. In this method, the extraction of feature points from the suture area and an optimal clustering method based on unimodal Rosin threshold

2019 Medical Informatics and Decision Making

64. Utility of skin perfusion pressure values with the Society for Vascular Surgery Wound, Ischemia, and foot Infection classification system. Full Text available with Trip Pro

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

2019 Journal of Vascular Surgery

65. Can we predict vascular status and culture result based through wound status in diabetic foot infection? Full Text available with Trip Pro

Can we predict vascular status and culture result based through wound status in diabetic foot infection? Diabetic foot infection (DFI) should be treated by a multidisciplinary team to prevent amputation and morbid status. As physicians encountering DFI in outpatient clinic, a proper selection of antibiotic treatment and diagnostic approach for a vascular status is essential. We retrospectively investigated the patients with DFI from 2016 to 2017. All patients were examined for vascular status (...) , wound status, and pathologic culture preceding the treatment. No statistical significance was observed between PEDIS grade 1 and 2 and 3 and 4 in culture status and culture results. Association analysis between vascular status and other variables, such as wound score and culture results, has no significant difference. Through these results, the helpful epidemiologic result of microbiology and necessity of examination for peripheral arterial disease were verified.

2019 Medicine

66. Hyperglycemia as a risk factor for postoperative early wound infection after bicondylar tibial plateau fractures: Determining a predictive model based on four methods. (Abstract)

Hyperglycemia as a risk factor for postoperative early wound infection after bicondylar tibial plateau fractures: Determining a predictive model based on four methods. Identify a glucose threshold that would put patients with isolated bicondylar tibial plateau fractures at risk of early wound infection (i.e. < 90 days).Retrospective review of medical records.Academic American College of Surgeons (ACS) Level 1 trauma center.Adult patients between 2010 and 2015 with an operatively treated (...) isolated bicondylar tibial plateau fracture and at least three glucose measurements during their hospitalization.To predict infection using four different methods: maximum preoperative blood glucose (PBG), maximum blood glucose (MGB), Hyperglycemic Index (HGI), and Time-Weighted Average Glucose (TWAG).126/381 patients met our inclusion criteria. Fifteen (12%) patients had an open fracture and 30/126 (23%) developed an infection. Median glucose for each predictive method studied was 114 (IQR 101.2-137.8

2019 Injury

67. Comparison between primary closure with Limberg Flap versus open procedure in treatment of pilonidal sinus, in terms of frequency of post-operative wound infection. Full Text available with Trip Pro

Comparison between primary closure with Limberg Flap versus open procedure in treatment of pilonidal sinus, in terms of frequency of post-operative wound infection. Pilonidal sinus is a disorder of the sacrococcygeal region affecting younger individuals with a higher hair and weight distribution. Treatment involves the use of various surgical modalities, most of which are associated with a high rate of complications. Open procedure (OP) and Limberg Flap (LF) are two commonly performed surgical (...) -probability sampling, a total of 60 patients were selected, 30 of whom underwent Limberg Flap procedure and the remaining 30 underwent open procedure. Postoperatively, observations for wound infection on date of discharge and then again on the various follow-up visits over the next 3 weeks. The data collected was then compared by applying the chi-square test, with p-value less than 0.05 considered statistically significant.Our results showed that both primary closure with Limberg flap, and open procedure

2019 Pakistan Journal Of Medical Sciences Controlled trial quality: uncertain

68. Procedure- and hospital-level variation of deep sternal wound infection from all-Japan registry. (Abstract)

Procedure- and hospital-level variation of deep sternal wound infection from all-Japan registry. Outcome of cardiovascular surgery has been improving over time, but the treatment of postoperative complications such as deep sternal wound infection (DSWI) still needs critical attention. A nationwide surgical registry was analyzed for procedural details and hospital factors related to DSWI.The Japan Adult Cardiovascular Surgery Database was used, which captured data from 82% of all the hospitals

2019 Annals of Thoracic Surgery

69. Vacuum-Assisted Closure for the Treatment of Deep Sternal Wound Infection After Pediatric Cardiac Surgery. (Abstract)

Vacuum-Assisted Closure for the Treatment of Deep Sternal Wound Infection After Pediatric Cardiac Surgery. Vacuum-assisted closure is being increasingly used to treat deep sternal wound infection following cardiac surgery, but most of the data refer to adults. This study investigated the safety and efficacy of vacuum-assisted closure in pediatric patients.Retrospective file review.Tertiary pediatric medical center.All children with deep sternal wound infection treated with vacuum-assisted (...) wound infections appeared a median of 10 days postoperatively (interquartile range, 7-14 d; range 3-100 d). Vacuum-assisted closure was applied a median of 13 days postoperatively (interquartile range, 10-18.5 d; range, 5-103 d) for a median duration of 10 days (interquartile range, 7-13.25 d; range, 1-21 d). Wound cultures were positive in 48 patients (96%); most isolates were Gram-positive (76%). The main bacterial pathogen was methicillin-susceptible Staphylococcus aureus (61%). Most patients

2019 Pediatric Critical Care Medicine

70. Povidone-Iodine Wound Lavage to Prevent Infection After Revision Total Hip and Knee Arthroplasty: An Analysis of 2,884 Cases. (Abstract)

Povidone-Iodine Wound Lavage to Prevent Infection After Revision Total Hip and Knee Arthroplasty: An Analysis of 2,884 Cases. Postoperative infection remains a major challenge in revision total hip arthroplasty (THA) and revision total knee arthroplasty (TKA). Wound irrigation with dilute povidone-iodine (PI) solution has emerged as a simple, inexpensive, and potentially successful means of reducing postoperative infections. The aim of this study was to assess its effectiveness in reducing (...) , we found no significant difference in the rate of reoperation for infection at 3 months (p = 0.58 for revision THA, and p = 0.06 for revision TKA) and at 12 months (p = 0.78 for revision THA, and p = 0.06 for revision TKA). Nonetheless, the hazard ratios from the propensity-score model trended higher for patients who received PI lavage: 1.6 and 1.3 for revision THA at 3 and 12 months, respectively, and 2.9 at both 3 and 12 months for revision TKA.PI wound lavage demonstrated no benefit

2019 The Journal of Bone and Joint Surgery. American Volume

71. Negative pressure wound therapy reduces surgical site infections. (Abstract)

Negative pressure wound therapy reduces surgical site infections. Surgical site infection (SSI) with lower extremity incisions represents a modifiable source of major morbidity. Our institutional bundled care protocol to decrease SSI includes optimization of perioperative risk factors, dedicated wound closure tray, and voluntary use of a closed surface negative pressure wound therapy (cNPWT) device applied over closed incisions in the operating room. This study examined the individual effect (...) returns to the operating room were for wound-related problems in the standard dressings group (48.3% vs 26.2%; P < .01). Binary logistic regression using an SSI end point demonstrated that female sex increases SSI (odds ratio, 2.43; confidence interval, 1.37-4.30; P < .01), whereas cNPWT reduces SSI (odds ratio, 0.32; confidence interval, 0.17-0.63; P < .01).The use of negative pressure wound therapy devices decreases the incidence of infrainguinal wound infections. This occurs as an independent

2019 Journal of Vascular Surgery

72. Long-term outcomes of lower extremity graft preservation using antibiotic beads in patients with early deep wound infections after major arterial reconstructions. (Abstract)

Long-term outcomes of lower extremity graft preservation using antibiotic beads in patients with early deep wound infections after major arterial reconstructions. Bypass graft preservation with wound sterilization using serial antibiotic bead exchange has been described in patients presenting with deep wound infections after extremity bypass. The long-term benefits of this approach remain poorly understood. We examined whether graft preservation and wound sterilization with antibiotic beads (...) affect amputation rates and patient survival.Patients who underwent operations for aortoiliac or infrainguinal aneurysmal or occlusive arterial disease were retrospectively analyzed. The Infection group included those with patent vascular grafts who developed Szilagyi class II or III deep wound infections within 90 days of index reconstruction and had no evidence of anastomotic or arterial bleeding. All patients in the infection group were managed with graft preservation using serial antibiotic bead

2019 Journal of Vascular Surgery

73. The effect of antibiotic prophylaxis on wound infections after laparoscopic cholecystectomy: A randomised clinical trial. (Abstract)

The effect of antibiotic prophylaxis on wound infections after laparoscopic cholecystectomy: A randomised clinical trial. The aim of this study was to determine whether the use of prophylactic antibiotics had any effects on the development of postoperative surgical wound infections between laparoscopic cholecystectomy patients. Patients who received a single dose of prophylactic antibiotics prior to surgery were included in the prophylaxis group, and those who did not receive preoperative (...) cholecystectomy as there is no statistically significant difference in the rate of postoperative wound infection among patients who were either given or not given prophylaxis.© 2019 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

2019 International wound journal Controlled trial quality: uncertain

74. Three wound-dressing strategies to reduce surgical site infection after abdominal surgery: the Bluebelle feasibility study and pilot RCT. Full Text available with Trip Pro

Three wound-dressing strategies to reduce surgical site infection after abdominal surgery: the Bluebelle feasibility study and pilot RCT. Surgical site infection (SSI) affects up to 20% of people with a primary closed wound after surgery. Wound dressings may reduce SSI.To assess the feasibility of a multicentre randomised controlled trial (RCT) to evaluate the effectiveness and cost-effectiveness of dressing types or no dressing to reduce SSI in primary surgical wounds.Phase A - semistructured (...) interviews, outcome measure development, practice survey, literature reviews and value-of-information analysis. Phase B - pilot RCT with qualitative research and questionnaire validation. Patients and the public were involved.Usual NHS care.Patients undergoing elective/non-elective abdominal surgery, including caesarean section.Phase A - none. Phase B - simple dressing, glue-as-a-dressing (tissue adhesive) or 'no dressing'.Phase A - pilot RCT design; SSI, patient experience and wound management

2019 Health technology assessment (Winchester, England) Controlled trial quality: predicted high

75. Classification of Trauma-Associated Invasive Fungal Infections to Support Wound Treatment Decisions. Full Text available with Trip Pro

Classification of Trauma-Associated Invasive Fungal Infections to Support Wound Treatment Decisions. To evaluate a classification system to support clinical decisions for treatment of contaminated deep wounds at risk for an invasive fungal infection (IFI), we studied 246 US service members (413 wounds) injured in Afghanistan (2009-2014) who had laboratory evidence of fungal infection. A total of 143 wounds with persistent necrosis and laboratory evidence were classified as IFI; 120 wounds (...) not meeting IFI criteria were classified as high suspicion (patients had localized infection signs/symptoms and had received antifungal medication for >10 days), and 150 were classified as low suspicion (failed to meet these criteria). IFI patients received more blood than other patients and had more severe injuries than patients in the low-suspicion group. Fungi of the order Mucorales were more frequently isolated from IFI (39%) and high-suspicion (21%) wounds than from low-suspicion (9%) wounds. Wounds

2019 Emerging Infectious Diseases

76. Application of <i>Lactobacillus gasseri</i> 63 AM supernatant to <i>Pseudomonas aeruginosa-</i>infected wounds prevents sepsis in murine models of thermal injury and dorsal excision. (Abstract)

Application of Lactobacillus gasseri 63 AM supernatant to Pseudomonas aeruginosa-infected wounds prevents sepsis in murine models of thermal injury and dorsal excision. Introduction. Severely burned patients are susceptible to bacterial infection within their burn wounds, which frequently leads to sepsis, multiple organ failure and death. The opportunistic pathogen Pseudomonas aeruginosa, an organism inherently resistant to multiple antibiotics, is a common cause of sepsis (...) in these patients.Aim. Development of a topical treatment unrelated to conventional antibiotics is essential for prevention of P. aeruginosa infection and sepsis, leading to a role for the direct application of probiotics or their by-products.Methodology. We examined the effectiveness of 20× concentrated supernatant from Lactobacillus gasseri strain 63 AM (LgCS) grown in de Man, Rogosa and Sharpe broth in inhibiting P. aeruginosa biofilms in vitro, as well as in reducing wound bioburden and P. aeruginosa sepsis

2019 Journal of Medical Microbiology

77. Effectiveness of Wound-Edge Protectors for Preventing Surgical Site Infections after Open Surgery for Colorectal Disease: A Prospective Cohort Study with Two Parallel Study Groups. (Abstract)

Effectiveness of Wound-Edge Protectors for Preventing Surgical Site Infections after Open Surgery for Colorectal Disease: A Prospective Cohort Study with Two Parallel Study Groups. Standard procedures to reduce the surgical site infection (SSI) rate after colorectal surgery have not been established. A prospective cohort study with 2 parallel study groups was performed to clarify the SSI rate after open surgery with and without a wound-edge protector (WEP) for colorectal disease.A total of 102

2019 Digestive surgery Controlled trial quality: uncertain

78. Single cell analyses reveal specific distribution of anti-bacterial molecule Perforin-2 in human skin and its modulation by wounding and Staphylococcus aureus infection. (Abstract)

Single cell analyses reveal specific distribution of anti-bacterial molecule Perforin-2 in human skin and its modulation by wounding and Staphylococcus aureus infection. Perforin-2 (P-2) is a recently described antimicrobial protein with unique properties to kill intracellular bacteria. We investigated P-2 expression pattern and cellular distribution in human skin and its importance in restoration of barrier function during wound healing process and infection with the common wound pathogen (...) in both professional and non-professional phagocytes. Furthermore, we found an induction of P-2 during wound healing. P-2 overexpression resulted in a reduction of intracellular S. aureus, while infection of human wounds by this pathogen resulted in P-2 suppression, revealing a novel mechanism by which S. aureus may escape cutaneous immunity to cause persistent wound infections.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

2019 Experimental Dermatology

79. Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia. Full Text available with Trip Pro

Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia. We report 3 cases of koala bite wound infection with Lonepinella koalarum-like bacteria requiring antimicrobial and surgical management. The pathogens could not be identified by standard tests. Phylogenetic analysis of 16S rRNA and housekeeping genes identified the genus. Clinicians should isolate bacteria and determine antimicrobial susceptibilities when managing these infections.

2019 Emerging Infectious Diseases

80. Staphylococcus aureus Biofilm Infection Compromises Wound Healing by Causing Deficiencies in Granulation Tissue Collagen. (Abstract)

Staphylococcus aureus Biofilm Infection Compromises Wound Healing by Causing Deficiencies in Granulation Tissue Collagen. The objective of this work was to causatively link biofilm properties of bacterial infection to specific pathogenic mechanisms in wound healing.Staphylococcus aureus is one of the four most prevalent bacterial species identified in chronic wounds. Causatively linking wound pathology to biofilm properties of bacterial infection is challenging. Thus, isogenic mutant stains (...) of S. aureus with varying degree of biofilm formation ability was studied in an established preclinical porcine model of wound biofilm infection.Isogenic mutant strains of S. aureus with varying degree (ΔrexB > USA300 > ΔsarA) of biofilm-forming ability were used to infect full-thickness porcine cutaneous wounds.Compared with that of ΔsarA infection, wound biofilm burden was significantly higher in response to ΔrexB or USA300 infection. Biofilm infection caused degradation of cutaneous collagen

2019 Annals of Surgery

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