Abstract
Background: The aim of the present study is to investigate the role of the colonization of suture thread to identify patients at risk of developing a surgical site infection (SSI) after clean surgical procedures. Methods: Patients who underwent elective clean surgery procedures at the Surgery Unit of the AOU-University of Campania Luigi Vanvitelli in a 21-month period were prospectively enrolled. For each patient, a synthetic absorbable thread in Lactomer 9-1 was inserted into the surgical site at the end of surgery and microbiologically evaluated after 48 h. Antibiotic prophylaxis was chosen according to international guidelines. Results: A total of 238 patients were enrolled; 208 (87.4%) of them were subjected to clean procedures without the placement of prosthesis, and 30 (12.6%) with prosthesis. Of the 238 patients, 117 (49.2%) underwent an antimicrobial prophylaxis. Overall, 79 (33.2%) patients showed a bacterial colonization of the thread: among the 208 without the implantation of prosthesis, 19 (21.8%) of the 87 with antibiotic prophylaxis and in 58 (47.9%) of the 121 without it; among the 30 patients with the implantation of prosthesis, only two patients showed a colonized thread. The patients with antibiotic prophylaxis developed a colonization of the thread less frequently than those without it (17.9% vs. 47.9%, p < 0.001). SSI was observed in six (2.5%) patients, all of them showing a colonized thread (7.6% vs. 0%, p < 0.001). The bacteria identified in colonized threads were the same as those found in SSIs. Conclusions: Our study presents a new method that is able to precociously assess patients who have undergone clean procedures who may develop SSI, and identify the microorganism involved.
Highlights
Surgical site infections (SSIs) are among the most common healthcare-associated infections, and are associated with longer post-operative hospital stays, intensive care admission and higher mortality [1].The burden of surgical site infection (SSI) in the United States is estimated at about 2% of all patients who undergo an operation [2,3], while in European countries the percentage of SSIs vary between 0.5% and 10.1%, Int
The aim of this study was to investigate the role of this method, which exploits the colonization of a suture thread to precociously identify the at-risk patients who have undergone only clean surgical procedures
All patients subjected to clean surgical operations with prosthesis placement received antibiotic prophylaxis; among the patients who underwent a clean procedure without the placement of prosthesis, only 87 (41.8%) received antibiotic prophylaxis because indicated
Summary
Surgical site infections (SSIs) are among the most common healthcare-associated infections, and are associated with longer post-operative hospital stays, intensive care admission and higher mortality [1].The burden of SSIs in the United States is estimated at about 2% of all patients who undergo an operation [2,3], while in European countries the percentage of SSIs vary between 0.5% and 10.1%, Int. Surgical site infections (SSIs) are among the most common healthcare-associated infections, and are associated with longer post-operative hospital stays, intensive care admission and higher mortality [1]. The aim of the present study is to investigate the role of the colonization of suture thread to identify patients at risk of developing a surgical site infection (SSI) after clean surgical procedures. Methods: Patients who underwent elective clean surgery procedures at the Surgery. A synthetic absorbable thread in Lactomer 9-1 was inserted into the surgical site at the end of surgery and microbiologically evaluated after 48 h. Results: A total of 238 patients were enrolled; 208 (87.4%) of them were subjected to clean procedures without the placement of prosthesis, and 30. Of the 238 patients, 117 (49.2%) underwent an antimicrobial prophylaxis
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