Incidence Of Postoperative Infection Research Articles

Infection of surgery for bone and soft tissue sarcoma with biological reconstruction: Data from the Japanese nationwide bone tumor registry

BackgroundAlthough biological reconstruction (such as recycled autograft, vascularized autograft, allograft, or bone transport) is possible for bone defects after malignant bone or soft tissue tumor resection, a high incidence of postoperative complications, including infection, poses a problem. The difficulty in accumulating cases has resulted in a lack of reliable etiological information, such as the incidence and risk factors of postoperative infections. MethodsWe conducted a retrospective study on the nationwide registry data. The primary endpoint was the need for additional surgical intervention for infection control. The overall incidence of postoperative infection and the related risk factors were analyzed. ResultsWe included 707 malignant bone and soft tissue tumors with biological reconstruction, including recycled autograft, vascularized autograft, allograft, bone transport, and combinations of these. The incidence of postoperative infection was 10.8%. Patients reconstructed by pedicled autograft showed a higher incidence of infection, while cases involving the combination of recycled and pedicled autograft or allograft showed a lower incidence. Independent risk factors for infection included age over 17, tumor diameter over 10 cm, the tumor located on the trunk or being high grade, reconstruction by pedicled autograft, and delayed wound healing. ConclusionInfection incidence was comparable to those in previous reports. Several conventional and novel risk factors were extracted by administering nationwide registry data. Data from the nationwide registry was informative for analyzing the incidence of postoperative infection in biological reconstruction with malignant bone and soft tissue tumor resection.

Incidence of Postoperative Infection Following Simultaneous Bilateral Knee Arthroplasty: A Systematic Review and Meta-Analysis.

Total knee arthroplasty is one of the most common orthopedic procedures. Simultaneous bilateral knee arthroplasty involves performing total knee arthroplasty on both knees in a single anesthetic session. This systematic review and meta-analysis followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. A primary search was performed using PubMed, EBSCO, Scopus, Web of Science, Clarivate, and Google Scholar databases. Quantitative data synthesis was performed using MedCalc® Statistical Software version 20.115 to determine the pooled prevalence of the infection among patients who underwent simultaneous bilateral knee arthroplasty. The Newcastle-Ottawa Scale was used to assess study quality. We included 30 studies in our quantitative data synthesis, with a total population of 118,502 patients (237,004 knees). The pooled prevalence of superficial infection, deep infection, and unspecified surgical site infection was estimated to be 0.86% (95% confidence interval: 0.62-1.13%), 0.84% (95% confidence interval: 0.64-1.05%), and 1.18% (95% confidence interval: 0.45-2.27%), respectively. There was significant heterogeneity (I2 >50%) in all analyses, and inspection of funnel plots revealed a symmetrical distribution of plotted data. We found that the infection rates following simultaneous bilateral knee arthroplasty were relatively low but heterogeneous, as the data showed marked variability. Superficial infections were more common than deep infections; however, there was a small difference in their prevalence. Furthermore, the reliability of our findings was limited owing to significant heterogeneity.

Corticosteroid Injections Administered Within 4 Weeks Prior to Hip Arthroscopy Are Associated With Higher Rates of Postoperative Infection

PurposeThe purpose of this study was to evaluate the association between the timing of intra-articular hip corticosteroid injections and the risk of postoperative infection in patients undergoing hip arthroscopy. MethodThe 2010-2021 PearlDiver M157 administrative claims database was queried for patients who underwent hip arthroscopy. Patients who received intra-articular corticosteroid injections within 12 weeks prior to arthroscopy were matched to those who did not 1:1 based on age, sex, and Elixhauser-Comorbidity Index, and the presence of diabetes mellitus, hypertension, obesity, and tobacco use. Those with injection prior to arthroscopy were subdivided based on having had the injection within 12 weeks prior to surgery. To verify that the corticosteroid injection and surgery were conducted in the hip joint, Current Procedural Terminology (CPT) codes were utilized. Using CPT coding and the International Classification of Diseases (ICD) 9th or 10th Revision, postoperative surgical site infection following corticosteroid injection was evaluated. The impact of the timing of preoperative corticosteroid injections on the incidence of postoperative infection was evaluated using multivariable logistic regression analysis. ResultsA total of 12,390 hip arthroscopy cases were identified, including 3,579 patients who received a corticosteroid injection 0-4 weeks prior to the surgery, 4,759 within 4-8 weeks prior to the surgery, and 4,052 within 8-12 weeks prior to the surgery. Compared to controls, patients who received a corticosteroid injection within 0-4 weeks preoperatively had a significantly higher rate of surgical site infection (OR 2.43; P=0.0001). No significant differences were observed in infection rates at the later time intervals (4-8 weeks or 8-12 weeks). Furthermore, in comparison to controls, patients who received a corticosteroid injection had a significantly higher rate of wound dehiscence (OR 1.84, P=0.0007). ConclusionIntra-articular corticosteroid injections within 4 weeks prior to hip arthroscopy were significantly associated with increased surgical site infection rates following hip arthroscopy surgery.

Effect of cefazolin sodium and amoxicillin sodium/clavulanate potassium on postoperative infection, pain and expression of inflammatory factors in patients undergoing orthopedic surgery

Purpose: To investigate the comparative effect of two antibacterial treatments in orthopedic surgery.
 Methods: A total of 96 patients who had undergone orthopedic surgery in Department of Nosocomial Infection Management, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, China from January 2021 to December 2022 were retrospectively analyzed and equally divided into two groups based on the postoperative medications administered to prevent infection. The control group was treated with amoxicillin sodium/clavulanate potassium while the study group was treated with cefazolin sodium. The incidence of postoperative infection, pain score, inflammatory factors and quality of life were determined and compared between both groups.
 Results: The incidence of postoperative infection in the study group was lower than in the control group (p < 0.05). Prior to intervention, the visual analogue scale (VAS) scores of the two groups were similar (p > 0.05), but decreased significantly after intervention (p < 0.05), with the score of the former after intervention lower than that of the latter (p < 0.05). Prior to intervention, the inflammatory factor levels in both groups were identical (p > 0.05); however, the levels fell significantly in both groups after intervention (p < 0.05), but the levels in the study group were lower than in the control group (p < 0.05). The quality of life scores were also higher for both groups after intervention (p < 0.05), but higher for the study group than for the control group (p < 0.05).
 Conclusion: Cefazolin sodium is more effective than amoxicillin sodium/clavulanate potassium in preventing infection in orthopedic patients after orthopedic surgery. However, there is a need to extend this treatment strategy to other clinical sites in order to validate these findings.

Predictors of postoperative mortality among neonates after major-risk surgery: A one-year experience from a Tunisian hospital

Background: Neonatal surgery in developing countries remains a high-risk modality p and its outcomes depend on various patient-related, system-related, and management-related factors. This study aims to describe our experience in managing newborns requiring surgical interventions and to investigate the primary predictors of postoperative mortality. Methods: In this observational study, we included all newborns aged less than 28 days who underwent surgery in the pediatric surgery department under general anesthesia with tracheal intubation for major-risk surgery. Patients were categorized into two groups based on the outcome (survival or death) during the two months following surgery. Following a comparison of the two groups, univariable and multivariable logistic regression analyses were conducted to explore predictors of perioperative mortality among neonates. Results: Sixty-seven newborns were included in this study, with an early mortality incidence of 28.3%. Anesthesia management did not impact neonatal mortality. The main predictors of neonatal mortality were revision surgery [aOR=35.5; 95% CI: 1.33- 94.1], surgery duration ≥ 120 minutes [aOR=36.5; 95% CI: 1.48- 312], preoperative mechanical ventilation [aOR=3.88; 95% CI: 1.12- 30.8], and the occurrence of perioperative adverse events [aOR=5.7; 95% CI: 1–29.5] or postoperative surgical complications [aOR=32.5; 95% CI: 1.05–101]. Conclusion: The early mortality rate after major neonatal surgery remains high in our department. It appears that preoperative poor conditions can elevate the risk. Additionally, major-risk surgeries requiring prolonged procedures and revision surgery, along with the incidence of postoperative infections, significantly increase the risk of neonatal mortality.

Retracted: Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Retracted: Machine Learning-Based Gynecologic Tumor Diagnosis and Its Postoperative Incisional Infection Influence Factor Analysis

Construction and validation of a nomogram prediction model for postoperative incisional infection in ankle fractures.

The aim was to investigate the independent risk factors for postoperative incisional infection in ankle fractures and to establish a nomogram prediction model accordingly. Data were collected from ankle fracture patients in the Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2022. Univariate and multivariate logistic regression analyses were used to determine the independent risk factors for postoperative incisional infection in ankle fractures and to establish the corresponding nomogram. Receiver operating characteristic curves were plotted and area under the curve was calculated, and calibration curves and decision curve analysis were plotted to evaluate the model performance. A total of 722 patients with ankle fractures were included in the study, and 76 patients developed postoperative incisional infections, with an incidence of 10.53%. After univariate and multivariate logistic regression analysis, a total of 5 variables were identified as independent risk factors for postoperative incisional infection in ankle fractures, namely, age ≥ 60 years (OR, 1.885; 95% CI, 1.156-3.045), having diabetes (OR1.625; 95% CI, 1.095-2.876), open fracture (OR, 5.564; 95% CI, 3.099-9.990), albumin < 35 g/L (OR, 2.618; 95% CI, 1.217-4.215), and operative time ≥ 2 hours (OR, 1.606; 95% CI, 1.077-3.247). The nomogram for postoperative incisional infection after ankle fracture constructed in this study has good predictive accuracy and helps orthopedic surgeons to intervene earlier in patients at high risk of postoperative incisional infection after ankle fracture.

Short-term effectiveness of orthopedic robot-assisted resection for osteoid osteoma

To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open surgery. A retrospective analysis was conducted on clinical data of 48 osteoid osteoma patients who met the selection criteria between July 2022 and April 2023. Among them, 23 patients underwent orthopedic robot-assisted resection (robot-assisted surgery group), and 25 patients received traditional open surgery (traditional surgery group). There was no significant difference ( P>0.05) in gender, age, disease duration, lesion location and size, and preoperative visual analogue scale (VAS) score, and musculoskeletal tumor society (MSTS) score between the two groups. The surgical time, intraoperative blood loss, intraoperative lesion localization time, initial localization success rate, infection, and recurrence were recorded and compared. VAS scores before surgery and at 24 hours, 1, 3, 6, and 9 months after surgery and MSTS score before surgery and at 3 months after surgery were assessed. All patients completed the surgery successfully, with no significant difference in surgical time between the two groups ( P>0.05). Compared to the traditional surgery group, the robot-assisted surgery group had less intraoperative blood loss, shorter lesion localization time, and shorter hospitalization time, with significant differences ( P<0.05). The initial localization success rate was higher in the robot-assisted surgery group than in the traditional surgery group, but the difference between the two groups was not significant ( P>0.05). All patients in both groups were followed up, with the follow-up time of 3-12 months in the robot-assisted surgery group (median, 6 months) and 3-14 months in the traditional surgery group (median, 6 months). The postoperative MSTS scores of both groups improved significantly when compared to those before surgery ( P<0.05), but there was no significant difference in the changes in MSTS scores between the two groups ( P>0.05). The postoperative VAS scores of both groups showed a gradually decreasing trend over time ( P<0.05), but there was no significant difference between the two groups after surgery ( P>0.05). During follow-up, except for 1 case of postoperative infection in the traditional surgery group, there was no infections or recurrences in other cases. There was no significant difference in the incidence of postoperative infection between the two groups ( P>0.05). Orthopedic robot-assisted osteoid osteoma resection achieves similar short-term effectiveness when compared to traditional open surgery, with shorter lesion localization time.

Effect of transverse colostomy versus ileostomy in colorectal anastomosis on post-operative wound complications: A meta-analysis.

A meta-analysis was conducted to evaluate the effect of colostomy or ileostomy on post-operative wound complications. The research was tested using Embase, PubMed and Cochrane Library databases. Included were randomized, controlled clinical trials (RCTs). A sensitivity analysis and a meta-analysis were carried out. The results indicated that there were no statistically significant differences in the reduction of wound infection between LC and LI. Out of 268 related studies, 5 publications were chosen and examined for compliance. Literature quality was evaluated throughout the trial. Studies with poor literature were excluded. The data were analysed with RevMan 5.3, and a decision was taken to analyse the data with either a stochastic or a fixed-effects model. There were no significant differences in the incidence of post-operative infection in patients with LC (OR, 0.79; 95% CI, 0.34, 1.81; p = 0.57), and the incidence of post-operative anastomotic fistulae (OR, 0.98; 95% CI, 0.30, 3.15; p = 0.97) was not significantly different from that with LI. These meta-analyses indicate that no significant reduction in the incidence of post-operative infections or anastomotic fistulae was observed by either LC or LI.

Retrospective analysis of 16 cases of lumbar hernia

BackgroundThrough a retrospective analysis of 16 cases of lumbar hernia, we discussed the anatomical basis, clinical manifestations, diagnosis, and treatment of this rare condition. MethodsWe collected medical data of 15 patients with a primary lumbar hernia and one patient with a secondary lumbar hernia treated in the General Surgery Department of Wuxi No.2 People's Hospital between January 2008 and June 2021 and analysed their demographic, preoperative, and postoperative data. ResultsAll patients underwent elective surgery performed by the same treatment team for superior lumbar hernias. The median area of the hernia defect was 12 cm2. Fifteen patients underwent sublay repair, and one underwent onlay repair. The median operative time and blood loss were 48 min and 22 mL, respectively. The hernia contents were extraperitoneal fat in 15 patients and partial small intestine in one. The median visual analogue scale score on postoperative day 1 was 3. A postoperative drainage tube was placed in three cases but not used in 13. The median duration of hospital stay was 5 days. Postoperative incision infection occurred in one case. During the follow-up period, no postoperative complications, including haematoma, seroma, incision infection or rupture, recurrence, and chronic pain, occurred in the other 15 cases. ConclusionLumbar hernias are rare and can be safely and effectively treated by open tension-free repair.

SPONTANEOUSREMOVALOFPLACENTAORMANUALREMOVALOFPLACENTA:WHICHISMOREBENEFICIALTOTHEPATIENTSPOST-OPERATIVELY:

Aim:Toassesswhichmethodofplacentaremovalhasmorebeneficialeffects,spontaneousremovalormanualremovalandadheretopracticesthatbenefitthepatient. Design:RETROSPECTIVECOHORTSTUDY Methodology: SampleSize:100 Inclusioncriteria: PostnatalpatientsProcedure:Thisstudyisaretrospectivecohortstudy.ThestudypopulationwillbepostnatalpatientswhodeliveredinChettinadHospital. After getting informed consent, the procedure will be explained thoroughly to the participantsand only the participants who are willing to take part in the study will be selected. Theparticipantswereobservedonanoutpatientbasisandthosewhowereadmittedinthepostnatalward. Parturients undergoing cesarean delivery were prospectively randomized to have theplacenta removed manually or spontaneously. Patients were excluded from participation if theyhad received intrapartum prophylactic antibiotics or had been determined to havechorioamnionitis. After delivery of the infant, women in the manual group had the placentaextracted by the primary surgeon, whereas women in the spontaneous group had the placentadelivered by gentle traction on the umbilical cord. All study subjects received perioperativeprophylactic antibiotics. Their pre operative and post operative reports were analyzed forHaemoglobin counts, their course of antibiotics and days of antibiotics taken post operativelywastakenintoconsideration,symptomssuchasDizziness,palpitations,headacheTirednessorweakness were asked to the patients and their complete blood counts report, urine routinereportswerecollectedtobecomparedpreandpostoperatively. Thisstudyisainvasivestudy. StudyDuration:2months(4/10/2023-04/12/2023)Results: A total of 100 women were enrolled in the investigation, with 48 assigned to the manual removalgroup and 52 allocated to have spontaneous removal. There were no statistically significantdifferencesinmeangestationalage,frequencyordurationofrupturedmembranes,frequencyordurationoflabor,ormeannumberofvaginalexaminationsbetweenthetwostudygroups. Postoperative infections occurred in 5 of 52 women in the spontaneous delivery groupcomparedwith12of48womeninwhichtheplacentawasmanuallyextracted.Subsetanalysisof patients delivered with ruptured membranes similarly demonstrated a statistically significantreduction in the incidence of postoperative infections with spontaneous placental removalcompared with manual extraction There was a similar trend toward a reduction in post deliveryinfectionsassociatedwithspontaneousplacentalremovalinwomenwithintactmembranes. Conclusion:Spontaneous delivery of the placenta after cesarean delivery is associated with a decrease intheincidenceofpostcesareaninfectionsandanemicsymptomscomparedtomanualremovaloftheplacenta.

CURRENT STRATEGIES IN THE PREVENTION OF POSTOPERATIVE INFECTIONS IN SPINAL SURGERY

This study aimed to analyze the strategies used to prevent postoperative infections in spinal surgery and evaluate their effectiveness in reducing the frequency of infections. The study design was retrospective and was conducted between January and December 2021 at the Department of Orthopedic &amp; Spine Surgery, Hayatabad Medical Complex. The study included a total of 90 patients who were divided into two groups based on the preventative techniques used. Group A (n=45) received standard preventive measures, such as preoperative antibiotics, accurate aseptic techniques, and postoperative wound care. In comparison, Group B (n=45) was given supplementary preventive measures such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions. The occurrence of postoperative infections, namely surgical site infections (SSIs) and deep wound infections, was documented and compared between the two groups. The mean age of patients in Group A was 55.2±8.6 years, while it was 57.8±9.2 years in Group B. Group A consisted of 27 (60%) male and 18 (40%) female patients, whereas Group B had 29 (64.44%) male and 16 (35.55%) female patients. Nine (20%) patients in Group A developed postoperative infections, while only three (6.7%) in Group B developed infections. The difference in postoperative infection incidence between the two groups was statistically significant (p&lt;0.05). Similarly, the incidence of SSIs was lower in Group B (4.4%) than in Group A (15.6%) (p&lt;0.05). Most patients in both groups (55.55% in Group A and 48.88% in Group B) received lumbar fusion surgery. Cervical fusion surgery was performed on 10 (22.22%) Group A patients and 12 (26.66%) Group B patients. Decompression surgery was performed on eight (17.77%) patients in Group A and nine (20%) individuals in Group B. The study's findings indicate that preventive techniques, such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions, can significantly reduce postoperative infections in spine surgery. However, further research is needed to determine the long-term effectiveness of these prevention approaches and explore alternative methods for preventing postoperative infections in spine surgery.

Bupivacaine liposomal injectable suspension does not provide improved pain control in dogs undergoing abdominal surgery.

To evaluate the difference in postoperative pain scores of dogs undergoing abdominal surgery receiving surgical incision infiltration of saline or bupivacaine liposomal injectable suspension (BLIS). 40 dogs undergoing exploratory laparotomy. Dogs were prospectively enrolled and randomized to receive either BLIS or saline surgical incision infiltration. All dogs received 5.3 mg of BLIS/kg or an equal volume of saline infiltrated in the muscle/fascia, subcutaneous tissue, and intradermal layer during closure. All dogs received a standardized postoperative pain management protocol. Pain assessment was performed at select time points postoperatively by blinded observers with an electronic algometer, short version of the Glasgow Composite Measure Pain Scale (GCMPS), and indirect measures of pain, including systolic blood pressure, heart rate, and serum cortisol levels. At day 0, blood pressure was higher in the saline group (149.6 vs 125.8 mm Hg; P = .006). At day 3, GCMPS was lower in the BLIS group (BLIS = 1, saline = 2, P = .027), though both average GCMPS scores were low and only 10 dogs were available for day 3 assessments (6 BLIS and 4 saline). No other differences in algometer readings, GCMPS scores, other measured parameters, or need for rescue analgesia were present between BLIS and saline groups at any time point. There was no difference in postoperative incisional infection rate or complications. Use of BLIS for exploratory laparotomy did not provide improved pain control over postoperative opioid administration alone. Patients that received BLIS had no increase in short-term complications.

Risk factors for postoperative infections in esophageal tumor patients

Postoperative infections (PI) are a serious complication after esophageal cancer surgery, as they might be correlated with an elevated risk of death. While several reports discuss risk factors for PI in esophageal tumor surgery, there is a limited amount of research on overall postoperative infections. Therefore, investigating the factors that influence PI holds great clinical significance. We retrospectively reviewed surgical data from a cohort of 902 patients diagnosed with esophageal tumors. The study included esophageal cancer patients treated in the Department of Thoracic Surgery at Anyang Tumor Hospital from January to December 2021. Preoperative and operative risk factors for PI were evaluated using univariable and multivariable analyses. The overall incidence of PI was 28.3% (255/902). Multivariable logistic regression analysis revealed that smoking and preoperative hospital stays are significant risk factors for PI after esophageal tumor surgery. Smoking and preoperative hospital stays are identified as risk factors for PI following esophageal tumor surgery. Based on our results, we predict that certain groups of patients may have a higher risk of PI following esophageal tumor surgery. Preventive measures or closely monitor of these patients may be required to reduce the incidence of postoperative PI.

The Protein Profiles of Local Tissue Postoperative Incision Infection After Plate Internal Fixation of Calcaneal Fractures

Background: Nowadays, the internal fixation has been an effective way for calcaneal fractures treatment. However, postoperative incision infection was one of the common complications found after the internal fixation operation and better treatment to avoid the infection is in need. Objective: In this work, we systematically preformed a comparative proteomic analysis between necrotic tissues and normal soft tissues aiming to find the molecular changes of the tissue during the fixation for better understanding the diseases. Method: The Necrotic Tissues (NTs) samples (n = 3) and the control soft tissues control (NC) samples (n = 3) which was 2-3 cm away from the NT were collected after the surgery. A LC-MS/MS based label free proteomic quantitation strategy was used to compare the proteome alterations followed by detailed bioinformatic analysis. Results: A total of 902 and 1286 protein groups were quantified in the NT group and the NC group separately, with 233 proteins upregulated and 484 proteins downregulated in the NT group. Those differently expressed proteins were highly correlated with the metabolic pathways, especially those downregulated proteins in the necrotic tissue indicating an inactive cell state. In addition, the detailed functional analysis showed that the upregulated proteins in necrotic tissue were highly enriched in the disease-related functions such as necrosis. Conclusion: This alerted us to clean the wound in time and found a safer strategy for internal fixation. Altogether, the emerging understanding of the proteomic properties in the necrotic tissue will guide the development of new strategies for internal fixation of calcaneal fractures.

Comparing the Efficacy of Postoperative Antibiotic Regimens in the Treatment of Maxillofacial Fractures: A Prospective Study.

The present study was designed to investigate the difference in the effectiveness of a 3 day postoperative course and a single perioperative dose of antibiotics on the incidence of postoperative infection in the management of maxillofacial trauma patients. About 183 maxillofacial trauma patients requiring open reduction and internal fixation (ORIF) under general anesthesia were divided based on the type of fracture sustained, i.e., mandibular fractures, Le Fort fractures, and zygomaticomaxillary complex fractures. Patients from each fracture type were randomized into two groups, A and B. All patients were administered amoxicillin/clavulanate 1.2 grams intravenously 8 hours from the time of admission till the patient was taken up for surgery. Once the patients were taken up for surgery, a perioperative dose was administered. No antibiotics beyond this point were given to patients in Group A. Patients in Group B were administered the same antibiotic for 3 postoperative days additionally. Outcomes in terms of purulent discharge from the surgical site, an abscess or any other sign of infection, and wound dehiscence requiring reopening of the surgical site were considered. Patients were reviewed at 1 week, 2 weeks, 1 month, 2 months, and 3 months. No statistically significant difference was found between the two groups across all three fracture types in terms of postoperative outcomes. However, increased numbers of complications were noted in the patients treated with an intra-oral approach in each fracture type irrespective of group. All complications were managed with local measures. A single perioperative dose of antibiotics is effective in minimizing postoperative complications following ORIF of maxillofacial fractures and there is no significant benefit in prolonging the course of antibiotics postoperatively with the need for further studies to be conducted considering comminuted, complex fractures and old fractures. In maxillofacial trauma, fractures frequently communicate with contaminated indigenous flora on the skin surface, oral cavities, or sinus cavities. Surgery is frequently performed using an approach across a contaminated area, even in closed fractures. Postoperative infections can be significantly decreased by using antibiotics in surgical procedures to treat facial fractures.

Incidence and risk of infection in malignant soft tissue tumor resection: Data from the nationwide soft tissue tumor registry

BackgroundPostoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration of nationwide registry data is a practical option for the accumulation of cases. MethodsData on malignant soft tissue tumor resection were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The incidence of postoperative infection and its risk factors were analyzed. ResultsA total of 14,460 cases were included. The incidence of infection was 2.6%. Significant risks for infection were male sex, lower extremity or trunk location, tumor diameter of over 10 cm, trans-compartmental invasion, high grade, autologous bone graft, myocutaneous flap, vascular reconstruction, reconstruction by prosthesis, postoperative radiotherapy, and delayed wound healing. ConclusionsThe incidence was lower than those in the previous studies, perhaps because of less frequent radiotherapy application. Some of the significant risk factors represented local invasiveness of the tumor, suggesting the importance of the preservation of soft tissue for infection prevention. The administration of nationwide registry data was informative for the analysis of infection in malignant soft tissue tumor resection.

INVESTIGATION OF BACTERIAL AND VIRAL SLOW INTERVERTEBRAL DISC INFECTIONS

Objective. Currently, few publications have been available regarding an effect of level, type of intrusion, and viral infections on spinal disc degeneration. The study was aimed to evaluate an incidence of indolent bacterial and viral intervertebral disc infections in unstratified group of patients operated on for spinal degenerative pathologies.&#x0D; Material and methods. For the study, intraoperative disc samples were collected from patients who underwent discectomy and total spinal fusion surgery for degenerative pathologies between the years December, 2018 to January, 2020. 447 samples were examined obtained from 392 patients (189 women and 203 men) with a mean age of 58.1 years.&#x0D; The following epidemiological and clinical data were collected: gender, age, spinal segments affected, type of surgical approach, preoperative C-reactive protein (CRP; reference range 0.00.5 mg/dL), and preoperative as well as 6-month postoperative ODI and NDI, both expressed as a percentage. The incidence of postoperative infections within six months after surgery as well as MI for each operated segment was assessed. Only patients with ventral cervical or dorsal thoracic access were enrolled in the study. In the lumbar region, the ventral assess was chosen for anterior lumbar interbody fusion, the lateral approach for oblique or extreme lateral interbody fusion, and the dorsal approach in case of standard microdiscectomy of posterior transforaminal interbody fusion or transforaminal interbody fusion.&#x0D; A logistic regression analysis was performed to model a risk of positive microbiological culture and a risk of emerging modal changes by using a set of independent variables selected in a stepwise manner by using the Akaike information criterion as a measure of quality of select procedure.&#x0D; Results. MRI for modal analysis was available for all 447 segments. MRI revealed 45 type 1 SCs (10.07% of all segments), 118 type 2 SCs (26.4%), and 5 type 3 SCs (1.12%). Microbiological culture was available in 410 segments. In these 410 segments, 39 type 1 MCs, 113 type 2 MCs, and 5 type 3 MCs were found. A statistically significant relationship was found between SC type 2 and a positive microbiological result (p = 0.0127). In contrast, there were no statistically significant associations for type 1 and type 3 SCs (p=0.3052 and p=0.0767, respectively).&#x0D; Conclusion. A relation between disc degeneration and infections seems unlikely. Histopathological evidence of inflammation in degenerated discs is rare and unrelated to microbiological findings.

Incidence and risk of surgical site infection/periprosthetic joint infection in tumor endoprosthesis—data from the nationwide bone tumor registry in Japan

BackgroundSurgical site infection (SSI)/periprosthetic joint infection (PJI) is a devastating complication in limb salvage surgery with endoprosthesis reconstruction for malignant bone tumors. The main bottleneck for data collection and analysis for the status of SSI/PJI in tumor endoprosthesis is the low absolute case numbers of this rare cancer. The accumulation of many cases is possible by administrating nationwide registry data. MethodsThe data on malignant bone tumor resection with tumor endoprosthesis reconstruction were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The primary endpoint was defined as the need for additional surgical intervention for infection control. The incidence of postoperative infection and its risk factors were analyzed. ResultsA total of 1342 cases were included. The incidence of SSI/PJI was 8.2%. The incidence of SSI/PJI in the proximal femur, distal femur, proximal tibia, and pelvis were 4.9%, 7.4%, 12.6%, and 41.2%, respectively. Location in the pelvis or proximal tibia, tumor grade, indication of myocutaneous flaps, and delayed wound healing proved to be independent risks for SSI/PJI, whereas age, sex, previous surgery, tumor size, surgical margin, application of chemotherapy and radiotherapy were not significant. ConclusionsThe incidence was equal to those in previous studies. The result reconfirmed the high incidence of SSI/PJI in pelvis and proximal tibia cases and cases with delayed wound healing. Novel risk factors such as tumor grade and application of myocutaneous flaps were marked. The administration of nationwide registry data was informative for the analysis of SSI/PJI in tumor endoprosthesis.

Comparison of Early Postoperative Pain between Lightweight Mesh and Heavyweight Mesh in Lichtenstein Hernia Repair for Geriatric Patients at Rumah Sakit Siloam Karawaci from January 2018 - December 2019

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Inguinal hernias are one of the most often cases in surgery. Inguinal hernias are usually found in males rather than females. There are two types of meshes in inguinal hernia repairs: heavyweight and lightweight mesh. There were still a lot of differences in the outcome of each mesh that was used. Therefore, with various different post operative pain results from past research, the author expresses an interest to conduct a research on this topic towards geriatric patients&lt;strong&gt;.&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this cross-sectional comparative study, 45 patients using heavyweight mesh and 45 patients using lightweight mesh herniorrhaphy with Lichtenstein technique in inguinal hernias at RS Siloam Karawaci Lippo Village and RSU were reviewed retrospectively. Patient's data were taken from medical record using purposive-sampling method. Early Postoperative pain on day 1 until 7 were classified following the Visual Analogue Scale (VAS). Incidence of postoperative infection and seroma were assessed in both groups. Collected samples will be processed using Pearson's Chi-Squared test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;This study shows that there is a significant difference between the use of lightweight mesh in reducing moderate early postoperative pain for men above the age of 60 years old (p = 0.025) rather than the use of heavyweight mesh. Incidence of other postoperative complications such as infection and seroma have no statistically difference between both groups.&lt;/p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The use of lightweight mesh has the advantage in reducing early postoperative pain from herniorrhaphy using Lichtenstein technique rather than heavyweight mesh in men above 60 years old.