Prevalence Of Wound Infection Research Articles

Prevalence of wound infection following right anterolateral thoracotomy and median sternotomy for resection of benign atrial masses that induce heart failure, arrhythmia, or thromboembolic events: A meta-analysis

<p class="MsoNormal"><strong><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; background: white;">Background:</span></strong></p> <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; background: white;">A meta-analysis study to assess the prevalence of wound infection (WI) following right anterolateral thoracotomy (RAT) and median sternotomy (MS) for resection of benign atrial masses (BAM) that induce heart failure, arrhythmia, or thromboembolic events.</span></p> <p class="MsoNormal"><strong><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">Methods:</span></strong></p> <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">A comprehensive literature examination till February 2023 was implemented and 296 linked studies were appraised. The 4 picked studies contained 206 subjects with </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-bidi-language: AR-EG;">BAM that induce heart failure, arrhythmia, or thromboembolic events</span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> in the picked studies' baseline, 116 of them were using RAT, and 90 were using MS. </span><span lang="EN-GB" style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-GB;">Odds ratio (OR)</span><span lang="EN-GB" style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">in addition to 95% confidence intervals (CIs) were used </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">to calculate the consequence of the prevalence of WI following RAT and MS for resection of BAM that induces heart failure, arrhythmia, or thromboembolic events </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">by the </span><span lang="EN-GB" style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-ansi-language: EN-GB;">dichotomous </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">and continuous styles and a fixed or random model.</span></p> <p class="MsoNormal"><strong><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">Results:</span></strong></p> <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">No significant difference was observed between RAT and MS in postoperative surgical site WI (OR, 0.18; 95% CI, 0.02-1.77, p=0.14) with no heterogeneity (I<sup>2</sup> = 0%) in subjects with </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-bidi-language: AR-EG;">BAM that induce heart failure, arrhythmia, or thromboembolic events</span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">.</span></p> <p class="MsoNormal"><strong><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">Conclusions:</span></strong></p> <p class="MsoNormal"><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">No significant difference was observed between RAT and MS in postoperative surgical site WI in subjects with </span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi; mso-bidi-language: AR-EG;">BAM that induce heart failure, arrhythmia, or thromboembolic events</span><span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> though precautions should be taken when commerce with the consequences since a low number of selected studies was picked for comparisons in this meta-analysis and all the selected studies were with low sample size.</span></p> <p> </p>

Prevalence of wound infections and postoperative complications after total elbow arthroplasty for rheumatoid arthritis: A meta-analysis.

This study aimed to systematically evaluate the prevalence of surgical site wound infections and postoperative complications after total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA) for clinical research and application. Embase, PubMed, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases were electronically searched to collect clinical studies on the application of TEA in the treatment of RA from inception to August 2023. Two independent researchers performed literature screening, data extraction, and quality assessment. A meta-analysis was performed using the R 4.3.1 software. Overall, 26 studies with a total of 2374 patients were included. The results of the meta-analysis revealed that after TEA in patients with RA, the prevalence of surgical site wound infections and postoperative complications was 3.37% (95% confidence interval [CI]: 2.68%-4.13%), and 31.63% (95% CI: 24.97%-38.28%), respectively. The prevalence of surgical site wound infections is low, whereas that of postoperative complications is high; thus, the safety of TEA remains debatable. Owing to limitations on the quality and number of included studies, the findings need to be verified in higher-quality studies.

Prevalence of Wound Infections; Evaluation of its Growth Frequency and Antibiotic Resistance Pattern in Chennai Population

Prevalence of Wound Infections; Evaluation of its Growth Frequency and Antibiotic Resistance Pattern in Chennai Population

Therapeutic efficiency of probiotic lactobacillus acidophilus, lactobacillus rhamnosus and antibiotic against isolates of pathogenic bacterial from skin wound infections

Background: Probiotic refer to harmless live normal flora micro-organisms (M.O), which are mostly strains of Lactobacillus spp., Bifidobacterium spp., and others. These microorganisms (M.O) help the host's health when given in the right dosages. Aims: To identify bacterial species isolated from wound infections, and also to evaluate in-vitro the antimicrobial activity of selected probiotic species and antibiotic against some pathogenic bacteria. Methods: Records of wound swabs collected from 102 patients with high suspicion of wound infections. Bacterial colonies were Gram stained and microscopically examined. Biochemical tests were done to identify pathogen species. The microtitre plate method (MTP) was used to detect biofilm formation by bacteria. The Kirby-Bauer disk diffusion method was used for antibiotic testing. The well diffusion method and agar spot method was used for detection probiotic affectivity to a group of bacteria isolated (totally 38 isolates). Results: Prevalence of wound infections was 81.4% (CI: 60.869). A total of 10 species were isolated from 83 infected wounds. The most common bacterial species detected was Staphylococcus aureus (26.5%), followed by Pseudomonas aeruginosa 14.4%, Proteus mirabilis (12%), Escherichia coli 10.8%, and Enterobacter cloacae (8.4%). Polymicrobial infection was found in 25(30.1%) of the samples and was mainly constituted with two species.

Compare the Outcomes of Subcutaneous Drains versus No Drains in Patients with Repeated Cesarean Section

Objective: The aim of this study is to compare the outcomes of subcutaneous drains versus no drains in patients with repeated cesarean section. Study Design: Randomized control trial Place and Duration: Conducted at Gyne & Obs Department, Shahida Islam Teaching Hospital Lodhran, during from 8-01-2020 to 8-08-2020. Methods: Total 90 pregnant women with repeated cesarean section were presented in this study. Patients were aged between 22-50 years. Detailed demographics of enrolled cases including age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were categorized into two groups, group I had 45 patients with subcutaneous drain and 45 patients of group II were without drain. Post-operative outcomes were assessed and compared among both groups. VAS was used to compare pain among both groups. SPSS 22.0 version was used to analyze the data. Results: Mean age of the patient in group I was 30.6±8.44 years with mean BMI 33.08±5.26 kg/m2 but in group II mean age was 29.03±7.37 years with mean BMI 31.12±11.58 kg/m2. Mean gestational age in group I was 37.9±3.9 weeks and in group II mean gestational age was 37.3±2.7 weeks. There was no any significantly difference in parity among both groups. Post-operative mean haemoglobin in group I was lower 7.9±1.6 gm% as compared to group II 8.11±0.4 gm%. Mean pain score in group I was 6.8±4.7 and in group II was 8.2±4.11. Prevalence of wound infection was greater in group II 5 (11.1%) as compared to group I 3 (6.7%). Hospital stay was shorter in group I 9.7±2.11 days as compared to group II 10.8±1.14 days. Frequency of superficial SSI and wound seroma were significantly higher among patients of group II. Conclusion: In this study we concluded that those patients who received subcutaneous drain undergoing cesarean section resulted low post-operative pain with fewer chances of wound infection as compared to the patients undergoing C-section without drain. Except this frequency of SSI and hospital stay was shorter among patients of drain group. Keywords: Cesarean, Drain, Wound Infection, Superficial Surgical Site Infection, Pregnant Women

Effect of Post Episiotomy Antibiotic on Maternal Infectious Morbidity(Clinical trial)

AbstractBackground: Episiotomy is a surgical wound done with sterile scissors to widen the vaginal opening. There is little information on the prevalence of post-episiotomy infection worldwide. Contrary to WHO recommendations, prophylactic antibiotics still prescribed in many hospitals including our hospital, to prevent the episiotomy site infection in all women after childbirth.Aim: To compare infectious morbidity rate between parturient women with uncomplicated vaginal birth received either prophylactic course of oral antibiotics post-episiotomy in addition to routine local care and who received routine local care only.Patient and method: A randomized trial conducted in the labour room of Alzhraa University Hospital, Cairo, Egypt within a 15 months duration. We recruited 630 pregnant ladies admitted for a non-complicated vaginal birth and indicated for episiotomy. Cases randomly assigned after delivery and at discharge into two groups. Group A: prescribed on discharge oral antibiotics twice daily for 5 days after the delivery and routine episiotomy care, Group B: received routine episiotomy care only. Primary outcomes: Episiotomy wound infection and endometritis, and secondry outcomes: Episiotomy wound dehiscence or gapping, Puerperal infection or adverse effects of antibiotics.Results: We reported a 7.5 % prevalence of wound infection in total study participants. Episiotomy overall wound complications were 7.8 %-6.7% in antibiotic and non antibiotic group respectively with no statistical difference. On the second visit, no cases reported with abnormal lochia or maternal fever.Conclusion: It is concluded that administration of prophylactic systemic antibiotic post episiotomy is not effective to prevent wound infection.

Prevalence of Wound Infection in Patients Undergoing Elective or Emergency Abdominal Surgery

Objective: To compare the surgical wound infection in patients undergoing elective or emergency abdominal surgeries. Study Design: Comparative study Place & Duration of Study: Study was conducted at surgery department of Divisional Headquarter Teaching hospital Mirpur Azad Kashmir for eighteen months duration from June 2019 to November 2020. Materials and Methods: 150 patients of both genders with ages 15 to 65 years who received laparotomy treatment due to intra-abdominal infection or complicated appendicitis were included in this study. Patient’s medical history, age, sex and residency were recorded after taking informed consent. All the patients were divided into two groups, Group A contained 75 patients (Elective) and Group B contains 75 patients (emergency) received laparotomy. Deep surgical wound infection was examined at the 7th day after surgery and compared between both groups. Results: Ninety eight (65.3%) patients 49 in each group were males and 52 (34.7%) patients 26 in each group were females. In Group A and B 27 and 29 patients were ages 15 to 30 years, 33 and 31 patients had ages 36 to 45 years, 15 and 15 patients were ages between 46 to 60 years. 10 (13.3%) patients in Group A and 12 (16%) patients in group B had deep surgical infection within 1 week after surgery. Statistically there is no significant difference between the both groups (p>0.356) Conclusion: It is concluded that the frequency of wound infection was high in emergency abdominal surgeries as compared to patients undergoing elective surgery, but the difference was not statistically significant. Keywords: Emergency laparotomy, Deep surgical site infection, PO Drain placement

Comparison of Wound Infection in Uncomplicated Acute Appendicitis by Subcuticular Suture and Interrupted Suture.

Postoperative complications such as wound infection and scarring are some of the major concerns regarding suturing techniques. This study is designed to evaluate postoperative outcomes of adhering subcuticular sutures in comparison to the interrupted suturing method in patients who underwent appendectomy for uncomplicated acute appendicitis. 240 patients were randomly assigned into two groups; 120 with interrupted and 120 subcuticular sutures after an appendectomy, at Shohada Ashayer hospital, Khorramabad, Iran. The prevalence of wound infection, three days after the surgery in the hospital and a week after discharge was determined and evaluated statistically. No wound infection was seen within three days of hospitalization in the subcuticular group whereas, 1 patient reported infection in the interrupted group, however, the difference was not statistically significant. A week after discharge, a patient was reported to have wound infection in the subcuticular group and 2 in the interrupted group. No significant difference was seen in this regard either. 55 females and 66 males received subcuticular sutures whereas, 74 males and 46 females were given interrupted sutures for wound closing. One male in interrupted and 1 male and female in the subcuticular group were referred for wound infection, after discharge, respectively. Among these groups, no significant differences were seen. In catarrhal appendicitis, the infection was reported in the interrupted group only which was not statistically significant. Subcuticular sutures provide better cosmetic outcomes without any additional complications in comparison to interrupted sutures.

Clinical Data, Echocardiography and Surgical Wound Infection of Patients Undergoing Cardiac Surgery

Introduction: Due to importance of surgeries for treatment of heart diseases, it is necessary to recognize surgical site infection and other Healthcare-Related Infections as the main post-surgical complications. Objective: To analyze the association and correlation between clinical and propaedeutic variables with the prevalence of wound infection in patients undergoing cardiac surgery Methodology: Quantitative, analytical study with a retrospective approach. Data collection was performed in the Medical Archive Sector of the Clinical Hospital of Uberlandia (HCU), using a previously structured instrument. Results: A total of 453 medical records were evaluated, mainly masculine gender (n=313; 69.1%). A time patient hospital stays had a mean of 36.47±28.7days, surgical indication of myocardial revascularization (n=278; 61.4%). The rate of surgical wound infection (SWI) found was 19%. Correlation and clinical associations were: Time of surgery and left ventricle ejection fraction (LVEF) (r=0,10; p<0,05); time hospital stay and almost all echocardiographic variables, weight and height (p=0.01); Systolic blood pressure (SBP) and left ventricle posterior wall (LVPW) (r=0.16), LVEF (r=0.12) and intraventricular septum (r=0.13), (p<0.01); Diastolic blood pressure (DBP) and left ventricle posterior wall (LVPW) (r= 0.10; p<0.01). Conclusion: The study has hight potential to increase scientific evidences and improving cardiovascular care, cardiovascular surgery field and prevention of healthcare-associated infections.

Prevalence of Multidrug-Resistant and Extended-spectrum Betalactamase Producing Bacterial Isolates from Infected Wounds of patients in Kathmandu Model Hospital


 The wound is an injury to living tissues caused by a cut, puncture, bite, blow, or other impacts. An infection is caused when germs enter wounds. This study was designed to isolate and identify the causative agents of wound infections and their antibiotic susceptibility pattern. A total of 339 samples were collected from January to June 2016 from Kathmandu Model Hospital, Kathmandu. Samples were inoculated on the Blood Agar and MacConkey agar plates were incubated at 37 °C for 24 hours. After incubation, all isolates were identified by using gram stain and biochemical methods. Antibiotic susceptibility tests were performed on Mueller Hinton agar plate by Kirby Bauers Disk Diffusion Technique. During the study period, altogether, 339 specimens were collected and processed as per the standard microbiological protocol. The overall prevalence of wound infection was 56.9%. Among 244 bacterial isolates, Escherichiacoli (24.2%) was most predominant bacteria followed by Staphylococcus aureus (19.7%), Coagulase-negative Staphylococcus (17.6%), Klebsiella pneumoniae (10.7%), Pseudomonasaeruginosa(8.6%), Acinetobacterspp (5.7%), Citrobacterfreundii(4.9%) Proteus mirabilis (3.3%), Streptococcus viridans (2.0%), Klebsiellaoxytoca (0.8%), Proteus vulgaris (0.4%), Serratiamarcescens (0.4%), Enterobacteraerogens (1.2%), Enterobacterfaecalis (0.4%). The most effective drug for Gram-negative bacteria and Gram-positive bacteria were amikacin and chloramphenicol, respectively. A total of Gram-negative bacteria, 77.55% were multidrug-resistant. The total Gram-negative bacteria most ESBL producers were E. coli (82.9%). We found S. aureus 33.3% of isolates were resistant to cefoxitin which indicates the increasing rate of Methicillin-resistant S. aureus(MRSA) in wound infection.

Bacterial Etiology of Wound Exudates in Tertiary Care Cancer Patients and Antibiogram of the Isolates.

Introduction:Patients with malignancies frequently develop infections as a result of surgical procedures and fungating wounds leading to pus formation. This cross-sectional study was conducted to explore the bacteriological spectra of infections of various cancer sites and their antibiotic sensitivity patterns among the patients visiting minor operation theatre (OT) of B.P. Koirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal.Methods:Over a period of 3 months from September to November 2018, a total of 183 wound exudates and pus samples were collected and analyzed by standard microbiological procedures. Isolates were identified based on the colony characters, Gram staining and an array of biochemical tests. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion technique according to criteria set by CLSI, 2016. Methicillin resistance in Staphylococcus aureus was tested with the help of cefoxitin using disc diffusion method.Results:Out of the 183 samples, 149 (81.4%) were culture positive. Among 13 different isolates identified, S. aureus (43.0%) was predominant followed by E. coli (14.0%). Higher incidence of bacteria was seen among the males (52.3%), in the age group 51 to 60 years (26.8%) and among the patients undergoing surgical intervention to deal with cancer (34.2%). The prevalence of wound infection was significantly affected by gender, age, and treatment regimen (P < .01). Out of the total 68 S. aureus isolates, 38 (44.1%) were deemed as Methicillin-resistant Staphylococcus aureus (MRSA). Among the 158 isolates, 85 (53.8%) were multi-drug resistant (MDR). Cefepime was the most effective antibiotic for Gram positive isolates whereas both imipenem and meropenem were found to be equally more effective for Gram negative isolates.Conclusion:This study suggests that patients with malignancies harbor pathogenic bacteria; therefore, prudent use of antibiotics is essential to prevent the emergence of MDR pathogens.

Lichtenstein procedure versus darn repair in primary inguinal hernia surgery

Introduction With the advent of newer methods for inguinal hernia repair like laparoscopy and mesh, older techniques like darn repair have gone into the background. However, in developing countries like Egypt where cost-effectiveness is of prime concern, darn repair still enjoys a good reputation and popularity for the repair of inguinal hernia. This study was carried out to compare darn repair with Lichtenstein repair regarding early outcome. Patients and methods A total of 100 male patients aged from 20 to 60 years old who presented with primary inguinal hernia were operated upon with Lichtenstein or darn repair as elective procedure from January 2013 to October 2016. They were subjected to this prospective randomized-controlled trial. The primary endpoint was to compare the early outcome of these two procedures. Results The need for analgesia and hospital stay was higher in patients who had Lichtenstein repair. Hematoma occurred in one (1%) patient and seroma occurred in four (4%) patients in both groups. The prevalence of wound infections as superficial and deep infections in groups A and B was 4 and 4%, respectively, which were resolved through conservative management. Complications of recurrence in group A were 2% as compared with group B, which had a recurrence of 4%. This difference was not significant. Conclusion Both darn repair and Lichtenstein repair resulted in rapid recovery and low recurrence rates; however, the advantage of the darn repair lies in the fact that it does not require mesh, so it is much cost effective.

Systematic review of absorbable vs non-absorbable sutures used for the closure of surgical incisions.

To report a systematic review of published randomized controlled trials (RCTs) investigating the role of absorbable suture (AS) against non-AS (NAS) used for the closure of surgical incisions. RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR. The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection (OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity (P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down (OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P < 0.0004). This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence, rather lead to a reduced risk of wound dehiscence compared to NAS.

A 5 - year surveillance of wound infections at a rural tertiary hospital in Nigeria.

Wound infections are associated with increased morbidity and mortality. To determine the prevalence, aetiology and susceptibility profile of bacterial agents of wound infection among in- and- out patients at a rural tertiary hospital in Nigeria, within a 5 year period. Wound swabs collected from 156 out-patients and 353 in-patients were, cultured and microbial isolates identified using standard methods. Antibiotic susceptibility testing was done on bacterial isolates. The prevalence of wound infection in 2006, 2007, 2008, 2009 and 2010 was 71.4%, 76.2%, 74.5%, 61.5%, and 67.0% respectively. The overall prevalence of wound infection was 70.1%. In all the years studied, out-patients had a higher prevalence of wound infection, but this was significant in 2007, 2009, and 2010 only. Staphylococcus aureus was the most prevalent pathogen in both in- and out - patients with the exception of 2009 where both Staphylococcus aureus and Pseudomonas aeruginosa had the same prevalence (24.4%) among in - patients. The flouroquinolones were the most potent antimicrobial agents against bacterial isolates from both in - and out -patients. Staphylococcus aureus was the most predominant etiologic agent of wound infection among in and out patients. A generally higher resistance pattern was observed among nosocomial bacterial pathogens. Prudent use of antibiotics is recommended.

Microbiological pattern of postcesarean wound infection at Federal Teaching Hospital, Abakaliki

Background: Cesarean section is one of the most common obstetric surgeries done in women of reproductive age group. Postcesarean wound infection is a worrisome occurrence despite the observation of aseptic techniques and administration of potent antibiotics. Common offending organisms include Staphylococcus species, Enterococcus faecalis, Escherichia coli, Proteus mirabilis, and Pseudomonas species. Objective: The objective of this study is to determine the prevalence, risk factors and common bacterial pathogens for surgical site infection (SSI), following cesarean section. Materials and Methods: A prospective surveillance was conducted at Federal Teaching Hospital, Abakaliki, from July 2011 to August 2012 using a semi -structured questionnaire. The following risk factors were studied, age, parity, booking status, type of cesarean section, duration of labor and length of membrane rupture. Microbiologic culture of those that had wound infection was done. IBM ® SPSS ® statistical software 2007 version 16 was used for statistical analysis. Results: The prevalence of wound infection was 7.0%. There were 1301 deliveries out of which 399 (30.7%) had cesarean section, and 28 (7.0%) had wound infection following cesarean delivery. Booking status was the only factor that significantly influenced the occurrence of wound infection (P < 0.01). Staphylococcus aureus and Citrobacter spp. were the common organisms isolated. Conclusion: The prevalence of SSI following cesarean section was high and S. aureus and Citrobacter spp. were the common pathogens isolated.

Prophylactic Antibiotics and Wound Infection

Surgical site infections account for 14%-25% of all nosocomial infections. The main aims of this study were to audit the use of prophylactic antibiotic, to quantify the rate of post-operative wound infection, and to identify risk factors for its occurrence in general surgery. A cross-sectional study was conducted in the General Surgery Department in Khartoum Teaching Hospital- Sudan. All Adult patients (age ≥18 years) admitted during March 1(st) to 31(st) October 2010 were recruited. Multivariable logistic analysis was done to identify wound infection risk factors. Prescriptions were audited against predetermined criteria. A total of 540 patients were recruited; (females73.7% of total ). The performed surgical procedures were 547. The rate of wound infection was 10.9%. Multivariable logistic analysis showed that; ASA score ≥ 3; (p= <0.001), wound class (p= 0.001), and laparoscopic surgical technique; (p= 0.002) were significantly associated with prevalence of wound infection. Surgical prophylaxis was unnecessarily given to 311 (97.5%) of 319 patients for whom it was not recommended. Prophylaxis was recommended for 221 patients; of them 218 (98.6 %) were given preoperative dose in the operating rooms. Evaluation of prescriptions for those patients showed that; spectrum of antibiotic was adequate for 160 (73.4%) patients, 143 (65.6%) were given accurate doses, only 4 (1.8%) had the first preoperative dose/s in proper time window, and for 186 (85.3%) of them prophylaxis was extended post-operatively. Only 36 (6.7%) prescriptions were found to be complying with the stated criteria. The rate of wound infection was high and prophylactic antibiotics were irrationally used. Multiple interventions are needed to correct the situation.

Prevalence and predictors of wound infection in elective clean and clean/contaminated surgery in Khartoum Teaching Hospital, Sudan

Background: Surgical site infections are the second most common cause of hospital acquired infections. The objectives of this study were to quantify the rate of wound infection and to identify risk factors associated for its prevalence among patients admitted for elective surgery in Khartoum Teaching Hospital in Sudan. A prospective study was conducted. All patients, aged >18 years admitted during March 1st 2010 to 31th October 2010 were recruited. Baseline data was collected before patient's operations on. Patients were followed up to one month for detection of wound infection using bedside and post-discharge surveillance. A total of 1387 patients were included with a mean age of 35±14 years. 1138(82%) were females. More than three quarters were healthy (79.3%) and 1367(98.6%) patients were operated on conventionally. The total number of the performed surgical procedures was 1426. The rate of wound infection was found to be 9%. Univariate analysis revealed that five variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.041), co-morbidity (P=0.006), presence of diabetes (P=0.010), ASA score (P=0.000) and surgical technique (P=0.007). Multivariate logistic analysis showed that ASA score 2 and ASA score > 3, {adjusted OR, 1.9 (1.2-3.0), P =0.006 and adjusted OR, 3.6 (2.0-6.7); P<0.001 respectively}, laparoscopic surgical technique {adjusted OR, 5.5 (2-14.8); P=0.001} were mostly significantly associated with the prevalence of wound infection. The rate of wound infection was high with patient’s physical status and use of the laparoscope technique being strong predictors of infection.

Microbiology of Wound Infections Among patients of a Tertiary Hospital in Benin City, Nigeria.

Wound infections are associated with increased morbidity and mortality. Etiologic agents of wound infections vary with geographical locations. This study was conducted to assess the prevalence of wound infections, the effect of age and gender on the prevalence as well as the etiologic agents and their susceptibility to antibacterial agents. Wound swabs collected from 2061 patients were processed to investigate etiologic agents using standard technique. Disc susceptibility of bacterial agents was determined. The overall prevalence of wound infections was 64.8%. The prevalence of wound infections was not significantly affected by gender but was significantly affected by age (P<0.001). The prevalence of wound infections was minimum among age group of <5 years old (20.0%) and maximum among the age group of 36-40 years old (77.5%). Staphylococcus aureus was the most prevalent etiologic agent (21.5%). β-lactams, fluoroquinolones and gentamicin were the most effective antibacterial agents. The prevalence of wound infections was high and was only affected by age. Staphylococcus aureus was the most predominant etiologic agent and β-lactam antibiotics are recommended.

Percutaneous dynamic hip screw

We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2-2.5 cm. The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex-matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre- and post-operative haemoglobin concentration, haematocrit and prevalence of wound infection. Thirteen consecutive cases were performed by one surgeon using the percutaneous technique. There were nine females and four males with a mean age of 84 years (range 62-96 years). Each had a 135 degrees four-hole plate. The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0-4.4 g/dl) compared to 3.5 g/dl (range 1.2-5.4 g/dl) in the control group (p = 0.014). The mean haematocrit drop was 0.07 (range 0-0.12) in the percutaneous group compared to 0.10 (range 0.03-0.17) in the control group (p = 0.017). The mean theatre time with the percutaneous technique was 57 min (range 40-75 min) and in the control group, 60 min (range 30-95 min). There were no wound problems. It is likely that this minimally invasive technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study.

Body Mass Index as a Predictor of Complications After Operative Treatment of Acetabular Fractures

Obesity, a growing public health concern, is often thought to be an important risk factor for postoperative complications. We hypothesized that body mass index is predictive of complications after operative treatment of acetabular fractures. A retrospective chart review identified 169 consecutive patients in whom an acetabular fracture had been treated with open reduction and internal fixation at a level-1 trauma center. The patients were stratified into four classes according to their body mass index: normal (<25), overweight (> or =25 but <30), obese (> or =30 but <40), and morbidly > or =40). The perioperative outcomes that were evaluated included estimated blood loss, wound infection, nerve palsy, deep venous thrombosis, pulmonary embolism, and heterotopic ossification. Multivariate general linear models were used to test for the relationship between body mass index and perioperative outcomes while controlling for potential intervening variables (including surgical approach, fracture type, and surgeon experience). Odds ratios were calculated as well. When body mass index was measured as a continuous variable, it was found to have a significant relationship with estimated blood loss (p = 0.003), prevalence of wound infection (p = 0.002), and prevalence of deep venous thrombosis (p = 0.03). Odds ratio analysis revealed that obese subjects (body mass index of > or =30) were 2.1 times more likely than patients of normal weight (body mass index of <25) to have an estimated blood loss of >750 mL and 2.6 times more likely to have a deep venous thrombosis. Morbidly obese patients (body mass index of > or =40) were five times more likely to have a wound infection. Body mass index is predictive of complications after operative treatment of acetabular fractures.