Severity Of Wound Infection Research Articles

The Severity of Wound Infection in Washing the Primary Prep Area with 70% Alcohol and Normal Saline in the Orthopedic Surgery Prepped with Povidone-Iodine: A Randomized Clinical Trial

Background: Despite significant advances in patient treatment, infection remains a complication after surgery. The present study compared the incidence and severity of wound infection with two methods of washing the primary prep area with 70% alcohol and normal saline in patients who are candidates for orthopedic surgery in Kowsar Hospital of Sanandaj, Iran. Methods: This single-blinded randomized clinical trial was conducted on 190 candidates for upper limb orthopedic surgery aged 18 to 65. Patients were randomly assigned to two alcohol and normal saline groups based on the table of random numbers. The primary outcome of this clinical trial was the incidence and severity of wound infection after surgery, which was measured by the standard scale of the Asepsis index. The results were analyzed using SPSS version 23, and statistical values less than 0.05 were considered significant. Results: Patients’ hospitalization duration in the intervention group was (3.02±1.04 days) and in the control group (2.86±1.03 days) showed no significant statistical difference (p=0.297). The frequency of wound infection in the alcohol group was lower than in the normal saline group. this difference was statistically significant (p=0.023). Also, the severity of wound infection in the 70% alcohol group (Mean=5.12, SD=3.19) was lower than in the normal saline group (Mean=7.69, SD=4.12). This difference was statistically significant (p<0.001). Conclusion: The present clinical trial showed that the incidence and severity of wound infection after surgery were lower in the group washing the skin of the surgical area with alcohol compared to the group washing with normal saline.

Contribution of Pseudomonas aeruginosa Exopolysaccharides Pel and Psl to Wound Infections.

Biofilms are the cause of most chronic bacterial infections. Living within the biofilm matrix, which is made of extracellular substances, including polysaccharides, proteins, eDNA, lipids and other molecules, provides microorganisms protection from antimicrobials and the host immune response. Exopolysaccharides are major structural components of bacterial biofilms and are thought to be vital to numerous aspects of biofilm formation and persistence, including adherence to surfaces, coherence with other biofilm-associated cells, mechanical stability, protection against desiccation, binding of enzymes, and nutrient acquisition and storage, as well as protection against antimicrobials, host immune cells and molecules, and environmental stressors. However, the contribution of specific exopolysaccharide types to the pathogenesis of biofilm infection is not well understood. In this study we examined whether the absence of the two main exopolysaccharides produced by the biofilm former Pseudomonas aeruginosa would affect wound infection in a mouse model. Using P. aeruginosa mutants that do not produce the exopolysaccharides Pel and/or Psl we observed that the severity of wound infections was not grossly affected; both the bacterial load in the wounds and the wound closure rates were unchanged. However, the size and spatial distribution of biofilm aggregates in the wound tissue were significantly different when Pel and Psl were not produced, and the ability of the mutants to survive antibiotic treatment was also impaired. Taken together, our data suggest that while the production of Pel and Psl do not appear to affect P. aeruginosa pathogenesis in mouse wound infections, they may have an important implication for bacterial persistence in vivo.

Incidence Risk Level and Severity of Orthopedic Surgical Site Infection in Jordan

Background Orthopedic surgical site infections are higher in developing countries compared with developed countries. Purpose This study aimed to determine the following: incidence rate of infection, levels of risk of infection, the severity of orthopedic infection, and the relationship between risk level of and severity level of orthopedic infection. Methods The study used a prospective approach to collect data about orthopedic surgery patients through assessing their health status and reviewing their medical records and monitoring for the occurrence of surgical site infection within 90 days after the operation. A total of 286 patients met the eligibility criteria from 18 hospitals. The severity of wound infection was assessed using the Additional treatment, Serous discharge, Erythema, Purulent exudate, Separation of deep tissues, isolation of bacteria, and duration of inpatient Stay wound scoring scale, and the levels of risk were assessed using the National Nosocomial Infection Surveillance risk index score. Results The incidence rate of orthopedic surgical site infection was (n = 8; 2.8%). Five patients (62.5%) had a moderate-risk level of infection, and 2 patients (25%) had a high-risk level. Most patients (n = 278; 97.2%) had satisfactory healing level. Both risk levels and severity levels of orthopedic surgical site infection were significantly correlated with each other. Conclusion Appropriate risk level and severity level assessment tools should be used to aid in the assessment of orthopedic surgical site infection.

The study of the effect of supplemental oxygen therapy on the incidence and severity of wound infection after cesarean section

The study of the effect of supplemental oxygen therapy on the incidence and severity of wound infection after cesarean section

Analysis of the bacteria spectrum and clinical treatment of topical skin infection during soft tissue expander implantation

To analyze the identification and antibiotics susceptibility of infectious bacteria obtained from the topic skin infection during soft tissue expander implantation. A retrospective analysis of 121 cases with local infections during soft tissue expander implantation between 2003 to 2012 in Department of Plastic and Reconstructive Surgery, Xijing Hospital was performed. The efficacy of clinical management of local infection was evaluated. Laboratory examination on exudates bacterial pathogen and antibiotic susceptibility were performed. . Based on the severity of wound infection, change of dressings, wound debridement, exudates drainage and intravenous antibiotics administration were applied. All infections were successfully controlled although the expanders were removed in 16 cases with severe infections. Total success rate of expansion in this cohort was 89.33％.Twenty-nine exudates samples collected from either skin rupture wounds or skin outlets of connector tubes of externally placed infusion ports in 29 patients underwent bacterial culture and antibiotic susceptibility test. The 23 samples showed positive while the rest 6 samples showed negative on bacterial identification in the bacterial culture test.Staphylococcus aureus strain was found in 20 samples (86.96％),Staphylococcus epidermidis in 1 sample, Klinefelter Citrobacter in 1 sample, and Aeromonas hydrophila in 1 sample. More than 80％ of the pathogens were susceptive to cefazolin, oxacillin, and levofloxacin. Staphylococcus aureus is the main pathogen of infection at expander implantation site. The local dressing change,surgical debridement, continuous infusion drainage, and the use intravenous antibiotics are the effective managements

Is it possible to predict the development of an incisional surgical site infection and its severity after biliary tract surgery for benign disease?

Wound infection; that is, incisional surgical site infection (ISSI), is a common complication after biliary tract surgery. The aim of the present study was to identify the various risk factors for wound infection and to establish a formula to predict the development and severity of wound infections. We analyzed the clinical data on 207 consecutive patients who underwent biliary surgery for benign diseases at our hospital. We identified the factors with the greatest influence on wound infection after biliary tract surgery, based on a statistical procedure. An original scoring system (ISSI predictive score) was proposed based on these risk factors. The incidence of postoperative wound infection was 9.7% (20/207). The patient's performance status; bile culture; perioperative fasting period (days); and intraoperative bile spillage were the most influential risk factors for wound infection. The incidences of wound infection in patients with ISSI predictive scores of >2.7 points and those with scores of 0-2.7 points were 75.0% (12/16) and 4.2% (8/191), respectively. Our score also correlated significantly with the severity of wound infection (r = 0.488, P < 0.001) and the length of the postoperative hospital stay (R = 0.508, P < 0.001). Our original scoring system makes it possible to predict not only the development of a wound infection and its severity after biliary tract surgery, but also the length of the postoperative hospital stay.

Retrofascial mesh repair of ventral incisional hernias

Background Recurrence rates after ventral incisional hernia repair are reported to be as high as 33% and are associated with considerable morbidity and lost time. The purpose of this study was to determine if retrofascial mesh placement reduces the incidence of recurrence as well as the severity of wound infections. Methods A prospective database covering the period from January 1995 to June 2003 was maintained. All patients underwent a standardized technique by a single surgeon. Polypropylene mesh was placed between the fascia and the peritoneum with the fascia closed over the mesh. Results There were 150 patients (126 women, 24 men) with a mean age of 55 years. Their average weight was 88 kg, with an average body mass index of 32. Sixty-three (42%) of the hernias were recurrences of a previous repair. The average size of the hernia was 8 × 14 cm. There was 1 postoperative mortality. There was a 9% postoperative infection rate with 2 patients (1%) requiring mesh removal. Long-term follow-up evaluation has revealed 3 recurrences (2%) and 3 readmissions for bowel obstruction with 1 patient requiring surgical release. There were no fistulas noted. Conclusions Incisional hernia repair with mesh placed in the retrofascial position decreases both the risk for recurrence and the severity of wound infection without significant problems from bowel obstruction or enteric fistula.

Povidone-Iodine Solution in Wound Treatment

Clinicians have used numerous strategies to combat wound infections, including topical and systemic administration of antibiotics, and various antiseptic agents such as hypochlorite (bleach) and hydrogen peroxide have been placed on wounds to kill bacteria or inhibit their growth. A commonly used antimicrobial agent is povidone-iodine (Betadine), a complex of iodine, the bactericidal component, with polyvinylpyrrolidone (povidone), a synthetic polymer. The most common commercial form is a 10% solution in water yielding 1% available iodine. Povidone-iodine is available as a surgical scrub or skin cleanser with a detergent base (0.75% available iodine) or in other forms. Decisions regarding choice of wound treatment involve two basic considerations: (1) how safe is the treatment, and (2) how effective is the treatment. The safety of a wound care treatment may be determined by whether the treatment retards the progress of the wound through the stages of healing (inflammatory, proliferative/reepithelializing, and remodeling). The efficacy of a wound care treatment (e.g., povidone-iodine) can be judged in vitro by its ability to kill microorganisms and in vivo by whether it decreases the rate or severity of wound infection. The task of evaluating the choice of povidone-iodine solution for treatment of wounds, especially the chronic wounds most often seen in physical therapy practice, is made complex by two factors. First, although there is a large body of research into various aspects of povidone-iodine use in wound care, the results are not always germane to the types of wound treatment most often provided by physical therapists. The relevance of in vitro studies regarding safety and effectiveness to in vivo use with patients may be limited. Much of the published research on wound healing uses animal wound models; however, the applicability of findings in animal studies to human wounds has been questioned.

Bacteriological investigations for determining the kind and the severity of wound infection. (Polish)

Bacteriological investigations for determining the kind and the severity of wound infection. (Polish)

Isolation of incisions into body cavities

A new plastic device for isolating the edges of incisions into body cavities is described and illustrated. The device, called an incision liner, has certain advantages over conventional technics of covering wound margins. In a group of patients who underwent abdominal operations the use of the incision liner seemed to be effective in minimizing the incidence and severity of wound infections.