Treatment Of Postoperative Wound Infections Research Articles

Fabrication of Eucalyptus Oil-loaded Ciprofloxacin Hydrochloride Topical Films for Enhanced Treatment of Post-Operative Wound Infection

Background: The efficacious penetration of antimicrobials at infectious sites and the reduction of microbial resistance development are critical in controlling the effective treatment of post-operative wound infection. Methods: To create the enhanced antimicrobial topical films, a solvent casting method for ciprofloxacin hydrochloride (CiproHCl) loaded eucalyptus oil (EO) containing low molecular weight chitosan films was used. Nine batches of CiproHCl with varying chitosan and glycerol concentrations were prepared and tested. Additionally, optimised CiproHCl films with EO were created and tested. The antimicrobial activity of CiproHCl-loaded EO containing low molecular weight chitosan films against S. Aureus, E. Coli, and B. Subtilus was tested. Results: The FT-IR spectroscopy and DSC analysis revealed no interaction between the drug and any of the other excipients, and the drug remained amorphous in chitosan film. The SEM analysis revealed that the prepared CiproHCl-loaded EO-containing films had smooth surfaces and large agglomerates. In vitro drug release testing revealed that the EO-loaded films have a sustained release profile of up to 16 hours with a cumulative drug release of 96.83%. In an ex vivo drug permeation study, CiproHCl-loaded EO-containing films demonstrated 2.44 times more permeation flux than CiproHCl-alone films. After six months, the stability study revealed that the CiproHCl-loaded EO-loaded EO-containing film showed no significant change in drug release profile or folding endurance. Conclusion: This present study highlights the possible usage of CiproHCl-loaded EO containing low molecular weight chitosan films in enhanced post-operative wound treatment.

The effect of two surgical modalities for the treatment of subtrochanteric fractures of the femur on postoperative wound complications in patients: A meta-analysis.

Currently, there are two methods of treating subtrochanteric femur fractures: intramedullary nailing and extramedullary plate fixation. However, it remains to be seen whether internal or external fixation is the primary treatment for subrotator femur fractures in adults. In this meta-analysis, we reviewed the effects of internal and external fixation on the treatment of subrotator and subrotator fractures. Until July 2023, the researchers have been researching the Cochrane Library, Embase, Web of Science and PubMed, with English as their only language. The aims of the study are as follows: (1) to assess the efficacy of internal and external fixation for the treatment of postoperative wound infections in adult patients with subrotator femur fractures; (2) to assess the efficacy of various types of internal fixation for the treatment of adult patients with subrotator femur fractures, including postoperative complications, infections, and operative time. Meta-analysis showed that there was no significant difference in the treatment of subrotator fracture with internal versus external fixation in terms of wound infections, intra-operative bleeding, length of incision, and operative time were not significantly different. Therefore, more research is needed to support these findings with a number of large, high-quality randomized studies.

Infection in neuro-muscular scoliosis deformity correction.

Assess the outcome of a standardised protocol for the treatment of post-operative wound infection in patients undergoing deformity correction for neuro-muscular scoliosis (NMS). Retrospective review of 443 consecutive patients with a minimum 18 months' follow-up, following a primary posterior deformity correction for NMS. In patients who developed a wound complication, the patient demographic and comorbidities, causative pathogen, number of re-operations, length of stay (LOS), rate of cure, and complications were analysed. Forty-four patients (9.9%) developed a wound infection. Marginally more infections were mono-microbial (23) than poly-microbial (21). Coagulase negative staphylococcus and Staphylococcus aureus were the most commonly cultured pathogens. Seventeen patients were treated with antibiotics alone, while 27 patients also required surgical debridement. The average LOS for those treated with antibiotics alone was 12 days (range: 9-15 days), in contrast to those requiring debridement, which was 35 days (range: 35-70 days). All patients were cured from their infection and ultimately achieved fusion. Infection is common in NMS deformity correction. This is marginally more common as a mono-microbial than poly-microbial infection with most pathogens being staphylococcal in origin. Our defined treatment strategy resulted in a cure for all patients and capacity for all patients to achieve fusion.

The use of a vascular patch CorMatrix ECM® for reconstruction of carotid arteries in the treatment of postoperative wound infection

Introduction. Operation site infection after carotid endarterectomy is a rare, but potentially fatal complication. The aim of this paper was to present two cases of using CorMatrix ECMR patch for reconstruction of a damaged artery in the course of an operation site infection. Outline of cases. There was an infection and pseudoaneurysm formation in these patients after carotid endarterectomy; one of them ruptured, causing massive hemorrhage. In both cases, carotid artery was reconstructed using CorMatrix ECMR patch resulting in resolution of infection and postoperative wounds healing with maintained complete patency of carotid arteries. Conclusion. The vascular patch of the extracellular matrix CorMatrix ECMR enables successful and safe angioplasty of an artery.

A Prospective Randomized Trial to Assess Oral Versus Intravenous Antibiotics for the Treatment of Postoperative Wound Infection After Extremity Fractures (POvIV Study): Erratum.

A Prospective Randomized Trial to Assess Oral Versus Intravenous Antibiotics for the Treatment of Postoperative Wound Infection After Extremity Fractures (POvIV Study): Erratum.

Gentamicin-Loaded Polysaccharide Membranes for Prevention and Treatment of Post-operative Wound Infections in the Skeletal System.

To develop polysaccharide-based membranes that allow controlled and localized delivery of gentamicin for the treatment of post-operative bone infections. Membranes made of gellan gum (GUM), sodium alginate (ALG), GUM and ALG crosslinked with calcium ions (GUM+Ca and ALG+Ca, respectively) as well as reference collagen (COL) were produced by freeze-drying. Mechanical properties, drug release, antimicrobial activity and cytocompatibility of the membranes were assessed. The most appropriate handling and mechanical properties (Young's modulus, E=92±4MPa and breaking force, F MAX =2.6±0.1N) had GUM+Ca membrane. In contrast, COL membrane showed F MAX =0.14±0.02N, E=1.0±0.3MPa and was deemed to be unsuitable for antibiotic delivery. The pharmacokinetic data demonstrated a uniform and sustainable delivery of gentamicin from GUM+Ca (44.4±1.3% within 3weeks), while for COL, ALG and ALG+Ca membranes the most of the drug was released within 24h (55.3±1.9%, 52.5±1.5% and 37.5±1.8%, respectively). Antimicrobial activity against S. aureus and S. epidermidis was confirmed for all the membranes. GUM+Ca and COL membranes supported osteoblasts growth, whereas on ALG and ALG+Ca membranes cell growth was reduced. GUM+Ca membrane holds promise for effective treatment of bone infections thanks to favorable pharmacokinetics, bactericidal activity, cytocompatibility and good mechanical properties.

A Prospective Randomized Trial to Assess Oral Versus Intravenous Antibiotics for the Treatment of Postoperative Wound Infection After Extremity Fractures (POvIV Study).

Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious. The POvIV study is a prospective, multicenter, randomized trial to compare PO with IV antibiotic therapy in patients with postoperative wound infections after extremity fractures. Patients between the ages of 18 and 84 who have a culture-positive surgical site infection after internal fixation for fracture repair or arthrodesis are approached for this study, and if they provide consent, are randomly assigned to receive either PO or IV antibiotics. Antibiotic selection is based on culture and sensitivity results. Randomization determines the route of administration. Patients are followed for 1 year after study enrollment. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.

Prevalence of Multidrug Resistant Bacteria in Postoperative Wound Infections at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Background: Postoperative wound infections are major problems throughout the world. Moreover, multidrug resistance (MDR) bacteria pose challenges for control. Hence, this study aimed to determine the prevalence of multidrug resistant bacteria from postoperative wound infections. Methods: A cross-sectional study was conducted from March to August 2015. A total of 197 patients who developed postoperative wound infections after surgery were included. Wound swabs were collected using sterile cotton swabs and dipped into sterile amines transport media. All samples were cultured on blood, MacConkey and mannitol salt agar. Culture positive samples were characterized by gram stain, colony morphology and standard biochemical tests. Antimicrobial susceptibility testing was performed on Muller-Hinton agar using disk diffusion. Data was analyzed using SPSS version 20. Results: Overall bacterial prevalence was 75.6% (n=149/197) and predominant bacterial isolates were Staphylococcus aureus 33.3% (n=56/168) and Escherichia coli 14.3% (n=24/168). Double infections were seen 11.4% (n=17/149) of which 23.5% (n=4/17) Staphylococcus aureus and Pseudomonas spp. occurred together. Highest proportion of bacteria 28.2% (n=42/149) were isolated from orthopedics department followed by general surgery 24.8% (n=37/149). Of all bacterial isolates, the multidrug resistance level was 65.5% (n=110/168). Gram positive and Gram negative bacteria showed an MDR level of 55.3% (n=42/76) and 73.9% (n=68/92) respectively. Amoxicillin (93.5%), ceftriaxone (85.3%) and penicillin (84.5%) were least effective. Conclusion: Aseptic surgical practice and standard operating procedures for wound management should be followed to minimize postoperative wound infections. The possible choices of antibiotic options for treatment of postoperative wound infections are few hence for preventing further emergence and spread of MDR bacteria rational use of antibiotics and regular monitoring of antimicrobial resistance patterns is essential.

Closed Suction Irrigation for the Treatment of Postoperative Wound Infections Following Posterior Spinal Fusion and Instrumentation

Retrospective review of clinical cases. This study describes the success rate of closed suction irrigation system (CSIS) in the treatment of post operative spinal infections. Given the widening use of spinal instrumentation, the management of related postoperative deep wound infections has become increasingly important. In the literature, there have been reports of several treatment methods yet no firmly established protocol for management of postoperative deep wound infections exists. The goal of this study was to determine the effectiveness of our protocol employing (CSIS) in the treatment of postoperative deep wound infections. A retrospective record review of 500 posterior instrumented fusions between 1990 and 2002. Twenty-eight consecutive infections (5%) were diagnosed and treated by a standardized treatment protocol of Incision and Drainage, and CSIS. Cultures were obtained, wounds closed primarily, and appropriate intravenous antibiotic treatments initiated. For statistical evaluation, patients were assigned a risk factor (RF) described by Levi et al (J Neurosurg. 1997;86:975-980). Point values were assigned to medical comorbidities that may contribute to postoperative infection risk; higher RF values indicate an increased risk. Twenty-one acute and 7 late (>6 months) infections were followed for 22.3 months (1-86 months), post-CSIS treatment. Twenty-one (75%) resolved without recurrence with one CSIS treatment. Seven acute infections (25%) required a second course of treatment. Hospitalization for the index procedure averaged 15.4 days; 28.9 days for reinfections. No patient with an acute infection required implant removal. The reinfection group had higher blood loss, more levels fused, and longer hospitalization. The reinfection group was comprised entirely of pediatric patients. No correlation was found between RF values and greater risk of recurrent infection. Removal of implants is unnecessary in acute infections, provided the infection does not return. CSIS is an effective method for treatment of postoperative wound infections following instrumented spinal fusion avoiding the need for secondary closure.

Mechanisms and treatment of postoperative wound infections in instrumented spinal surgery

Purpose of review Patients undergoing spinal surgery with placement of instrumentation are at an increasing risk of developing a postoperative infection. This review identifies the mechanisms and treatment options for postoperative infections in the spine, and how to achieve a reduced incidence. Recent findings The incidence of postoperative surgical site infection in the thoracolumbar spine continues to be relatively low. Certain patients have, however, been identified as having an increased risk of attracting a postoperative infection despite meticulous technique and advanced antibiotics. Patients with diabetes, obesity and trauma are especially at risk and preoperative and postoperative serum glucose control should be a priority. The primary route for infection is direct inoculation of the open wound during surgery, and strategies to reduce intraoperative contamination have been shown to reduce postoperative wound problems. Surgical site infection with hardware in place should have aggressive open debridement and high volume irrigation. The removal of instrumentation is often not required. Summary Postoperative surgical site infection after spinal surgery can potentially be a devastating outcome after a successful operative intervention. The key in management is prevention and modification of known risk factors as well as aggressive debridements when an infection has been identified.

Treatment of postoperative wound infections following spinal fusion with instrumentation.

Postoperative wound infections following spinal fusion with instrumentation often present diagnostic and therapeutic difficulties. This article reviews 34 such infections. An infection rate of 3.7% was noted. Depending on various clinical indicators, treatment strategies included short-course antibiotics, prolonged intravenous antibiotics, or intravenous antibiotics followed by suppressive antibiotics and eventual hardware removal. To eradicate these infections, removal of instrumentation is often required; this option, however, may result in an unstable spine. Treatment algorithms were developed for treatment of postoperative spinal surgical site infections and to minimize the possibility of spine instability. All patients were cured of their infections.

CLINICAL USE OF CEFOPERAZONE IN TREATMENT OF POSTOPERATIVE WOUND INFECTIONS AND INFECTIONS OF ABDOMINAL CAVITY

CLINICAL USE OF CEFOPERAZONE IN TREATMENT OF POSTOPERATIVE WOUND INFECTIONS AND INFECTIONS OF ABDOMINAL CAVITY

Oral Administration of Metaphen in the Treatment of Gastric and Duodenal Ulcers

Article1 January 1933Oral Administration of Metaphen in the Treatment of Gastric and Duodenal UlcersCLARENCE MORTON TRIPPE, A.M., M.D., F.A.C.P.CLARENCE MORTON TRIPPE, A.M., M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-6-7-901 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe opinion is at present generally held that many patients with ulcer belong to the spasmophilic-vasoneurotic type, and therefore antispasmodic drugs, such as atropine and belladonna, in conjunction with the Sippy diet, are used in the treatment of ulcers and nervous dyspepsia. However, it is the opinion of the author (and also that of many other neurologists) that more attention must be paid to direct treatment of the stomach and the intestines, and that one should not rely exclusively on the above and on general methods of psychotherapy and physiotherapy, as, for instance, drug sedatives and stimulants. In the direct...References1 AARON CD: Diseases of the digestive organs with special reference to their diagnosis and treatment, 1918, Lea & Febiger, Philadelphia, 448. Google Scholar2 RAIZISSSEVERAC GWM: A new organic mercury compound with powerful germicidal properties, Jr. Lab. and Clin. Med., 1923, ix, 71-80. Google Scholar3 RAIZISSSEVERAC GWM: Metaphen (4-nitro-3, 5-biacetoxymercuri-2-cresol) and its bactericidal properties, Jr. Infect. Dis., 1927, xl, 447-452. 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CrossrefGoogle Scholar28 SMITHIES F: Observations upon the nature, diagnosis and clinical management of gastric ulcers with suggestions for a rational regimen of treatment, Am. Jr. Med. Sci., 1923, clxvi, 781-801. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Asbury Park, New Jersey PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCertain newer methods of treating peptic ulcer 1 January 1933Volume 6, Issue 7Page: 901-912KeywordsAtropineDietDrug psychotherapyDrugsDuodenal ulcersGastric ulcersOral administrationPhysiotherapySedativesStomach Issue Published: 1 January 1933 PDF DownloadLoading ...