Surgical infections
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Surgical infections · Aug 2007
Review Meta AnalysisSurgical site infections and supplemental perioperative oxygen in colorectal surgery patients: a systematic review.
Four randomized trials have evaluated the impact of supplemental perioperative oxygen on the incidence of surgical site infections (SSIs), with mixed results. The objectives of this meta-analysis were: (1) To evaluate further the effect of supplemental perioperative oxygen on SSIs after colorectal surgery; and (2) to generate a strategy for future studies to determine definitively the value of this intervention. ⋯ Supplemental perioperative oxygen is associated with a lower risk of SSI in patients undergoing colorectal surgery. The heterogeneity among the individual reports may be secondary to differences in study protocols.
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Surgical infections · Aug 2007
Clinical TrialEffect of chlorhexidine/silver sulfadiazine-impregnated central venous catheters in an intensive care unit with a low blood stream infection rate after implementation of an educational program: a before-after trial.
Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate. ⋯ Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.
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Surgical infections · Aug 2007
Single-institutional experience with the surgical infection prevention project in intra-abdominal surgery.
The incidence of surgical site infection (SSI) is becoming a key component of standard measures of quality of performance. We hypothesized that institutional implementation of a protocol targeting known risk factors would reduce the incidence of SSI associated with intra-abdominal surgery. ⋯ The implementation of a prevention protocol resulted in a substantial trend toward a reduction in the incidence of SSI. These data support the use of protocol implementation as a cost-effective method of reducing perioperative infectious morbidity associated with intra-abdominal surgery.
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Surgical infections · Aug 2007
Outcomes of Acinetobacter baumannii infection in critically ill surgical patients.
Multi-drug resistant (MDR) organisms in intensive care units (ICUs) are a growing concern. The emergence of several infections with MDR Acinetobacter baumannii prompted a review of cases and evaluation of the efficacy of intervention. ⋯ The majority of A. baumannii isolates were MDR, and a significant proportion were sensitive only to colistin. Treatment of A. baumannii infection with colistin is effective by both intravenous and nebulized routes of administration. However, infection with A. baumannii in critically ill surgical patients is associated with a high mortality rate, particularly in transplant patients.