Surgical infections
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Surgical infections · Oct 2016
Review Meta AnalysisGentamicin-Collagen Sponges for the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Controlled Trials.
To study the effectiveness of gentamicin-collagen sponges (GCS) for the prevention of surgical site infections (SSIs). ⋯ When analyzing lower-quality studies or only clean procedures, GCS significantly reduced the risk of SSI. Further high-quality randomized studies are needed to confirm the benefit of GCS for lowering mortality rates.
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Surgical infections · Aug 2016
Incidence and Risk Factors for Infection When Teicoplanin Is Included for Prophylaxis in Patients with Hip Fracture.
Surgical site infection (SSI) rate after surgery for hip fracture is about 4%. The aim of the present study was to review the efficacy of dual prophylaxis using teicoplanin plus cefuroxime and risk factors for SSI. ⋯ Dual prophylaxis including cefuroxime and teicoplanin was associated with a 2% rate of SSI. Staphylococcus aureus caused only two SSIs. Reducing SSI is of utmost importance for patients' quality of life and to avoid additional cost of surgical procedures. Therefore, more experience with dual prophylaxis is needed to confirm our results.
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Surgical infections · Jun 2016
ReviewBiology and Metabolism of Sepsis: Innate Immunity, Bioenergetics, and Autophagy.
Sepsis is a complex, heterogeneous physiologic condition that represents a significant public health concern. While many insights into the pathophysiology of sepsis have been elucidated over the past decades of research, important questions remain. This article serves as a review of several important areas in sepsis research. ⋯ Cellular bioenergetic changes provide insight into the development of organ dysfunction in sepsis. Autophagy and mitophagy perform crucial cell housekeeping and stress response functions. Finally, age-related changes and their potential impact on the septic response are reviewed.
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Surgical site infections (SSI) due to Staphylococcus aureus are associated with substantial mortality rates and morbidity. Hence, various strategies are being investigated to prevent them. We explore time trends and risk factors associated with S. aureus SSI to identify high risk patients who might benefit the most from these strategies. ⋯ Future S.aureus SSI prevention measures should focus on patients with risk profiles identified from this and other similar studies.
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Surgical infections · Apr 2016
ReviewPersistent Inflammation, Immunosuppression, and Catabolism: Evolution of Multiple Organ Dysfunction.
Multiple organ dysfunction (MOD) has plagued intensive care units (ICUs) for more than four decades, and its epidemiology has evolved because more patients are surviving previously lethal insults. Over the years, different predominant phenotypes of MOD have been described, all of which have consumed tremendous healthcare resources and have been associated with prolonged ICU stays and prohibitive mortality rates. ⋯ Unfortunately, as our population ages and peri-operative care improves, PICS will become an insurmountable epidemic. We believe PICS is the next horizon in surgical critical care and have developed a program to study the pathogenesis and novel therapies for this vexing problem.