Books on the topic 'Surgical site infection'
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1
Matsumoto, Hiroko. Predicting Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery. [New York, N.Y.?]: [publisher not identified], 2020.
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2
Ireland), HISC (Northern. Northern Ireland surveillance report: Surveillance of surgical site infection related to procedures performed by orthopaedic surgeons in Northern Ireland, 2001-2003. Belfast: HISC, 2004.
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Ireland), HISC (Northern. Pan celtic collaborative surveillance report: Surveillance of surgical site infection related to procedures performed by orthopaedic surgeons in Scotland, Wales and Northern Ireland, 2001-2003. Belfast: HISC, 2004.
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4
Surgical site infection. RCOG Press, 2008.
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Marín, Andrés García, and Jaime Ruiz-Tovar. Prophylaxis of Surgical Site Infection in Abdominal Surgery. Nova Science Publishers, Incorporated, 2019.
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Ruiz-Tovar, Jaime. Prophylaxis of Surgical Site Infection in Abdominal Surgery. Nova Science Publishers, Incorporated, 2019.
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7
World Health Organization. Regional Office for Europe. Global Gidelines for the Pevention of Surgical Site Infection. World Health Organization, 2016.
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8
Thompson, Norris B., and SreyRam Kuy. Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery. Edited by SreyRam Kuy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0013.
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This landmark study proposed a model for predicting surgical site infections (SSI). Using logistic regression analysis, variables independently associated with increased risk of SSI were identified, which included smoking, alcohol use, comorbidities, disseminated cancer, weight loss greater than 10%, emergency surgery, and length of operative time. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
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Adams, Debra, and Anna Casey. Infection: prevention, control, and treatment. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642663.003.0014.
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Infection prevention, control, and treatment are vital elements of all healthcare environments. The nurse should have a good working knowledge of policies and procedures to ensure patients are cared for in a clean and appropriate environment. The surgical patient is at risk of developing infections, particularly surgical site infections. Most infections are preventable, and measures should be taken at every stage of a patient’s care to reduce the risk of infection.This chapter discusses infection prevention, control, and treatment, including key policies and procedures in the United Kingdom. It provides an overview of microbiology, aseptic technique, antibiotic therapy, and cleanliness standards.
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Damani, Nizam. Manual of Infection Prevention and Control. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198815938.001.0001.
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The Manual of Infection Prevention and Control provides practical guidance on all aspects of healthcare-associated infections (HAIs). It outlines the basic concepts of infection prevention and control (IPC), modes of transmission, surveillance, control of outbreaks, epidemiology, and biostatistics. The book provides up-to-date advice on the triage and isolation of patients and on new and emerging infectious diseases, and with the use of illustrations, it provides a step-by-step approach on how to perform hand hygiene and how to don and take off personal protective equipment correctly. In addition, this section also outlines how to minimize cross-infection by healthcare building design and prevent the transmission of various infectious diseases from infected patients after death. The disinfection and sterilization section reviews how to risk assess, disinfect and/or sterilize medical items and equipment, antimicrobial activities, and the use of various chemical disinfectants and antiseptics, and how to decontaminate endoscopes. The section on the prevention of HAIs reviews and updates IPC guidance on the prevention of the most common HAIs, i.e. surgical site infections, infections associated with intravascular and urinary catheters, and hospital- and ventilator-acquired pneumonias. In view of the global emergence of antimicrobial resistance to the various pathogens, the book examines and provides practical advice on how to implement an antibiotic stewardship programme and prevent cross-infection against various multi-drug resistant pathogens. Amongst other pathogens, the book also reviews IPC precautions against various haemorrhagic and bloodborne viral infections. The section on support services discusses the protection of healthcare workers, kitchen, environmental cleaning, catering, laundry services, and clinical waste disposal services.
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Davies, Patricia. Wound care. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642663.003.0012.
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It is imperative that the surgical nurse has a good understanding of wound care, as all surgical patients will have a wound of some description. Prevention of surgical site infection begins with a pre-operative assessment and continues post-operatively with the assessment of the wound dressing and the surgical site. This chapter discusses the physiology of wound healing, wound assessment, and dressings for primary- and secondary-intention wounds. This chapter also outlines the prevention of surgical site infections, and common wound infections and their treatment.
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Alsulaimy, Mohammad, and Seyed Mohammad Kalantar Motamedi. Bariatric Surgery and Perioperative Infections. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0011.
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Morbid obesity is associated with an increased risk of infectious complications including surgical site, urinary tract, and pulmonary infections. Surgical site infections (SSI) are the most common, followed by urinary and respiratory infections. Various risk factors in obese patients including impaired immunity, and altered pulmonary and circulatory systems contribute to the increased susceptibility of morbid obese patients to infectious complications. Perioperative infections are defined to occur within 30 days of the initial operative procedure. Surgical site and urinary tract infections usually occur within 7–10 days post-operatively. Therefore, it is recommended that patients should be followed up between 7 to 10 days post-op to examine surgical sites, and to screen for possible urinary tract symptoms. This chapter will discuss the diagnosis, treatment, and possible preventative measures of the aforementioned infectious complications in the bariatric surgery population.
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Schelenz, Silke. Fungal diseases of the gastrointestinal tract. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0026.
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Fungal diseases of the gastrointestinal (GI) tract can occur because of an overgrowth of yeast in the gut, exposure to contaminated food and water, or as part of disseminated invasive fungal infections from other sites. The extent of the disease depends on the underlying risk factors, such as diabetes or immunosuppression, and ranges from colonization, localized infection, or fungaemia, to aggressive life-threatening GI tract infections. Candida spp. are the commonest cause of mucosal infection, although mould infections are increasingly reported. Serious invasive mould infections are difficult to diagnose as symptoms are often non-specific. Early recognition, prompt antifungal treatment, and surgical intervention can be lifesaving.
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Ash, Simon A., and Donal J. Buggy. Outcomes of anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0039.
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Prevailing attitudes and conviction maintain that anaesthetic management, while ensuring safety, analgesia, and comfort perioperatively, has little influence on long-term patient outcomes. Gradually accumulating evidence is challenging this conventional wisdom, suggesting that choice of anaesthetic technique and perioperative management may, on the contrary, exert previously unrecognized long-term influences. This chapter seeks to review topical aspects of anaesthesia management which may influence postoperative patient outcomes. These include cardiovascular and pulmonary outcomes, surgical site infection, blood transfusion, perioperative glycaemic control, cancer recurrence, the development of chronic persistent pain, and postoperative cognitive dysfunction.
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Khan, Umraz, Graeme Perks, Rhidian Morgan-Jones, Peter James, Colin Esler, Vince Smyth, and Vanya Gant. Pathways in Prosthetic Joint Infection. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198791881.001.0001.
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This book provides a concise overview of methods of assessing and managing prosthetic joint infection (PJI). It covers the classification of PJI sites, risk factors, and preoperative assessment, before considering safe patient pathways. Drawn from the authors’ clinical experience and a review of the current literature, the book also explains surgical and drug management of acute infection, the management of chronic infection, and specific microbiology issues relating to PJI. Proposed models for revision arthroplasty networks are discussed and future aims are considered. The proposed pathways are backed by illustrated case histories.
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Klein, Eili Y. Antibiotic Resistance. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0068.
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Antibacterial resistance threatens the ability of physicians to treat infections, reversing medical gains and increasing the probability of morbidity and mortality in infected patients. Decreased antibiotic efficacy also threatens advanced surgical procedures dependent on antibiotic effectiveness, such as organ and prosthetic transplants. Even simple procedures consider antibiotic prophylaxis to be a standard means of controlling surgical site infections. Despite the link between increased antibiotic use and resistance, a large fraction of antimicrobial use is inappropriate, particularly for acute respiratory tract infections. Methicillin-resistant Staphylococcus aureus (MRSA) is the most significant antibiotic-resistant pathogen, but new pathogens such as carbapenem-resistant enterobacteriaceae (CRE) are increasing in clinical significance. Antibiotic use and resistance is rising rapidly in developing countries, particularly India, China, and various African countries. The inappropriate use of antibiotics must be reduced, and incentives for the development of new antibiotics should be increased.
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Chinai, Sneha A. Brain Abscess. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0008.
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A brain abscess is a life-threatening infection within the brain that originates as cerebritis and evolves into an encapsulated collection of purulent material. Epidemiologically, brain abscesses are seen more frequently in immunocompromised patients. The signs and symptoms of a brain abscess are influenced by the location and size of the infection, the causative pathogen, and the patient’s immune status and medical comorbidities. This diagnosis requires neurosurgical consultation for management and inpatient admission. The majority of patients undergo either needle aspiration or surgical excision. This is critical for obtaining a specimen for culture in order to direct accurate and specific antimicrobial therapy. Needle aspiration is more commonly utilized and has a lower mortality rate than surgical excision. Repeat imaging is required for any change in mental status. Empiric antibiotic selections are guided by the most likely source of infection and are adjusted for renal function.
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Serfass, Evan R., and Justin D. Ramos. Ventricular Septal Defect. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0007.
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Ventricular septal defect (VSD) is the most common congenital cardiac lesion, and VSDs are found as isolated lesions in up to 20% of children with congenital heart disease. The natural history and pathophysiology of VSD varies by patient age, patient size, anatomic location, and size of the defect. Patients who have large lesions and significant left-to-right shunt resulting in heart failure symptoms, failure to thrive, pulmonary hypertension, or recurrent respiratory infections may be indicated for early surgical repair during infancy. This chapter presents a clinical scenario of a symptomatic infant undergoing primary surgical repair of a VSD to demonstrate principles of the anatomy, pathophysiology, diagnosis, and medical management of patients with VSDs. Anesthetic management is also discussed, considering the effects of left-to-right shunt, pulmonary hypertension, delayed sternal closure, and Eisenmenger’s syndrome.
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Agarwal, Anil, Neil Borley, and Greg McLatchie. General surgery. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0001.
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This chapter covers topics a surgical trainee will find useful. Preoperative assessment covers ASA Grades, NICE guidance, cardiopulmonary exercise testing (CPEX), P-POSSUM. Preoperative medication review covers medications to continue, and medications to be stopped. Consent details test of materiality, Montgomery vs Lanarkshire Health Board, adults who lack capacity, best interests, Advanced Directive, Living Will, Lasting Power of Attorney, Independent Mental Capacity Advocate (IMCA), Gillick Competency, delegation of consent, and consent forms. Surgical site infections (SSIs), NICE guideline on antibiotic prophylaxis, and venous thromboembolism (VTE). The WHO surgery checklist explains team brief, sign in, time out, sign out, debrief. Types of skin preparation—chlorhexadine, betadine. Absorbable, non-absorbable sutures, synthetic, biological meshes. Enhanced recovery, day surgery. Diathermy, ultrasound devices, lasers. Duty of candour. Open and close midline laparotomy incision, induction of pneumoperitoneum, diagnostic laparoscopy. Lichtenstein, totally extraperitoneal (TEP), transabdominal preperitoneal (TAPP), Lockwood, Lothiesen, McEvedy femoral hernia repair, ventral and incisional hernia repair, excision biopsy, abscess incision and drainage, ingrowing toenails.
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Clavijo, Claudia F., Ronnie Zeidan, and Efrain Riveros-Perez. Crisis Management in the Perioperative Setting. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190885885.003.0006.
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Anesthesiologists play a fundamental role in patient safety, particularly in emergent situations or during a crisis in the perioperative setting. Adequate knowledge and constant preparation is required to manage these events appropriately. This chapter discusses the common intraoperative crises that anesthesia residents encounter, especially during the first few months of residency; these include laryngospasm, oxygen failure, anaphylaxis, local anesthetic systemic toxicity, malignant hyperthermia, surgical site infections, and operating room fires. We also review the presentation and pathophysiology and provide step-by-step corrective actions to manage these crises until help arrives, including the use of medications, supplies, and equipment. A stepwise therapeutic approach to cardiac arrest in the operating room is also addressed.
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Laundy, Matthew, Mark Gilchrist, and Laura Whitney, eds. Antimicrobial Stewardship. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198758792.001.0001.
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The problem of antimicrobial-resistant organisms and untreatable infections is of global concern. The concept of antimicrobial stewardship has been developing over the last 10 years. The aim of antimicrobial stewardship is to control antimicrobial use in order to reduce the development of resistance, avoid the side effects associated with antimicrobial use, and optimize clinical outcomes. This book provides a very practical approach to antimicrobial stewardship. It’s very much a ‘how to’ guide supported by a review of the available evidence. Section 1 sets the scene and covers the problem of antimicrobial resistance; the problems in the antimicrobial supply line and initiatives to improve the situation; the principles and goals of antimicrobial stewardship; the psychological, social, cultural, and organizational factors in antimicrobial use and prescribing; and how to establish an antimicrobial stewardship programme. Section 2 reviews the components of antimicrobial stewardship: audit and feedback; antimicrobial policies and formularies; antimicrobial restriction; intravenous to oral switch; measuring antimicrobial consumption; measuring and feeding back stewardship; and the use of information technology in antimicrobial stewardship. Section 3 explores special areas in antimicrobial stewardship: antimicrobial pharmacokinetics and pharmacodynamics; intensive care units; paediatrics; surgical prophylaxis; near-patient testing and infection biomarkers; antimicrobial stewardship in the community and long-term care facilities; and finally antimicrobial stewardship in resource-poor communities.
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Eckert, J., P. Deplazes, and P. Kern. Alveolar echinococcosis (Echinococcus multilocularis). Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0061.
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In this chapter three forms of echinococcosis in humans are described that are caused by a larval stage (metacestode) of Echinococcus multilocularis Leuckart, 1863, Echinococcus oligarthrus (Diesing, 1863) or Echinococcus vogeli Rausch and Bernstein, 1972. E. multilocularis is the causative agent of alveolar echinococcosis (AE). In the human host the metacestode of E. multilocularis behaves like a malignant tumour, characterized by infiltrative proliferation and the potential to induce serious disease. The liver is nearly exclusively the primary site of metacestode development, but metastases may by formed in adjacent and distant organs. Typically AE exhibits a chronic progressive clinical course, which finally leads to death in up to 90% of untreated patients within 10 years after diagnosis. An undefined proportion of cases are abortive with inactivation of the parasite. Evidence has accumulated in recent years that anti-parasitic therapy with benzimidazoles (albendazole or mebendazole) over many years or lifelong, if necessary combined with interventional procedures, can inhibit disease progression and improve or stabilse the patient’s clinical condition. Radical surgery in an early stage of the infection combined with anti-parasitic therapy for two years may lead to cure. The introduction of benzimidazole therapy of AE (1977), combined with improved diagnostic and surgical procedures, has resulted in significantly increased life-expectancies of adequately treated AE patients. In highly endemic areas ultrasound population screening (partially combinated with antibody detection) has been successfully used for early detection of AE cases. Countrywide annual AE incidence rates are mostly low at approximately < 0.1 to 2.0 per 100,000 inhabitants, but they can be much higher locally. Furthermore, there are indications of emerging case numbers in some areas of Europe and Asia. In spite of relatively low case numbers, AE is a significant disease due to its severity and high costs of treatment (median costs of approximately 145,800 per case).
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Sohn, Woon-Mok, and Jong-Yil Chai. Anisakiosis (Anisakidosis). Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0070.
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The term ‘anisakiosis (anisakidosis)’ or ‘anisakiasis’ collectively defines human infections caused by larval anisakids belonging to the nematode family Anisakidae or Raphidascarididae. Anisakis simplex, Anisakis physeteris, and Pseudoteranova decipiens are the three major species causing human anisakiosis. Various kinds of marine fish and cephalopods serve as the second intermediate hosts and the infection source. Ingestion of viable anisakid larvae in the fillet or viscera of these hosts is the primary cause of infection. The parasite does not develop further in humans as they are an accidental host. Clinical anisakiosis develops after the penetration of anisakid larvae into the mucosal wall of the alimentary tract, most frequently the stomach and the small intestine. The affected sites undergo erosion, ulceration, swelling, inflammation, and granuloma formation around the worm. The patients may suffer from acute abdominal pain, indigestion, nausea, vomiting, and in some instances, allergic hypersensitive reactions. Symptoms in gastric anisakiosis often resemble those seen in peptic ulcer or gastric cancer, and symptoms in intestinal anisakiosis resemble those of appendicitis or peritonitis. Treatments include removal of larval worms using a gastroendoscopic clipper or surgical resection of the mucosal tissue surrounding the worm. No confirmed effective anthelmintic drug has been introduced, though albendazole and ivermectin have been tried in vivo and in vitro. Prevention of human anisakiosis can be achieved by careful examination of fish fillet followed by removal of the worms in the restaurant or household kitchen. Immediate freezing of fish and cephalopods just after catching them on fishing boats was reported helpful for prevention of anisakiosis. It is noteworthy that anisakiosis is often associated with strong allergic and hypersensitivity reactions, with symptoms ranging from isolated angioedema to urticaria and life threatening anaphylactic shock.
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Jakobsson, Jan. Anaesthesia for day-stay surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0068.
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Day-stay surgery is becoming increasingly common the world over. There are several benefits of avoiding in-hospital care. Early ambulation reduces the risk for thromboembolic events, facilitates wound healing, and avoiding admission reduces the risk for hospital-related infection. Additionally, the risk of neurocognitive side-effects can be avoided by returning the elderly patient to their home environment. Day-stay anaesthesia calls for adequate and structured preoperative assessment and patient evaluation, and the potential risk associated with surgery and anaesthesia should be assessed on an individual basis. Need for preoperative testing should be based on functional status of the patient and preoperative medical history but even the surgical procedure should be taken into account. Preoperative fasting should be in accordance with modern guidelines, refraining from food for 6 hours and fluids for 2 hours prior to induction in low-risk patients. Preventive analgesia and prophylaxis of postoperative nausea and vomiting (PONV) should be administered preoperatively. Local anaesthesia should be administered prior to incision, constituting part of multimodal analgesia. The multimodal analgesia strategy should also include paracetamol and a non-steroidal anti-inflammatory drug in order to reduce the noxious stimulus from the surgical field. Third-generation inhaled anaesthetics or a propofol-based maintenance are both feasible alternatives. Titrating depth of anaesthesia by using an EEG-based depth of anaesthesia monitor may facilitate the recovery process. The laryngeal mask airway has become commonly used and has several advantages. Ultrasound-guided peripheral blocks may facilitate the early postoperative course by reducing pain and avoiding the use of opiates. Perineural catheters may be an option for prolongation of the block following painful orthopaedic procedures but a strict protocol and follow-up must be secured. Not only pain but even nausea and vomiting should be prevented, and therefore risk stratification, for example by the Apfel score, and PONV prophylaxis in accordance with the risk score is strongly recommended. Early ambulation should be encouraged postoperatively. Safe discharge should include an escort who also remains at home during the first postoperative night. Analgesics should be provided and be readily available for self-care when the patient comes home. Pain medication should include an opioid; however, the benefit versus risk must be assessed on an individual basis. Patients should also be instructed about a rescue return-to-hospital plan. Quality of care should include follow-up and analysis of clinical practice, and institution of methods to improve quality should be enforced for the benefit of the ambulatory surgical patient.