Incidence, aetiology, and control of sternal surgical site infections

Yavuz, Serap Şimşek; Tarçın, Özlem; Ada, Sait; Dinçer, Fitnat; Toraman, S.; Birbudak, S.; Eren, Ergin; Yekeler, İbrahim

doi:10.1016/j.jhin.2013.07.010

Cited by 25 publications

(34 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The reasons for these trends are not clear, but some have proposed that infection prevention measures targeting S. aureus may not be as effective for reducing risk for CNS SSI and that additional measures (eg, environmental decontamination) may be required to reduce CNS SSI risk. 22 Antimicrobial-resistant (AMR) pathogens responsible for SSIs displayed significant trends over time. We observed a reduction in infections due to MRSA, recognizing that widespread reductions in bloodstream infections due to S. aureus and MRSA 23 and low rates of MRSA nonsurgical wound infection in smaller hospitals 24 have previously been reported in Victoria.…”

Section: Discussionmentioning

confidence: 99%

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Worth

Bull

Spelman

et al. 2015

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVETo evaluate time trends in surgical site infection (SSI) rates and SSI pathogens in Australia.DESIGNProspective multicenter observational cohort study.SETTINGA group of 81 Australian healthcare facilities participating in the Victorian Healthcare Associated Infection Surveillance System (VICNISS).PATIENTSAll patients underwent surgeries performed between October 1, 2002, and June 30, 2013. National Healthcare Safety Network SSI surveillance methods were employed by the infection prevention staff at the participating hospitals.INTERVENTIONProcedure-specific risk-adjusted SSI rates were calculated. Pathogen-specific and antimicrobial-resistant (AMR) infections were modeled using multilevel mixed-effects Poisson regression.RESULTSA total of 183,625 procedures were monitored, and 5,123 SSIs were reported. Each year of observation was associated with 11% risk reduction for superficial SSI (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.88–0.90), 9% risk reduction for deep SSI (RR, 0.91; 95% CI, 0.90–0.93), and 5% risk reduction for organ/space SSI (RR, 0.95; 95% CI, 0.93–0.97). Overall, 3,318 microbiologically confirmed SSIs were reported. Of these SSIs, 1,174 (35.4%) were associated with orthopedic surgery, 827 (24.9%) with coronary artery bypass surgery, 490 (14.8%) with Caesarean sections, and 414 (12.5%) with colorectal procedures. Staphylococcus aureus was the most frequently identified pathogen, and a statistically significant increase in infections due to ceftriaxone-resistant Escherichia coli was observed (RR, 1.37; 95% CI, 1.10–1.70).CONCLUSIONSStandardized SSI surveillance methods have been implemented in Victoria, Australia. Over an 11-year period, diminishing rates of SSIs have been observed, although AMR infections increased significantly. Our findings facilitate the refinement of recommended surgical antibiotic prophylaxis regimens and highlight the need for a more expansive national surveillance strategy to identify changes in epidemiology.Infect Control Hosp Epidemiol 2015;00(0): 1–8

show abstract

Section: Discussionmentioning

confidence: 99%

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Worth

Bull

Spelman

et al. 2015

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…This could lead to considerable local relief of postoperative pain and perhaps reduce the administration of systemically acting analgesics. Second, the infection of the sternotomy wound is a common complication after cardiac surgery, which is often associated with mediastinitis and the most protracted wound healing problems with instability of the sternum [79]. A reoperation for revision of the infected and unstable sternum is essential in such cases and not only provides an extremely stressful engagement with additional risks and pain for the patient himself but is usually directly associated with increased postoperative mortality [80].…”

Section: Degradable Sternal Cerclage and Release Of Active Agentmentioning

confidence: 99%

Cardiovascular Applications of Magnesium Alloys

Schilling¹,

Bauer²,

LaLonde³

et al. 2017

Magnesium Alloys

View full text Add to dashboard Cite

Therapy in cardiovascular medicine often relies on implantation of prosthetic materials or application of stents. The diseases of many cardiovascular structures require their complete and immediate repair by utilising prosthetic materials. The ideal cardiovascular prosthesis involves good functional properties, capability of regeneration and does not activate the host's immune system. Ideally, the graft can be applied for a temporary use and degrades after a predefined period according to controlled degradation kinetics. Only biological grafts would provide this spectrum of properties by today's level of knowledge. However, biological prostheses exhibit some relevant drawbacks as well, such as insufficient mechanical stability or restricted availability. Implants or supporting structures of magnesium alloys would bridge this gap and would either provide a substrate for innovative and temporary grafts or would-as supporting structures-transiently add some missing properties to regenerative biological prostheses. This chapter reviews the different fields of cardiovascular therapeutic applications of magnesium alloys. The required properties of magnesium alloys and their preparation, fabrication and testing will be discussed under the specific cardiovascular perspective.

show abstract

“…Ванкомицин был выбран в связи с этиологией стернальной инфекции, в част-ности медиастинита. Наиболее распространенными этиологическими возбудителями являются золоти-стый стафилококк, коагулазонегативные стафилокок-ки и реже грамотрицательные бактерии [28,29,31].…”

Section: вве дениеunclassified

Choise of local antibacterial medications for prevention of sternal infection

et al. 2017

View full text Add to dashboard Cite

Infection of wounds in surgery is one of the most frequent complications in the postoperative period. The development of this complication increases the duration of hospitalization, resulting in higher treatment costs, as well as the impact to the level of hospital mortality. There are many methods are exist to avoid this complication, which are allow to decontamination of pathogenic and conditionally pathogenic microorganisms including applying antimicrobial agents prior to surgery. One such method is intravenous antibiotic shortly before surgery. But there is evidence in the literature of successful local antibiotics in neurosurgery, traumatology and orthopedics, operations on the thorax and abdominal organs, including for prevention of sternal infection. For this purpose most often used vancomycin and gentamicin. This is often a causative agent of wound infection, which is a gram-positive flora: Staphylococcus aureus and Staphylococcus epidermidis. To increase the effectiveness of preventive measures to reduce the incidence of sternal infection intraoperatively topically applied antibiotics in various forms when closing the wound. For parenteral administration of antibiotics effective therapeutic dose is often not achieved, because it depend on the time period since the introduction of the substance until the start of the operation [3]. Local application of antibiotics to a reduction of frequency wound infection, as concentration of a substance is directly dependent on the applied dose.

show abstract

Incidence, aetiology, and control of sternal surgical site infections

Cited by 25 publications

References 20 publications

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

Cardiovascular Applications of Magnesium Alloys

Choise of local antibacterial medications for prevention of sternal infection

Contact Info

Product

Resources

About