Reducing Postsurgical Wound Complications: A Critical Review

Delmore, Barbara; Cohen, Joshua M.; O’Neill, Daniel R.; Chu, Andy S; Pham, Vinh; Chiu, Ernest S.

doi:10.1097/01.asw.0000516426.62418.48

Cited by 20 publications

(7 citation statements)

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“…The skin’s integrity can be damaged by trauma, tears, cuts or contusions, resulting in skin wounds. Full-thickness wounds that extend beyond the two layers of skin (dermis and epidermis) heal through a granulation process and scar formation [ 1 ]. Scars are apparently distinguished from the surrounding skin (e.g., darker colour, stretched, depressed or raised), and may also have various symptoms such as inflammation, erythema, pruritus and pain.…”

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Green Tea EGCG on Skin Wound Healing: A Comprehensive Review

Zhong

et al. 2021

Molecules

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Epigallocatechin gallate (EGCG) is associated with various health benefits. In this review, we searched current work about the effects of EGCG and its wound dressings on skin for wound healing. Hydrogels, nanoparticles, micro/nanofiber networks and microneedles are the major types of EGCG-containing wound dressings. The beneficial effects of EGCG and its wound dressings at different stages of skin wound healing (hemostasis, inflammation, proliferation and tissue remodeling) were summarized based on the underlying mechanisms of antioxidant, anti-inflammatory, antimicrobial, angiogenesis and antifibrotic properties. This review expatiates on the rationale of using EGCG to promote skin wound healing and prevent scar formation, which provides a future clinical application direction of EGCG.

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Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Green Tea EGCG on Skin Wound Healing: A Comprehensive Review

Zhong

et al. 2021

Molecules

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“…Seventh, in addition to the discussed patient-related risk factors for SSIs, there are several other modifiable risk factors that were not investigated in this study, but may be the focus of future studies. As reported by Delmore et al 22 , perioperative considerations should include the use of clippers (rather than shaving), avoidance of hypothermia, hypovolemia, and hypotension, the use of oxygen, tension-free closure, and surgical drains where necessary.…”

Section: Discussionmentioning

confidence: 99%

Operating room architecture is not a risk factor for surgical site infections

Jentzsch

Kutschke

Zingg

et al. 2021

Sci Rep

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Surgical site infection (SSI) may cause a substantial burden for patients and healthcare systems. A potential risk of different architectures of the operating room for SSI is yet unknown and was subject of this study. This observational cohort study was performed in a university hospital and evaluated patients, who underwent a broad spectrum of orthopedic surgeries in 2016 (open-plan operating room architecture) versus (vs) 2017 (closed-plan operating room architecture). Patients, who underwent surgery in the transition time period from the open-plan to the closed-plan operating room architecture and those, who were treated e.g. for osteomyelitis as index procedure were excluded. The primary outcome was revision surgery for early SSI within 30 (superficial) or 90 (deep or organ/space) days of surgery. Age, gender, American society of anesthesiologists (ASA) classification, and the body mass index (BMI) were considered as potential interacting factors in a logistic regression analysis. The incidence of revisions for SSI was 0.6 percent (%) (n = 45) in the 7'740 included surgical cases (mean age of 52 (standard deviation (SD) 19) years; n = 3'835 (50%) females). There was no difference in incidences of revision for SSI in the open- vs closed-plan operating room architecture (0.5% vs 0.7%; adjusted odds ratio (OR) = 1.34 (95% confidence interval (CI) 0.72–2.49, P = 0.35)). Age and gender were not a risk factor for revision for SSI. However, ASA classification and BMI were identified as risk factors for the incidence of revision for SSI (OR = 1.92 (95% CI 1.16- 3.18, P = 0.01) and OR = 1.05 (95% CI 1.00–1.11, P = 0.05)). The overall incidence of revisions for early SSI after a broad spectrum of orthopedic surgeries was relatively low (0.6%) and independent from the operating room architecture. An increase in ASA classification and possibly BMI, however, were identified as independent risk factors for revision for SSI.

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“…For example, the presence of free pus is much more common in acute wounds than in hard-to-heal wounds. 23 However, this was not a problem for the validation, as the direct indicators were not analytically evaluated. The validation was primarily concerned with the 'non-direct' indicators and, in particular, with the number of these required to make a diagnosis of local wound infection.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Index for Local Infections score validity: a retrospective European analysis

et al. 2020

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Objective: A score to identify local wound infections was developed by a panel of experts from seven European countries. The Therapeutic Index for Local Infections (TILI) score was designed for health professionals who are not specialised in wound care. This study was carried out to test the validity of the TILI score in everyday practice. Method: Content validity was analysed by means of evaluation by a panel of experts, individually and face-to-face, followed by a European multicentred, retrospective, observational study. Participating clinicians sent anonymised copies of completed TILI scores for patients with leg ulcers along with a photograph of the wound for analysis by two blinded reviewers. Concordance (Kappa index) and convergent criterion validity (sensitivity, specificity, accuracy, Youden's J Index and receiver operator characteristic (ROC) or area under the curve (AUC) curve) were calculated to construct validity and reliability. Results: A total of 307 patients with leg ulcers from seven institutions in five European countries were included in this retrospective analysis. It was shown that the diagnosis of local wound infection could be documented well with five of the six clinical criteria included in the TILI score. By summing up these facultative criteria in comparison with any direct criteria that may be present, there would have been an indication for local antiseptic wound therapy in 22% of patients examined. Conclusions: The results show that the TILI score is concordant with the expert assessment of patients and with good diagnostic characteristics. Thus, the easy-to-use TILI score can now be used in the daily routine practice of health professionals to diagnose local wound infections.

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Reducing Postsurgical Wound Complications: A Critical Review

Cited by 20 publications

References 0 publications

Beneficial Effects of Green Tea EGCG on Skin Wound Healing: A Comprehensive Review

Beneficial Effects of Green Tea EGCG on Skin Wound Healing: A Comprehensive Review

Operating room architecture is not a risk factor for surgical site infections

Therapeutic Index for Local Infections score validity: a retrospective European analysis

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