The Evidence Behind Prophylaxis and Treatment of Wound Infection After Surgery

Al-Dabbagh, Mona; Dobson, Simon

doi:10.1007/978-1-4614-4726-9_11

Cited by 6 publications

(6 citation statements)

References 47 publications

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“…Surgical site infections (SSI) are a common type of healthcare-associated infections and frequent complication of hospitalization, responsible for prolonged hospital stay, increased intensive care unit admissions, hospital readmissions after surgery, significantly increased costs (1300-5000 USD per SSI), and delays to adjuvant systemic therapy; they occur in 2 to 5% of patients undergoing surgery in the USA [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Simone¹,

Sartelli

Coccolini

et al. 2020

World J Emerg Surg

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Background: Surgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to prevent SSI. We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intraabdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections. Methods: The literature was searched for focused publications on SSI until March 2019. Critical analysis and grading of the literature has been performed by a working group of experts; the literature review and the statements were evaluated by a Steering Committee of the WSES.Results: Wound protectors and antibacterial sutures seem to have effective roles to prevent SSI in intra-abdominal infections. The application of negative-pressure wound therapy in preventing SSI can be useful in reducing postoperative wound complications. It is important to pursue normothermia with the available resources in the intraoperative period to decrease SSI rate. The optimal knowledge of the pharmacokinetic/pharmacodynamic characteristics of antibiotics helps to decide when additional intraoperative antibiotic doses should be administered in patients with intra-abdominal infections undergoing emergency surgery to prevent SSI.Conclusions: The current position paper offers an extensive overview of the available evidence regarding surgical site infection control and prevention in patients having intra-abdominal infections.

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Section: Introductionmentioning

confidence: 99%

“…They also a result in deleterious softer endpoints such as patient psychosocial distress, loss of income, and decreased productivity [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Simone¹,

Sartelli

Coccolini

et al. 2020

World J Emerg Surg

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“…Wound infection is a common surgical complication leading to significant mortality and morbidity (Al-Dabbagh and Dobson, 2013). Surgical site infections (SSIs) are the most common type of hospitalacquired infection for surgical patients in both the United Kingdom and United States (Wilson et al, 2004;Lamagni et al, 2015), occurring in about 10% and 38% of patients respectively.…”

Section: What Is the Impact Of Blisters?mentioning

confidence: 99%

A review of blisters caused by wound dressing components: Can they impede post-operative rehabilitation and discharge?

Eastburn

Ousey

Rippon

2016

International Journal of Orthopaedic and Trauma Nursing

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This review highlights that some wound dressings can be the cause of blistering. It also presents the mechanisms by which blisters may be caused by poor choice of dressings. The subsequent impact of the blisters on preventing patient mobility -and hence rehabilitation in terms of physiotherapy -are also identified. The possibility that the clinical sequelae (e.g. delayed wound healing, restricted joint range of motion (ROM), muscle atrophy and increased risk of deep vein thrombosis (DVT)) resulting from this might have a significant and deleterious impact upon patient-related outcomes is discussed. Strategies for the treatment and prevention of blisters are proposed, based upon current knowledge and expertise. The criticality of the wound care specialist and the physiotherapist working together to overcome these challenges and enhance patient care, are underlined. This article is a review of the relevant literature combined with opinions based upon experience and knowledge of the authors.

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“…This condition has consistently been reported to account for up to 25% of all healthcare-associated infections 1 2. Prolonged hospitalisation, more frequent hospital re-admissions after surgery and a greater than twofold increase in costs and mortality have consistently been associated with this condition over the past decade 3 – 9.…”

Section: Introductionmentioning

confidence: 99%

“…In order to minimise the risk of SSI, several perioperative care interventions, including skin cleansing, hair removal, hypothermia prevention and perioperative antibiotic therapy, have been extensively studied over the past two decades 2 16 – 20. However, few studies of the efficacy of surgical primary prevention manoeuvres aimed at reducing contamination within the surgical site exist, especially among patients undergoing prolonged and complex gastrointestinal operations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a dual-ring wound protector for prevention of incisional surgical site infection after Whipple's procedure (pancreaticoduodenectomy) with preoperatively-placed intrabiliary stents: protocol for a randomised controlled trial

et al. 2014

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IntroductionAmong surgical oncology patients, incisional surgical site infection is associated with substantially increased morbidity, mortality and healthcare costs. Moreover, while adults undergoing pancreaticoduodenectomy with preoperative placement of an intrabiliary stent have a high risk of this type of infection, and wound protectors may significantly reduce its risk, no relevant studies of wound protectors yet exist involving this patient population. This study will evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among adults undergoing pancreaticoduodenectomy with preoperatively-placed intrabiliary stents.Methods and analysisThis study will be a parallel, dual-arm, randomised controlled trial that will utilise a more explanatory than pragmatic attitude. All adults (≥18 years) undergoing a pancreaticoduodenectomy at the Foothills Medical Centre in Calgary, Alberta, Canada with preoperative placement of an intrabiliary stent will be considered eligible. Exclusion criteria will include patient age <18 years and those receiving long-term glucocorticoids. The trial will employ block randomisation to allocate patients to a commercial dual-ring wound protector (the Alexis Wound Protector) or no wound protector and the current standard of care. The main outcome measure will be the rate of surgical site infection as defined by the Centers for Disease Control and Prevention criteria within 30 days of the index operation date as determined by a research assistant blinded to treatment allocation. Outcomes will be analysed by a statistician blinded to allocation status by calculating risk ratios and 95% CIs and compared using Fisher's exact test.Ethics and disseminationThis will be the first randomised trial to evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among patients undergoing pancreaticoduodenectomy. Results of this study are expected to be available in 2016/2017 and will be disseminated using an integrated and end-of-grant knowledge translation strategy.Trial registration numberClinicalTrials.gov identifier NCT01836237.

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The Evidence Behind Prophylaxis and Treatment of Wound Infection After Surgery

Cited by 6 publications

References 47 publications

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

A review of blisters caused by wound dressing components: Can they impede post-operative rehabilitation and discharge?

Efficacy of a dual-ring wound protector for prevention of incisional surgical site infection after Whipple's procedure (pancreaticoduodenectomy) with preoperatively-placed intrabiliary stents: protocol for a randomised controlled trial

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