Wound Healing and Infection in Surgery

Sørensen, Lars Tue

doi:10.1001/archsurg.2012.5

Cited by 497 publications

(153 citation statements)

References 147 publications

(195 reference statements)

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“…A large meta-analysis determined the risk for surgical infection among smokers as 1.79 times that of non-smokers. Additionally, former smokers also carry an increased risk versus individuals who have never smoked [26]. Most of our patients were current or former smokers.…”

Section: Discussionmentioning

confidence: 99%

Infection following penile prosthesis placement at an academic training center remains low despite involvement of surgeons-in-training

2018

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PurposePrimary care providers harbor misconceptions regarding penile prosthetic surgery, largely overestimating the rate of infection. Rates of infection following surgery for primary placement and revision are estimated as 1% to 3% and 10% to 18%, respectively. Our objective was to determine the contemporary incidence of infection following inflatable penile prostheses surgery at an academic training center where surgeons-in-training are routinely involved.Materials and MethodsReview of a prospectively collected single-surgeon database was performed. All cases of inflatable penile prostheses placement from January 2011 through June 2017 were reviewed. Information regarding training level of assistant surgeon(s) was collected, and follow-up data was compiled regarding postoperative infections and need for revision surgery.ResultsThree hundred nine cases meeting inclusion criteria were identified. Mean patient age was 64.2 years, and mean follow-up was 28.7 months. Distribution involved 257 (83.2%) for primary placement, 45 (14.6%) for removal/replacement, and 7 (2.3%) in setting of prior device removal. Diabetes was noted in 31.1% of men. Surgeon-in-training involvement was noted in 100% of cases. Infection was confirmed in a patient who had skin breakdown over an area of corporal reconstruction with polytetrafluoroethylene. The overall postoperative infection rate was 0.3%.ConclusionsIn this series from an academic training center, infection following penile prosthetic surgery is low, similar to other centers of excellence, even with 100% involvement of surgeons-in-training. This data should be used to better inform primary care providers and members of the general public potentially interested in restoration of sexual function.

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Section: Discussionmentioning

confidence: 99%

Infection following penile prosthesis placement at an academic training center remains low despite involvement of surgeons-in-training

2018

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“…Smokers were less responsive to periodontal therapy than non-smokers23. Cigarette smoking delays healing process1415 and impairs inflammatory and immune responses to periodontal pathogens, exerting both systemic and local effects24. However, the mechanisms of cigarette smoking on periodontal diseases are still unclear.…”

Section: Discussionmentioning

confidence: 99%

“…However, cigarette smoking has been found to delay this healing process14. Besides, the incidence of delayed healing is double in smokers than in non-smokers15, likely due to the inhibition of stem cell recruitment to tissues and regeneration by cigarette smoking1617. Active components in cigarette smoke will influence these stem cell regenerative potentials and lead to delayed healing phenomena18.…”

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confidence: 99%

Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Huang

Cao

et al. 2015

Sci Rep

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Cigarette smoking contributes to the development of destructive periodontal diseases and delays its healing process. Our previous study demonstrated that nicotine, a major constituent in the cigarette smoke, inhibits the regenerative potentials of human periodontal ligament-derived stem cells (PDLSC) through microRNA (miRNA) regulation. In this study, we hypothesized that the delayed healing in cigarette smokers is caused by the afflicted regenerative potential of smoker PDLSC. We cultured PDLSC from teeth extracted from smokers and non-smokers. In smoker PDLSC, we found significantly reduced proliferation rate and retarded migration capabilities. Moreover, alkaline phosphatase activity, calcium deposition and acidic polysaccharide staining were reduced after BMP2-induced differentiation. In contrast, more lipid deposition was observed in adipogenic-induced smoker PDLSC. Furthermore, two nicotine-related miRNAs, hsa-miR-1305 (22.08 folds, p = 0.040) and hsa-miR-18b (15.56 folds, p = 0.018), were significantly upregulated in smoker PDLSC, suggesting these miRNAs might play an important role in the deteriorative effects on stem cells by cigarette smoke. Results of this study provide further evidences that cigarette smoking affects the regenerative potentials of human adult stem cells.

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“…Among the available variables, we focused on the following preoperative adjusters: age, 12 gender, 12 surgeon, 12 alcohol use, 18 tobacco use, 18,27 Charlson Comorbidity Score, 12 Veterans RAND-12 (VR-12) physical component score (PCS), 12,28–30 VR-12 mental component score (MCS), 31 year of surgery, bilaterality, 32 and BMI. 12,16 Additionally, the PCS improvement model also includes an adjusting variable for the time period in which postoperative PCS was captured.…”

Section: Methodsmentioning

confidence: 99%

Do Aggregate Socioeconomic Status Factors Predict Outcomes for Total Knee Arthroplasty in a Rural Population?

Keeney

Koenig

Paddock

et al. 2017

The Journal of Arthroplasty

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Background We sought to determine whether several pre-operative socioeconomic status (SES) variables meaningfully improve predictive models for primary total knee arthroplasty (TKA) length of stay (LOS), facility discharge, and clinically significant Veterans RAND-12 Physical Component Score (PCS) improvement. Methods We prospectively collected clinical data on 2,198 TKAs at a high-volume rural tertiary academic hospital from April 2011 through March 2016. SES variables included race/ethnicity, living alone, education, employment, and household income, along with numerous adjusting variables. We determined individual SES predictors and whether the inclusion of all SES variables contributed to each 10-fold cross-validated area under the model’s area under the receiver operating characteristic (AUC). We also used 1000-fold bootstrapping methods to determine whether the SES and non-SES models were statistically different from each other. Results At least 1 SES predicted each outcome. Ethnic minority patients and those with incomes<$35,000 predicted longer LOS. Ethnic minority patients, the unemployed, and those living alone predicted facility discharge. Unemployed patients were less likely to achieve PCS improvement. Without the 5 SES variables, the AUC values of the LOS, discharge, and PCS models were 0.74 (95% CI 0.72–0.77, “acceptable”; 0.86 (CI 0.84–0.87, “excellent”); and 0.80 (CI 0.78–0.82, “excellent”), respectively. Including the 5 SES variables, the ten-fold cross-validated and bootstrapped AUC values were 0.76 (CI 0.74–0.79); 0.87 (CI 0.85–0.88); and 0.81 (0.79–0.83), respectively. Conclusions We developed validated predictive models for outcomes after TKA. Although inclusion of multiple SES variables provided statistical predictive value in our models, the amount of improvement may not be clinically meaningful.

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Wound Healing and Infection in Surgery

Cited by 497 publications

References 147 publications

Infection following penile prosthesis placement at an academic training center remains low despite involvement of surgeons-in-training

Infection following penile prosthesis placement at an academic training center remains low despite involvement of surgeons-in-training

Cigarette smoking hinders human periodontal ligament-derived stem cell proliferation, migration and differentiation potentials

Do Aggregate Socioeconomic Status Factors Predict Outcomes for Total Knee Arthroplasty in a Rural Population?

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