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Surgical asepsis

Joshua P Totty, Amy E Harwood, Paris L Cai, Louise H Hitchman, George E Smith, Ian C Chetter
Background: Surgical site infection in vascular surgery has a reported incidence of up to 19%. A novel method of reducing this rate of infection is dressings coated with dialkylcarbamoylchloride (DACC), a hydrophobic wound contact layer that binds bacteria and removes them from the wound bed. Early research has suggested that DACC-coated wound dressings are effective in reducing surgical site infection when applied to wounds healing by primary intention post-operatively, therefore this trial aims to assess the feasibility of producing high-quality evidence assessing this theory...
2019: Pilot and Feasibility Studies
Aakash Agarwal, Christian Schultz, Vijay K Goel, Anand Agarwal, Neel Anand, Steve R Garfin, Jeffrey C Wang
Study Design: A literature review. Objectives: An evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them. Methods: PubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on spine implants, and associated pre- and intraoperative implant processing and handling methodology suggested to avoid them. Systematic reviews, observational studies, bench-top studies, and expert opinions were included...
October 2018: Global Spine Journal
Talel Badri, Houcine Maghrebi, Amal Hamdi, Noura Sellami, Mohamed Jouini, Zoubeir Ben Safta
BACKGROUND: Infection of surgical wounds is the main cause of nosocomial infections. In the event of a defect in the care chain, in particular, during the change of the postoperative dressings, the infectious risk would be increased. AIM: To evaluate the gestures of change of dressing practiced by nurses of a university hospital department of surgery, in order to observe the insufficiencies. METHODS: We conducted a two-month-duration prospective, descriptive study having a qualitative approach, consisting of a protocol for observing nursing procedures carried out during the implementation of postoperative dressings in a university hospital surgery department from Tunis...
June 2018: La Tunisie Médicale
Gladys O Melekwe, Edwin A Uwagie-Ero, Hassan A Zoaka, Eugene A Odigie
Contamination of surgical sites often resulting from inadequate surgical site preparation and poor asepsis is a common cause of surgical site infection (SSI) and postoperative complications. Standard practice ensuring preoperative skin disinfection helps to prevent the incidence of SSI. The choice of antiseptic therefore poses a serious counterbalance for the surgeon. This study was carried out to determine whether skin asepsis immediately prior to surgical site incision will reduce skin microbial burden that may potentiate the incidence of SSI and to compare the clinical effectiveness of chlorhexidine gluconate B...
June 2018: International Journal of Veterinary Science and Medicine
Analia Veitz-Keenan, Debra M Ferraiolo, James R Keenan
Asepsis is described as a state free from microorganisms. In medicine, an aseptic environment is necessary and expected to avoid the spread of infection through contact between persons, sprays and splashes, inhalation, and sharps. Most dental procedures are performed in a "clean "environment with the common use of personal protective equipment (PPE) such as disposable gloves, masks and protective eyewear with disinfection of surfaces and sterilization of instruments. For surgical procedure such as the insertion of endosseous implants, the recommendations are not clear...
2018: European Journal of Oral Implantology
Mustafa Goztok, Mustafa Cem Terzi, Tufan Egeli, Naciye Cigdem Arslan, Aras Emre Canda
BACKGROUND: The aim of this study was to investigate the effect of irrigating the surgical site with 0.05% chlorhexidine gluconate (CHG) on surgical site infection (SSI) in temporary loop ileostomy closure. METHODS: In this observational cohort, patients who underwent diverting loop ileostomy and elective ileostomy closure for any reason between September 2014 and July 2016 were enrolled. Irrigation of the surgical site with 0.05% CHG or saline were compared regarding post-operative incision complications...
August 2018: Surgical Infections
Andrew J Kobets, James T Goodrich
The 19th and 20th centuries heralded the advancement of our understanding of surgical infections, reducing the risk of morbidity and mortality to patients by overturning long-held dogmas surrounding infections and perioperative care. These advancements impacted the development and establishment of the field of neurological surgery by minimizing surgical risk through aseptic techniques and promoting surgical benefit via improved neurological localization and surgical technique. Infections were significant contributors to morbidity and mortality for all surgical patients, and historically almost half of patients lost their lives as a consequence of perioperative wound contamination...
July 10, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Don K Nakayama
Surgical antisepsis and asepsis established the standard of using scientific evidence to determine surgical practice. The microbiological discoveries of Louis Pasteur (1822-1895) were the inspiration for Joseph Lister's (1827-1912) use of carbolic acid as an antiseptic on surgical wounds. German and Swiss surgeons invented aseptic surgical practice based on the studies of Robert Koch (1843-1910), a life-saving revolution in medicine as profound as anesthesia. Together they changed human history, sparing millions the horrors of hospital gangrene and making the entire body accessible to surgical intervention...
June 1, 2018: American Surgeon
Panagiota Copanitsanou, Vasileios A Kechagias, Theodoros B Grivas, Peter Wilson
BACKGROUND: In Greece there is no systematic assessment of surgical wounds with the use of a validated instrument, while the ASEPSIS scoring method has been widely used internationally. AIM: To examine the frequency of wound infections and their correlations both with patient background factors, as well as surgery factors, with the use of ASEPSIS. METHODS: In this prospective, observational study, participants undergoing orthopaedic surgeries in a large hospital in Greece were assessed during hospitalisation and the first month after discharge using the ASEPSIS wound assessment tool...
August 2018: International Journal of Orthopaedic and Trauma Nursing
Luís Belo, Isa Serrano, Eva Cunha, Carla Carneiro, Luis Tavares, L Miguel Carreira, Manuela Oliveira
BACKGROUND: Most of surgical site infections (SSI) are caused by commensal and pathogenic agents from the patient's microbiota, which may include antibiotic resistant strains. Pre-surgical asepsis of the skin is one of the preventive measures performed to reduce SSI incidence and also antibiotic resistance dissemination. However, in veterinary medicine there is no agreement on which biocide is the most effective. The aim of this study was to evaluate the effectiveness of two pre-surgical skin asepsis protocols in dogs...
March 14, 2018: BMC Veterinary Research
Joshua P Totty, Amy E Harwood, Tom Wallace, George E Smith, Ian C Chetter
OBJECTIVE: This study aims to assess whether a clinician reviewing photographs of a wound was an acceptable substitute for clinical review in order to identify or exclude surgical site infection (SSI). METHOD: We undertook a mixed methods study consisting of a qualitative public involvement exercise and a prospective, non-randomised, single-centre study of patients undergoing clean or clean-contaminated vascular surgery. For the qualitative study, two semi-structured focus group interviews were conducted...
March 2, 2018: Journal of Wound Care
Steven I Hajdu
The fields of medicine and oncology made substantial progress between 1800 and 1885. The first half of this period was dominated by the spectacular progress in physiology, cytology, histology, histopathology, and diagnostic microscopy. In the second half of the period, advancements in surgical techniques, anesthesia, asepsis, and laboratory medicine, including bacteriology, chemistry, and biochemistry, led to the development of medical specialties, including surgical pathology and surgical oncology. Although wars, revolutions, and socioeconomic upheavals interrupted the daily life of the populace, distinguished artists, scientists, and physicians continued, against all odds, to advance their field of interest...
January 15, 2018: Cancer
Pankaj Kaul
BACKGROUND: Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. METHODOLOGY AND REVIEW: This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and management of deep sternal wound infections and mediastinitis after cardiac surgery...
November 2, 2017: Journal of Cardiothoracic Surgery
Muhammad Asif Rasheed, Farhan Ahmed Majeed, Syed Zahid Ali Shah, Aneeqa Naz
BACKGROUND: The frequently encountered thoracic trauma in surgical emergencies is a major cause of mortality and morbidity. Eighty percent of thoracic trauma can be managed by simple insertion of tube thoracostomy. Though guidelines for insertion are comprehensively explained in literature, an ideal algorithm for discontinuation is not available. A standard and safe defined protocol would eliminate hesitancy in confident removal among general surgeons. The objective of this study was to determine role of clamping trial prior to removal in terms of frequency of recurrent pneumothorax...
July 2016: Journal of Ayub Medical College, Abbottabad: JAMC
Nelson Bua, George E Smith, Joshua P Totty, Daniel Pan, Tom Wallace, Daniel Carradice, Ian C Chetter
BACKGROUND: Dressings coated with dialkylcarbamoyl chloride (DACC) are highly hydrophobic and irreversibly bind multiple types of bacteria, trapping them in the dressing and reducing the number of organisms at the wound surface. We aimed to assess the impact of DACC-coated postoperative dressings on the incidence of surgical site infection (SSI) in nonimplant vascular surgery patients. METHODS: Two hundred patients undergoing nonimplant vascular surgery were prospectively recruited at a single vascular center...
October 2017: Annals of Vascular Surgery
F Boriani, N Fazio, C Fotia, L Savarino, N Nicoli Aldini, L Martini, N Zini, M Bernardini, N Baldini
Autografts represent the gold standard for peripheral nerve reconstruction but their limited availability, the discrepancy of nerve caliber, and long surgical times are drawbacks. Allografts have therefore become a valid alternative option. In particular, acellular nerve allografts (ANAs) rather than fresh allografts do not need immunosuppression and appear to be safe and effective based on recent studies. An innovative method was conceived to obtain ANAs, so as to speed up nerve decellularization, without compromising nerve architecture, and without breaking the asepsis chain...
August 2017: Journal of Biomedical Materials Research. Part A
B M Gillespie, W Chaboyer, A Erichsen-Andersson, R M Hettiarachchi, S Kularatna
BACKGROUND: Surgical-site infection (SSI) occurs in 1-10 per cent of all patients undergoing surgery; rates can be higher depending on the type of surgery. The aim of this review was to establish whether (or not) surgical hand asepsis, intraoperative skin antisepsis and selected surgical dressings are cost-effective in SSI prevention, and to examine the quality of reporting. METHODS: The authors searched MEDLINE via Ovid, CINAHL via EBSCO, Cochrane Central and Scopus databases systematically from 1990 to 2016...
January 2017: British Journal of Surgery
Alwiena J Blignaut, Siedine K Coetzee, Hester C Klopper, Suria M Ellis
AIMS AND OBJECTIVES: To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. BACKGROUND: Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice...
November 2017: Journal of Clinical Nursing
Adrien Hertault, Jonathan Sobocinski, Rafaëlle Spear, Richard Azzaoui, Matthieu Delloye, Dominique Fabre, Stephan Haulon
The concept of hybrid room was defined as an optimized surgical theater, offering the best compromise between asepsis criteria from standard surgical rooms and high quality imaging equipment from fixed radiological suites. This review aimed at summarizing what vascular surgeons should expect from hybrid rooms in daily practice and in the near future.
April 2017: Journal of Cardiovascular Surgery
Marcela Concha-Rogazy, Catalina Andrighetti-Ferrada, Maximiliano Curi-Tuma
Aseptic techniques are those practices designed to reduce the risk of surgical site infection (SSI), defined as such, all those that occur within the first 30 days of the procedure. While the patient’s risk of developing an SSI in dermatologic surgery is low since many of the procedures are considered sterile, there are different factors associated with an increased or decreased risk of developing SSI. The characteristics of the surgical wound (such as involving infected or inflamed tissue or when breaks in the aseptic technique occur), patient characteristics (such as age, comorbidities, medication use and smoking) and procedure factors (such as setting, surgical technique, type of procedure, duration and body region involved)...
August 2016: Revista Médica de Chile
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