Abstract:
BACKGROUND:Patients with necrotizing soft tissue infections (NSTIs) require prompt surgical debridement, appropriate intravenous antibiotics, and intensive support. Despite aggressive treatment, their mortality and morbidity rates remain high. The benefit of hyperbaric oxygen (HBO) as an adjunctive treatment is controversial. We investigated the effect of HBO in treating NSTIs. METHODS:We analyzed clinical data retrospectively for 78 patients with NSTIs: 30 patients at one center were treated with surgery, antibiotics, and supportive care; 48 patients at a different center received adjunctive HBO treatment. We compared the two groups in terms of demographic characteristics, risk factors, NSTI microbiology, and patient outcomes. To identify variables associated with higher mortality rates, we used logistic regression analysis. RESULTS:Demographic characteristics and risk factors were similar in the HBO and non-HBO groups. The mean patient age was 49.5 years; 37% of the patients were female, and 49% had diabetes mellitus. Patients underwent a mean of 3.0 excisional debridements. The median hospital length of stay was 16.5 days; the median duration of antibiotic use was 15.0 days. In 36% of patients, cultures were polymicrobial; group A Streptococcus was the organism most commonly isolated (28%). We identified no statistically significant differences in outcomes between the two groups. The mortality rate for the HBO group (8.3%) was lower, although not significantly different (p = 0.48), than that observed for the non-HBO group (13.3%). The number of debridements was greater in the HBO group (3.0; p = 0.03). The hospital length of stay and duration of antibiotic use were similar for the two groups. Multivariable analysis showed that hypotension on admission and immunosuppression were significant independent risk factors for death. CONCLUSIONS:Adjunctive use of HBO to treat NSTIs did not reduce the mortality rate, number of debridements, hospital length of stay, or duration of antibiotic use. Immunosupression and early hypotension were important risk factors associated with higher mortality rates in patients with NSTIs.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
George ME,Rueth NM,Skarda DE,Chipman JG,Quickel RR,Beilman GJdoi
10.1089/sur.2007.085subject
Has Abstractpub_date
2009-02-01 00:00:00pages
21-8issue
1eissn
1096-2964issn
1557-8674journal_volume
10pub_type
杂志文章,多中心研究abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) is a common complication of critical illness among surgical and trauma patients. Inappropriate empiric treatment of VAP increases the mortality rate. The rates of Pseudomonas aeruginosa (PA) VAP susceptibility to doripenem (DOR) are higher than those to imipenem-cilastat...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.076
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:A substantial proportion of operative procedures are complicated by infections, either remote from or related to the surgical site. These infections account for substantive morbidity and health care costs. With limited research funds available to study interventions designed to either prevent or reduce the m...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.101
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Negative-pressure wound therapy (NPWT) has been suggetsed to have a positive impact on the healing of sternal or extremity wounds. However, few data deriving from breast surgery have been published. We evaluated the available literature regarding the effectiveness of NPWT systems in the healing of breast tis...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.165
更新日期:2014-12-01 00:00:00
abstract:: Background: The use of mechanical bowel preparation and prophylaxis with oral antimicrobial agents can prevent surgical site infection (SSI) in colorectal surgical procedures, but routine adoption of these and other practices by surgeons has been limited. The aim of this s...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.203
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Extraintestinal Enterobius vermicularis infections are rare but may occasionally affect the female genital tract. Although mostly asymptomatic or causing minor clinical problems, they may lead to severe infectious complications. METHODS:Case report and review of the pertinent English language literature. R...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.090
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Superficial surgical site infection (SSI) can be caused by bacterial invasion during surgery. We investigated whether bacteria are found at the wound margin during surgery and whether a wound protector (WP; Alexis® Wound Retractor; Applied Medical, Rancho Santa Margarita, CA) contributes to preventing invasi...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.072
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Chronic osteomyelitis associated with a stage IV decubitus ulcer is a challenging condition to manage, characterized by frequent relapses and need for long-term anti-microbial therapy. Although gram-positive cocci are the most common causes, fungal infections have been reported, usually in immunocompromised ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.046
更新日期:2018-07-01 00:00:00
abstract:: Background: Operating room (OR) traffic and door openings have emerged as potential modifiable risk factors for the development of surgical site infections. Methods: This study compared the microbial load of a Control OR withou...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.361
更新日期:2020-12-23 00:00:00
abstract:: Background: Biliary tract infection (BTI) is a common complication in patients with biliary obstruction caused by various biliary tract disorders. To improve the management of patients with BTI, microbial profiles from bile cultures and antibiotic resistance patterns were ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.041
更新日期:2019-09-01 00:00:00
abstract::Surgical infections present a significant burden of disease globally. Management focuses on source control and appropriate antibiotic therapy. This remains a challenge in low- and middle-income settings, where access to surgical care and antibiotics is limited. This paper discusses the complex challenges facing the ma...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2018.125
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Bacterial infections are a well-known complication of traumatic amputations. In cases involving contact with soil or water contaminated with manure, one also must be aware of infections with fungi, particularly Scedosporium spp. We report on an immunocompetent trauma patient with an infection caused by a rec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.038
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Intra-abdominal infection may lead to adhesion and abscess formation. An adhesion barrier can reduce these complications but also aggravate intra-peritoneal infection, causing the opposite effects. The fear of infection propagation has limited clinical adhesion barrier use in a contaminated or infected abdom...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.111
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Surgical site infections are the third most common healthcare-associated infection, often leading to prolonged hospital stay and excessive expenditures. Management of these infections has become more challenging due to rising rates of multi-drug-resistant organisms and few new antibiotic options. METHODS:Th...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Invasive mucormycosis or aspergillosis is a life-threatening infection. The disease typically occurs in immunocompromised patients (e.g., those with diabetes mellitus or burns) but is rarely serious in otherwise-healthy young trauma patients. METHODS:Case report and literature review. RESULTS:A previously-...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.065
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Implant infections represent a relevant problem after immediate breast cancer reconstruction. In addition to difficulties in distinguishing early infections from other post-surgical complications (such as hematoma, seroma, and liponecrosis) late breast implant infections still represent a grey area of our kn...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.146
更新日期:2015-10-01 00:00:00
abstract:: Background: In past decades, surgical site infections (SSIs) were neglected and not given much global attention in low- and middle-income countries (LMICs). The risk and incidence of SSIs in LMICs continue to increase. Methods: ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.006
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Central venous catheters (CVCs) are used to deliver a variety of therapies, as well as for measurement of hemodynamic parameters. The major associated complication is catheter-related blood stream infection (CRBSI). METHOD:Review of the pertinent English-language literature. RESULTS:The incidence of CRBSI ...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.7.s2-65
更新日期:2006-01-01 00:00:00
abstract:: Background: Fungal isolates from peritoneal fluid sampling in patients with perforated peptic ulcer (PPU) is not uncommon and its management unclear. This study aims to evaluate whether the presence of fungus in peritoneal fluid cultures is a predictor of morbidity and mor...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.024
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Staphylococcus aureus nasal carriage is an independent risk factor for developing nosocomial infections and for developing surgical site infection (SSI) in particular. The number of post-operative nosocomial S. aureus infections can be reduced by screening patients and decolonizing nasal carriers. In additio...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.022
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Appendectomy for acute appendicitis is an effective, universally accepted procedure performed more than 300,000 times annually in the United States. It is generally believed that appendicitis progresses invariably from early inflammation to later gangrene and perforation, and that appendectomy is required fo...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2007.079
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:With high morbidity and potentially devastating consequences, surgical site infections (SSIs) after cardiac surgery add substantially to the healthcare burden. Inhibiting migration of skin microbes is likely to reduce contamination of the surgical incision by endogenous potential pathogens. We studied the ef...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.050
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Treatment of peritonitis requires prompt surgery and antibiotic therapy. It usually takes two or three days to obtain definitive results of peritoneal cultures and to adapt empirical antibiotic therapy. We assessed the potential time gain associated with direct culture of peritoneal samples on antibiotic aga...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.095
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Selection of a pre-operative hand antisepsis agent has not been studied in relation to surgical site infection (SSI) culture data. In our hospital, we introduced an alcohol-based hand rub (ABR) in 2012 as an alternative to traditional aqueous surgical scrubs (TSS). It was the goal of this study to review any...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.125
更新日期:2017-05-01 00:00:00
abstract:: Background: Within the United States, surgical site infections (SSIs) have now become the most common hospital-acquired infection and impact 2%-5% of all surgical patients. It is estimated that approximately 60% of SSIs could be prevented through improved adherence to pre-...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.135
更新日期:2019-10-01 00:00:00
abstract:: Background: The greatest burden of sepsis- and septic shock-related morbidity and mortality is in low- and middle-income countries (LMICs). Accurate tracking of incidence and outcomes of patients in LMICs with sepsis has been limited by changing definitions, lack of diagno...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.047
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:To determine if there is a difference in periocular post-operative infection rates when utilizing new versus re-processed monopolar electrocautery tips. METHODS:Retrospective cohort study of 4,976 consecutive surgical cases involving 17,149 procedures. Post-operative infections were identified using chart r...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.055
更新日期:2015-06-01 00:00:00
abstract:: Background: Implanting hardware into surgical sites increases the rate of infection associated with these sites. Without novel efforts to reduce this rate of infection, we can expect to see an increase in the number of hardware-associated infections as more patients are im...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.075
更新日期:2020-05-01 00:00:00
abstract:: Background: Coronavirus 2019 (COVID-19) in the post-operative period is challenging. Its clinical manifestations may have similarities to other septic, thoracic, or gastrointestinal post-surgical complications. Additionally, the post-operative period may be a time of incre...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.169
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Group A streptococcal necrotizing soft-tissue infection with toxic shock is a life-threatening disease. Corticosteroid use in the treatment of this process has been reported rarely. METHOD:Case reports and review of pertinent literature. RESULTS:Two infections caused by the same clonal strain of Streptococ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.035
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:This report presents a case of femoral osteomyelitis secondary to urinary tract infection in a female neonate with bilateral urinary duplication and right ectopic ureterocele. METHODS:A female neonate with a history of late perinatal sepsis presented to the emergency department and was found to have left dis...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.075
更新日期:2011-02-01 00:00:00