Abstract:
BACKGROUND:We defined the contemporary conversion rate from laparoscopic appendectomy (LA) to open appendectomy and identified pre-operative factors associated with conversion. METHODS:Retrospective review of 941 consecutive LAs performed for suspected acute appendicitis in a single urban university hospital between 2000 and 2007. Patient characteristics, clinical features, physical examination findings, laboratory values, computed tomography (CT) findings, surgeon identity, operative findings, and pathologic results were assessed. Categorical variables were compared in patients undergoing LA and those in whom conversion was necessary using the Fisher exact test; the Student t-test was used to compare continuous variables. Multivariable analysis was performed with binomial logistic regression. Statistical significance was established at α = 0.05. RESULTS:The overall conversion rate was 4.1% and did not change significantly over the course of the study. By univariable analysis, conversion was significantly associated with older age, male gender, American Society of Anesthesiologists (ASA) score >2 points, longer duration of symptoms, rigidity on physical examination, increased percentage of neutrophils on admission white blood cell differential count, extraluminal air on CT, inexperience of the attending surgeon with LA, retrocecal location of the appendix, gross necrosis or perforation, murky or purulent ascites, and microscopic evidence of perforation. By multivariable analysis, advanced age (hazard ratio [HR] 1.02 per year; 95% confidence interval [CI] 1.01-1.04, p = 0.02), ASA score >2 points (HR 11.2; 95% CI 5.6-24.4; p < 0.001), CT inflammation grade ≥ 4 (HR 4.8; 95% CI 1.9-12.3; p = 0.001), and attending surgeon inexperience (HR 7.4; 95% CI 2.6-20.8; p < 0.001) were independent predictors of conversion. CONCLUSION:The conversion rate during laparoscopic appendectomy has not changed significantly over the past seven years and remains ~4%. Independent pre-operative predictors of conversion are advanced age, ASA score >2 points, attending surgeon inexperience, and extensive inflammation observed on pre-operative CT scan. Proceeding directly with open appendectomy under these circumstances may reduce operative time, expense, and morbidity.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Wagner PL,Eachempati SR,Aronova A,Hydo LJ,Pieracci FM,Bartholdi M,Umunna BP,Shou J,Barie PSdoi
10.1089/sur.2010.079subject
Has Abstractpub_date
2011-08-01 00:00:00pages
261-6issue
4eissn
1096-2964issn
1557-8674journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these int...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.286
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Pre-existing humoral barriers challenge the transplantation of living donor kidneys (LDK) into highly sensitized ABO- and human leukocyte antigen (HLA)-incompatible recipients. Conditioning these LDK recipients' immune systems is required before they undergo transplantation. We hypothesized that medical dese...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.231
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events fo...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.075
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Colorectal anastomotic leakage (CAL) is the most important complication of colorectal surgery, accounting for one third of post-operative deaths. To prevent it, many interventions have been tested in animal models, mostly rats. However, few of these models have been validated. We aimed to develop a reproduci...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.197
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Tracheostomy is one of the most common procedures performed in trauma patients in the intensive care unit (ICU). Few studies have evaluated the incidence of surgical site infections (SSIs) specifically in a trauma population. Our objective was to compare the incidence of SSI after open versus percutaneous tr...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.059
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Six hours from injury to washout is considered the gold standard in the treatment of open traumatic fractures. Despite this being our hospital policy, the rural nature of our Level I trauma center causes delays in discovery and transport, creating a unique randomization of time to washout. We hypothesized th...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.075
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-op...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2017.058
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The incidence and consequences of post-operative infections in patients undergoing major elective surgery is not well understood. METHODS:Using a large U.S. healthcare claims database, we identified all patients who underwent major elective surgery between January 1, 2007, and December 31, 2009. For each su...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.200
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Colorectal surgical procedures have a high rate of surgical site infection (SSI), and obesity has been implicated as a predictor of such infection. We hypothesized that abdominal wall thickness (AWT), as a metric of obesity, would predict postoperative superficial and deep incisional SSI after colorectal sur...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.109
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The use of silver for the treatment of various maladies or to prevent the transmission of infection dates back to at least 4000 b.c.e. Medical applications are documented in the literature throughout the 17th and 18th centuries. The bactericidal activity of silver is well established. Silver nitrate was used...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2011.097
更新日期:2013-02-01 00:00:00
abstract:: Background: Catheter-associated urinary tract infections (CAUTIs) are associated with urinary catheterization. Up to 25% of hospitalized patients may be catheterized during their stay. Urethral catheters are necessary as part of many urologic procedures, but the removal of...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.223
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:Implant infection is a common clinical complication of abdominal hernia repair. Our objectives were to determine if acellular dermal matrix (ADM) grafts resisted Staphylococcus aureus infection better (as measured by ability to reduce or clear bacterial counts) than synthetic (polytetrafluoroethylene [PTFE])...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2007.044
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The pathogenicity of Enterococcus in polymicrobial surgical infections is controversial. The objective of this analysis was two-fold. The impact of Enterococcus on clinical outcome was assessed in adults with complicated intra-abdominal (IAI), complicated skin and skin structure (CSSSI), or acute pelvic (PI)...
journal_title:Surgical infections
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1089/109629602762539553
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:There is a paucity of data regarding whether sterile handling of endotracheal tubes (ETTs) impacts the incidence and prevalence of pneumonia in the emergency, urgent, or elective clinical scenarios. Intensive care units employ infection control and reduction schemes to reduce pneumonia rates. METHODS:A MEDL...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2006.054
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biof...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.026
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:It has been suggested that the damage observed in invasive amebiasis is related to interactions between polymorphonuclear leukocytes (PMN) and Entamoeba histolytica trophozoites. We analyzed the relation between infiltrating inflammatory cell populations and E. histolytica density in intestinal amebic lesion...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.011
更新日期:2009-04-01 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:Group A Streptococcus (GAS) is an uncommon cause of infection after clean surgery in non-pregnant adults. METHODS:Report of three cases and review of the literature. results: For the first time in France, severe GAS infections were observed in three patients who underwent thyroidectomy at three hospitals. T...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2007.069
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The emergence of multi-drug resistant microorganisms presents a critical problem for patients undergoing surgery. Acidic pH, which is produced by oxidized regenerated cellulose (ORC), is a broad-spectrum physiological detriment to survival of microorganisms known to cause surgical infections. The purpose of ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629603322419599
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Each year, as many as two million operations are complicated by surgical site infections in the United States, and surgical patients account for 30% of patients with sepsis. The purpose of this study was to determine recent trends in sepsis incidence, severity, and mortality rate after surgical p...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.046
更新日期:2009-02-01 00:00:00
abstract:: Background: Rates of infections with multi-drug-resistant organisms (MDROs) are increasing among critically ill patients. Among non-surgical patients, MDROs increase directly the risk of adverse secondary events including death. However, similar effects do not appear to oc...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.240
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The Surviving Sepsis Campaign (SSC) was launched in 2002 as a collaborative initiative of the European Society of Intensive Care Medicine (ESICM), the International Sepsis Forum (ISF), and the Society of Critical Care Medicine (SCCM). Its objective was, through the development and promulgation of evidence-ba...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2010.024
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:In 2013, the Centers for Disease Control and Prevention (CDC) developed new surveillance definitions for ventilator-associated events (VAE), leading to concerns that hospitals may be underreporting the true incidence of ventilator-associated pneumonias (VAPs). We sought to compare rates of clinically diagnos...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.152
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:We aim to assess the patient factors and concomitant infectious outcomes associated with urinary tract infection (UTI) occurrence and the impact of UTI on length of stay (LOS), re-admission, and death in a colorectal surgical population. PATIENTS AND METHODS:National Surgical Quality Improvement Program Use...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.282
更新日期:2017-07-01 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:The aim of this study was to investigate the effect of door opening rates on air quality in the operation room during hip revision surgery by measuring the number of colony forming units per cubic meter (CFU/m(3)). METHODS:During 70 hip revision operations the number of CFU/m(3) was measured at four time po...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.174
更新日期:2016-10-01 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: Multi-drug resistance is considered a serious health threat particularly in the intensive care unit (ICU) setting. Studies evaluating multi-drug-resistant (MDR) pathogens in critically ill trauma patients are limited. The objectives were to describe the inciden...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.031
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Vacuum-assisted fascial closure (VAFC-KCI(®)) of an open abdomen is one of the latest methods. METHODS:A prospective observational study was performed with medical records of nine patients who had been treated by abdominal VAFC-KCI(®) from March 2006 to October 2007 in the Department of Surgical Sciences, U...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.042
更新日期:2010-12-01 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