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 that orthopedic complications after open fractures are related to the severity of the fractures, not the timing of the washout. METHODS:Patients and fractures were reviewed retrospectively over 6.3 years, evaluating for demographics, injury severity, location of fracture, mechanism of injury, Gustilo fracture grade, and time from injury to initial washout. Orthopedic wound complication rates were compared using logistic regression. RESULTS:A total of 1,487 open fractures in 1,278 patients were reviewed. Time from injury to washout was 26 to 4,749 min (mean, 510 min), with 48 patients having no washout. Overall, 8.2% of fractures (n=122) had an orthopedic complication, rates of which increased with severity (Injury Severity Score, Abbreviated Injury Score [AIS], and Gustilo class) and blunt injuries but were not related to time to washout. Penetrating injuries showed no difference in complication rates according to time to washout. Lower extremity fractures had a higher rate of complications than those of the upper extremity (odds ratio 2.2), likely because of differences in fracture grade. By multivariable logistic regression, only fracture grade, Revised Trauma Score (RTS), and male gender were independent predictors of wound complications; penetrating trauma was predictive of low risk. Time to washout was not an independent predictor of wound complications. CONCLUSIONS:Although grossly contaminated fractures should not be left unattended, the degree of initial injury, as judged by fracture grade and physiology (RTS), was predictive of orthopedic wound complications, whereas time to washout was not. Hence, there is little benefit of washout in Gustilo grade 1/AIS 1 fractures or penetrating injuries, regardless of grade, and adherence to a specific time to washout is not beneficial.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Schlitzkus LL,Goettler CE,Waibel BH,Sagraves SG,Hasty CC,Edwards M,Rotondo MFdoi
10.1089/sur.2010.075subject
Has Abstractpub_date
2011-10-01 00:00:00pages
359-63issue
5eissn
1096-2964issn
1557-8674journal_volume
12pub_type
杂志文章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: Gallstones and cholecystitis are common clinical problems. There is a wide spectrum of disease severity, from rare symptoms of biliary colic to severe cholecystitis with marked gallbladder infection and inflammation that can cause life-threatening sepsis. The c...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.110
更新日期:2020-05-29 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:In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents. METHODS:In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomon...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.262
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The optimal duration of antimicrobial therapy for treatment of complicated intra-abdominal infections (cIAI) in critically ill surgical patients is unknown. Recent evidence suggests that a short (four-day) course of therapy may be effective, however data in severely critically ill patients are limited. PATI...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.011
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Temporary intra-operative portocaval shunts (TPCS) are believed to improve outcomes after cava-sparing liver transplantation. We hypothesize that decompression of the portal venous system via a TPCS reduces gut congestion, thereby decreasing bacterial translocation. Thus, we sought to clarify whether transpl...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.036
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The third most common healthcare-associated infection is surgical site infection (SSI), accounting for 14%-16% of infections. These SSIs are associated with high morbidity, numerous deaths, and greater cost. METHODS:A prospective study was conducted to assess the incidence of SSI in a single university hosp...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.096
更新日期:2013-06-01 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: 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: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:The prevalence of human immunodeficiency virus (HIV) is disproportionately elevated in trauma patients. Although HIV traditionally has been associated with poorer outcomes among the critically ill, recent evidence suggests that the outcomes of surgical patients have improved with the greater use of antiretro...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.050
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.150
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units. METHODS:A focused review was undertaken o...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2004.5.289
更新日期:2004-10-01 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: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:Antimicrobial resistance is a growing problem in the intensive care setting. This study was designed to evaluate the trends in bacterial prevalence and changes in antibiotic resistance at a large university hospital over the past decade. Antimicrobial resistance data were compared among the surgical intensiv...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629602760105808
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Skin and soft tissue infections are common problems dealt with in emergency departments and medical offices. It is routine practice to prescribe antibiotic agents after incision and drainage of cutaneous abscesses. However, current evidence does not support prescribing oral antibiotic agents after surgical d...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2017.225
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Purpura fulminans (PF) is a rare but lethal complication of severe infection. Aggressive surgical debridement of irreversibly devitalized tissue improves survival frequently at the cost of disfigurement. The ethical dilemma of surrogate decision-making for these often incapacitated patients presents a unique...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.223
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Blood stream infections (BSIs) remain as a serious life-threatening condition after solid organ transplant (SOT). In recent years, a progressive growth in the incidence of bacteremia caused by non-lactose fermenting gram-negative bacilli (NLF GNB) has been observed. NLF GNB led to high mortality among SOT re...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2015.005
更新日期:2015-10-01 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::Broad-spectrum beta-lactam antibiotics have several advantages in the treatment of intra-abdominal infections. These agents are effective against gram-negative rods and anaerobes, reach therapeutic levels rapidly after parenteral administration, and, in the absence of penicillin allergy, generally exhibit low toxicity...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629600321308
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Cefazolin remains the preferred preoperative antibiotic for the majority of surgical procedures. However, outcome evidence supporting current dosing recommendations for pre-operative prophylaxis is scarce, particularly for obese patients. With more than 33% of adults in the United States classified as obese,...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.167
更新日期:2014-08-01 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:BACKGROUND:Current scolicidal agents, which have been used for inactivation of protoscoleces during surgical procedures, are associated with adverse side effects including sclerosing cholangitis. This investigation aimed to evaluate the scolicidal effects of Bunium persicum (Boiss) essential oil against protoscoleces o...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.010
更新日期:2016-12-01 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: Sarcopenia is a syndrome that can have negative consequences after gastric cancer (GC) surgery. This study aims to determine the effect of sarcopenia on surgical site infection (SSI) that develops after open GC surgery. Patients and Met...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.211
更新日期:2020-11-11 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: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:Daptomycin is used increasingly to treat prosthetic joint infection (PJI). A possible side effect of this drug is eosinophilic pneumonia. We describe two patients with PJI treated with daptomycin who had this side effect with different clinical presentations. METHODS:Case reports and review of the literatur...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.200
更新日期:2014-12-01 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