Abstract:
BACKGROUND:The utility of hyperbaric oxygen therapy (HBOT) in the treatment of necrotizing soft tissue infections (NSTIs) has not been proved. Previous studies have been subject to substantial selection bias because HBOT is not available universally at all medical centers, and there is often considerable delay associated with its initiation. We examined the utility of HBOT for the treatment of NSTI in the modern era by isolating centers that have their own HBOT facilities. METHODS:We queried all centers in the University Health Consortium (UHC) database from 2008 to 2010 that have their own HBOT facilities (n=14). Cases of NSTI were identified by International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes, which included Fournier gangrene (608.83), necrotizing fasciitis (728.86), and gas gangrene (040.0). Status of HBOT was identified by the presence (HBOT) or absence (control) of ICD-9 procedure code 93.95. Our cohort was risk-stratified and matched by UHC's validated severity of illness (SOI) score. Comparisons were then made using univariate tests of association and multivariable logistic regression. RESULTS:There were 1,583 NSTI cases at the 14 HBOT-capable centers. 117 (7%) cases were treated with HBOT. Univariate analysis showed that there was no difference between HBOT and control groups in hospital length of stay, direct cost, complications, and mortality across the three less severe SOI classes (minor, moderate, and major). However, for extreme SOI the HBOT group had fewer complications (45% vs. 66%; p<0.01) and fewer deaths (4% vs. 23%; p<0.01). Multivariable analysis showed that patients who did not receive HBOT were less likely to survive their index hospitalization (odds ratio, 10.6; 95% CI 5.2-25.1). CONCLUSION:At HBOT-capable centers, receiving HBOT was associated with a significant survival benefit. Use of HBOT in conjunction with current practices for the treatment of NSTI can be both a cost-effective and life-saving therapy, in particular for the sickest patients.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Shaw JJ,Psoinos C,Emhoff TA,Shah SA,Santry HPdoi
10.1089/sur.2012.135subject
Has Abstractpub_date
2014-06-01 00:00:00pages
328-35issue
3eissn
1096-2964issn
1557-8674journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Most HIV-1 replication occurs in secondary lymphoid tissues, and evaluating these tissues is crucial to investigations of pathogenesis. Inguinal lymph nodes (LN) are obtained frequently for these studies as they are readily detectable in most individuals and provide abundant numbers of cells. Knowledge of th...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.218
更新日期:2014-08-01 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: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:The lack of uniformity of criteria for defining recipient-site infection after oral oncologic surgery with simultaneous reconstruction is problematic despite numerous studies on this issue. This study aimed to investigate the difference in the criteria for defining recipient-site infection after oral oncolog...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2017.101
更新日期:2017-10-01 00:00:00
abstract:: Background: The Gatti and the bilateral internal mammary artery (BIMA) scores were created to predict the risk of deep sternal wound infection (DSWI) after bilateral internal thoracic artery (BITA) grafting. Methods: Both score...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.252
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Conceptually, appropriateness of antibiotic therapy includes choice of agent relative to susceptibility of pathogens as well as dosing, timing of onset, and duration of therapy, but is most commonly considered in terms of choice of antibiotic. It has been suggested that inappropriate antibiotic selection can...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2005.6.41
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Metal implants are used frequently in orthopedic procedures and the occurrence of subclinical low-virulence infection is difficult to diagnose. The objective of this study was to examine the hypothesis that peri-prosthetic subclinical infections may be diagnosed effectively in a murine model system using sci...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.186
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Musculoskeletal trauma represents a large source of morbidity in low and middle human development index countries (LMHDICs). Open reduction and internal fixation (ORIF) of traumatic long bone fractures definitively manages these injuries and restores function when conducted safely and effectively. Surgical s...
journal_title:Surgical infections
pub_type: 杂志文章,meta分析,评审
doi:10.1089/sur.2017.273
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The designation "gram-positive bacillus" includes a variety of pleomorphic microorganisms, including diphtheroids, coryneform species, coccobacilli, and other small rods. Despite differing greatly in their virulence, sources, and even genus, these microscopically similar organisms are often difficult to diff...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.085
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Accurate diagnosis and initial management of skin and soft tissue infections (SSTIs) are essential to providing adequate care to patients. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of SSTIs, and surgeons and other healthcare providers should assess these infections caref...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.064.supp
更新日期:2008-01-01 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::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: This study was performed to investigate the combination of admission serum procalcitonin (PCT) and albumin (alb) concentrations as a diagnostic predictor for discriminating patients with nosocomial blood stream infection (BSI) among those with spontaneous intra...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.260
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:By definition, the term "surgical infection" implies that surgery plays the major role in therapy, whereas antimicrobial chemotherapy is only supplementary. Despite this view, the efficacy of such drugs is relevant, and for this reason, drug activity surveillance is necessary, especially for opportunistic an...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.269
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Neutrophil dysfunction has been documented after injury in animals and human beings. This review evaluates the relative effects of the hormonal and endotoxin response to injury on immune resistance. METHOD:Review of the pertinent English-language literature. RESULTS:In volunteers given total parenteral nut...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.161
更新日期:2012-10-01 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: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: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:There has not been an appraisal of outcomes of appendectomy for more than 10 years. More reliable diagnostic techniques and minimally invasive surgery are now in widespread use, yet the impact of these advances remains unknown. METHODS:A retrospective review was performed of 453 patients who underwent appen...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2011.104
更新日期:2012-06-01 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
abstract:: Background: Hand infections can spread quickly and destroy functional structures. Early diagnosis and adequate therapy can prevent severe morbidities. The aim of this study was to evaluate systematically the spread of hand infections according to injury mechanism, pathogen...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.035
更新日期:2020-07-28 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:Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident. METHODS:Case report and literature review. RESULTS:A two-year old boy admitted for elective bilateral osteotomies of tibiae was detected to be febrile at day one post-operatively w...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.192
更新日期:2014-10-01 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:PURPOSE:To discover the incidence of postoperative surgical site infections in non-immunocompromised pediatric patients with an absolute neutrophil count (ANC) < or = 1,000 preoperatively. METHODS:Office and hospital charts of consecutive patients with preoperative ANC < or = 1,000 undergoing elective surgery over a t...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.085
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:An appendectomy is a contaminated or potentially dirty surgical procedure that can be associated with surgical site infection (SSI). METHODS:A single-center unblinded prospective cohort study examined the role of antimicrobial incise film drapes in lowering the rate of SSI after appendectomy. Any patient ag...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.188
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). PATIENTS AND METHODS:Between October 2007 and December 2013, patients who under...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.102
更新日期:2017-02-01 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:Implant-related infections in hand surgery are dreaded complications, potentially leading to loss of finger joint function or amputation. Knowledge about the clinical presentation and treatment concepts of these infections is limited. The aim of this study is to present a consecutive series of patients with ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2018.133
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Portal hypertension in the mucosa of the intestine and the presence of granulomas in the wall of this organ can alter digestive function in patients with schistosomiasis. Citrulline is a potential marker of intestinal function in some diseases that affect the morphometry of the mucosa because of its close as...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.066
更新日期:2010-10-01 00:00:00