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-existing practice guidelines. Methods: The myriad of contributing factors leading to SSIs highlights the need for a multi-faceted approach. Although collaboration and coordination among providers and patients represents a requirement of any sustainable solution, it also creates a space and possible role for innovative technologies and mobile applications utilizing patient-generated health data (PGHD). Results: Upon analysis of hospital practice, we have identified substantial variability in documentation, peri-operative care, and post-discharge instruction with regard to SSI prevention and incision care techniques. This variability is further exacerbated by a loss of information within each transition of patient care. As a result, a patient's risk of SSI often becomes dictated by their provider's preferred (and sometimes arbitrary) peri-operative practices and their own initiative in following poorly explained pre-operative instructions. The quality and efficiency of any subsequent SSI treatment similarly rests on a seemingly inconsistent approach with poor patient instruction for the post-discharge setting. Conclusions: Surgical site infection risk can be mitigated successfully through reliable performance of several evidence-based process measures within the operating room, which are now at the guideline level. However, optimal performance only happens when teams and patients are aligned and truly believe both that the evidence is correct, and that SSIs are preventable. The journey toward this goal will be an iterative process that may take months to years. Although technology can be complementary, it cannot replace human passion for harm prevention.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Collins CR,Wick ECdoi
10.1089/sur.2019.135subject
Has Abstractpub_date
2019-10-01 00:00:00pages
577-580issue
7eissn
1096-2964issn
1557-8674journal_volume
20pub_type
杂志文章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: 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: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:Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the trea...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2012.091
更新日期:2013-08-01 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: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: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:This report is a review of the published literature for studies of triclosan that address mechanism of action, efficacy on skin and in the oral cavity, and the potential for development of resistance. METHODS:Triclosan citations from the past three decades were searched using Medline and other search engine...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2002.3.s1-55
更新日期:2002-01-01 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:Vancomycin is used widely as empiric therapy for gram-positive organisms in patients with an intra-abdominal infection (IAI), even in those with no history of methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. Potential adverse effects of vancomycin include nephrotoxicity, increase...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.211
更新日期:2015-08-01 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
abstract:BACKGROUND:Intestinal fatty acid binding protein (iFABP) is elevated in plasma by intestinal injury. We investigated the influence of surgical trauma and severe sepsis caused by abdominal and pulmonary infection on plasma iFABP concentrations. METHODS:Seventy-nine patients were included in this prospective observation...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.073
更新日期:2015-06-01 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: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:We reported similar rates of ventilator-associated pneumonia (VAP) previously in trauma patients intubated either in a pre-hospital (PH) venue or the emergency department. A subset of PH intubations with continuous quality assessment was re-examined to identify the intubation factors associated with VAP. ME...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.074
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Orbital hydatidosis is rare, accounting for only 1% of all hydatid cysts. Herein we report a case and review the sparse literature. METHODS:Case report and review of pertinent literature. RESULTS:A 74-year-old farmer presented with progressive proptosis and loss of vision of the left eye. Evaluation reveal...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2009.019
更新日期:2010-08-01 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: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: Surgical site infections (SSIs) are recognized complications of surgical procedures. Methicillin-resistant Staphylococcus aureus (MRSA) colonization increases the likelihood of developing SSIs. Decolonization of MRSA has been shown to reduce post-operative SSIs...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.020
更新日期:2020-05-04 00:00:00
abstract::Complicated intra-abdominal infections (cIAIs) are still associated with high morbidity and mortality levels. Early prognostic evaluation is a great challenge, and a serious amount of resources have been used to find the perfect mortality predictor. Monocyte human leukocyte antigen-DR (mHLA-DR) expression has been stu...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2019.050
更新日期:2020-03-01 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: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:Low plasma concentrations and genetic polymorphisms of mannan-binding lectin (MBL) have been associated with infectious disease complications during various conditions. The present study examined the nature and expression of MBL deficiency during a surgery-induced acute-phase response. METHODS:Blood was sam...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.443
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Suppurative kidney infections (SKIs) have potentially lethal implications and a high incidence of treatment-related morbidity and death. Until this point, there has been no study that has derived a prognostic model for adverse early outcomes in SKI. Therefore, our aim was to derive and validate a simple scor...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2010.057
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS:This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, t...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.219
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Surgical site infection (SSI) continues to be a common if often times preventable infection. Considerable patient morbidity and economic cost are the consequences. METHODS:Review of the pertinent English-language literature. RESULTS:The National Surgical Infection Prevention (SIP) Project was an initiative...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2008.9951
更新日期:2008-12-01 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: 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::Multiple organ dysfunction syndrome (MODS) is caused by an overwhelming, uncontrolled systemic inflammatory response that is activated by a number of hostile stimuli including sepsis, hypovolemic shock, and severe trauma resulting in massive tissue injury. The indiscriminate activation of the inflammatory response due...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/109629600750018123
更新日期:2000-10-01 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