MyMedR

Clostridium perfringens surgical site infection after osteotomy for knee deformity correction in a non-immunocompromised child

Abd Rashid AH, Ramli R, Ibrahim S

Surg Infect (Larchmt), 2014 Oct;15(5):656-8.

PMID: 24828080 DOI: 10.1089/sur.2012.192

Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident.

Matched MeSH terms: Surgical Wound Infection/microbiology*

Fulltext Risk factors for neurosurgical site infections after a neurosurgical procedure: a prospective observational study at Hospital Kuala Lumpur

Buang SS, Haspani MS

Med J Malaysia, 2012 Aug;67(4):393-8.

PMID: 23082448

Surgical site infection (SSI) after craniotomy even though rare, poses a real risk of surgery and represents a substantial burden of disease for both patients and healthcare services in terms of morbidity, mortality and economic cost. The knowledge of risk factor for surgical site infection after craniotomy will allow the authority to implement specific preventive measures to reduce the infection rate. Therefore, the objectives of this study are to determine the incidence and the risk factors of surgical site infection after craniotomy.

Matched MeSH terms: Surgical Wound Infection/microbiology

Perforated appendicitis--the Malaysian experience

Lee CM, Teoh MK

J R Coll Surg Edinb, 1990 Apr;35(2):83-7.

PMID: 2355382

Perforated appendicitis, with its increased complication rate, today still poses a formidable problem in the Kuala Lumpur General Hospital. Out of 1694 emergency operations performed by our unit in 1987, there were 927 appendicectomies. A retrospective study of these cases showed 126 cases of perforated appendicitis, which were then subjected to detailed analysis. We have a diagnostic accuracy of 81% and perforation rate of 18%. In addition, it is interesting to note the racial differences in the relationship of diagnostic accuracy to perforation rate. Perforation is associated with an increased wound infection rate. Transperitoneal drainage in perforated appendicitis did not lead to a lower incidence of wound infection or improve postoperative performance. Distinguishing between perforated and non-perforated appendicitis may be difficult. Perforation could occur while awaiting operation. We recommend the early administration of systemic antibiotics should appendicectomy be delayed and the cautious use of drains in cases of perforated appendicitis.

Matched MeSH terms: Surgical Wound Infection/microbiology

Fulltext Orthopaedic infections: organisms and antibiotic sensitivity

Yusof MI, Yusof AH

Med J Malaysia, 2004 Dec;59(5):574-7.

PMID: 15889557

Staphylococcus aureus infection remains the commonest organism causing musculoskeletal infection and antibiotic is the mainstay of treatment apart from adequate and appropriate surgical intervention. The exact figure of antibiotic resistance in orthopaedic practice is not known but it is expected to be higher than previously reported as the use of antibiotics is rampant. Its sensitivity to various antibiotics differs from one center to another making local surveillance necessary. From 66 patients with musculoskeletal infections studied in our centre, Staphylococcus aureus was cultured in 50-65% of patients, depending on the sample taken. Fifteen percent of this were methicillin resistant Staphylococcus aureus (MRSA). Staphylococcus aureus was found to be sensitive to cloxacillin in 95% of patients' sample. MRSA remained highly sensitive to vancomycin, clindamycin and fucidic acid.

Matched MeSH terms: Surgical Wound Infection/microbiology*

Fulltext The use of surgical antibiotic prophylaxis in seven Malaysian hospitals

Lim VK, Cheong YM, Suleiman AB

Southeast Asian J. Trop. Med. Public Health, 1994 Dec;25(4):698-701.

PMID: 7667716

A survey on the use of antibiotics in surgical prophylaxis was carried out in seven Malaysian hospitals. Details of antibiotic prescriptions were obtained through questionnaires completed by the prescriber. A total of 430 such prescriptions was analysed. A large number of different antibiotic regimens were used for a variety of surgical procedures. The majority of prescriptions (70%) were issued for procedures where such prophylaxis was probably not necessary. Antibiotics were also often prescribed for durations that were longer than necessary. There is an urgent need to educate surgeons and standardize surgical prophylactic regimens in order to reduce cost and combat the emergence of antibiotic resistance.

Matched MeSH terms: Surgical Wound Infection/microbiology

Case report post-splenectomy sepsis in thalassemic patients

Zarina AL, Hamidah A, Zulkifli SZ, Jamal R

Southeast Asian J. Trop. Med. Public Health, 2005 Mar;36(2):471-3.

PMID: 15916058

Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.

Matched MeSH terms: Surgical Wound Infection/microbiology*

Effectiveness of Probiotic, Prebiotic, and Synbiotic Therapies in Reducing Postoperative Complications: A Systematic Review and Network Meta-analysis

Kasatpibal N, Whitney JD, Saokaew S, Kengkla K, Heitkemper MM, Apisarnthanarak A

Clin Infect Dis, 2017 May 15;64(suppl_2):S153-S160.

PMID: 28475793 DOI: 10.1093/cid/cix114

Background: Microbiome-directed therapies are increasingly used preoperatively and postoperatively to improve postoperative outcomes. Recently, the effectiveness of probiotics, prebiotics, and synbiotics in reducing postoperative complications (POCs) has been questioned. This systematic review aimed to examine and rank the effectiveness of these therapies on POCs in adult surgical patients.

Methods: We searched for articles from PubMed, Embase, Cochrane, Web of Science, Scopus, and CINAHL plus. From 2002 to 2015, 31 articles meeting the inclusion criteria were identified in the literature. Risk of bias and heterogeneity were assessed. Network meta-analyses (NMA) were performed using random-effects modeling to obtain estimates for study outcomes. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated. We then ranked the comparative effects of all regimens with the surface under the cumulative ranking (SUCRA) probabilities.

Results: A total of 2,952 patients were included. We found that synbiotic therapy was the best regimen in reducing surgical site infection (SSI) (RR = 0.28; 95% CI, 0.12-0.64) in adult surgical patients. Synbiotic therapy was also the best intervention to reduce pneumonia (RR = 0.28; 95% CI, 0.09-0.90), sepsis (RR = 0.09; 95% CI, 0.01-0.94), hospital stay (mean = 9.66 days, 95% CI, 7.60-11.72), and duration of antibiotic administration (mean = 5.61 days, 95% CI, 3.19-8.02). No regimen significantly reduced mortality.

Conclusions: This network meta-analysis suggests that synbiotic therapy is the first rank to reduce SSI, pneumonia, sepsis, hospital stay, and antibiotic use. Surgeons should consider the use of synbiotics as an adjunctive therapy to prevent POCs among adult surgical patients. Increasing use of synbiotics may help to reduce the use of antibiotics and multidrug resistance.

Matched MeSH terms: Surgical Wound Infection/microbiology

Dermacyn irrigation in reducing infection of a median sternotomy wound

Mohd AR, Ghani MK, Awang RR, Su Min JO, Dimon MZ

Heart Surg Forum, 2010 Aug;13(4):E228-32.

PMID: 20719724 DOI: 10.1532/HSF98.20091162

Sternal wound infection is an infrequent yet potentially devastating complication following sternotomy. Among the standard practices used as preventive measures are the use of prophylactic antibiotics and povidone-iodine as an irrigation agent. A new antiseptic agent, Dermacyn super-oxidized water (Oculus Innovative Sciences), has recently been used as a wound-irrigation agent before the closure of sternotomy wounds.

Matched MeSH terms: Surgical Wound Infection/microbiology

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