Background: Wound infections continue to be problematic in clinical practice where empiric treatment of infections is routine. Objectives: A retrospective cross-sectional study to determine the current causative organisms of wound infections and their antibiotic susceptibility patterns in the Niger Delta University Teaching Hospital (NDUTH), Okolobiri, Bayelsa State of Nigeria. Methods: Records of wound swabs collected from 101 patients with high suspicion of wound infection were analysed. Smears from the wound swabs were inoculated on appropriate media and cultured. Bacterial colonies were Gram stained and microscopically examined. Biochemical tests were done to identify pathogen species. The Kirby-Bauer disk diffusion method was used for antibiotic testing. Results: Prevalence of wound infection was 86.13% (CI: 79.41–92.85). Most bacteria were Gram negative bacilli with Pseudomonas aeruginosa being the most prevalent pathogen isolated. The bacterial isolates exhibited a high degree of resistance to the antibiotics tested (42.8% to 100% resistance). All isolates were resistant to cloxacillin. Age group and sex did not exert any effect on prevalence, aetiological agent or antimicrobial resistance pattern. Conclusion: We suggest a multidisciplinary approach to wound management, routine microbiological surveillance of wounds, rational drug use and the institution of strong infection control policies.

Summary:Head injury in children is a major concern all over the world. The increasing level of poverty in the world is exposing more children to trauma situations. The future consequences of trauma in these children are enormous, hence prevention they say, is better than cure.Aim of the Study:The study was designed to determine the etiological pattern, age group affectation and treatment outcome in children managed for head injury in our center.Methods:It was a prospective, descriptive and cross-sectional study of children with head injuries managed in our center from July 2010 to December 2013. Data were collected using structured proforma that was part of our prospective Data Bank approved by our hospital Research and Ethics Committee. Data were collected in accident and emergency unit, Intensive Care Unit, wards and out-patient clinic. The data was analyzed using Epi Info 7 software.Results:Total of 76 children managed by the unit and followed-up to a minimum of 3 months qualified for the study. There were 42 males. The age ranged from 7 months to 18 years with a mean of 8.66 years. There were 30 adolescent/teenagers. Road traffic accident formed 63.15%. Pedestrian accident was more among preschool and school children. Thirty-seven patients had mild head injury. Sixty-six patients were managed conservatively. The commonest posttraumatic effect was seizure (15.79%). Good functional outcome (≥4) was seen in 92.1%. Mode of accident and severity of injury affected the outcome.Conclusions:The etiologies of traumatic brain injury, from our study, were age dependent with falls commonest in toddlers and pedestrian accident commonest in pre-school and school ages. The outcome of treatment was related to severity of injury.

Summary. With increasing use of motorcycle as means of transport in developing countries, traumatic brain injuries from motorcycle crashes have been increasing. The only single gadget that protects riders from traumatic brain injury is crash helmet. Objective. The objectives were to determine the treatment outcome among traumatic brain injury patients from motorcycle crashes and the rate of helmet use among them. Methods. It was a prospective, cross-sectional study of motorcycle-related traumatic brain injury patients managed in our center from 2010 to 2014. Patients were managed using our unit protocol for traumatic brain injuries. Data for the study were collected in accident and emergency, intensive care unit, wards, and outpatient clinic. The data were analyzed using Environmental Performance Index (EPI) info 7 software. Results. Ninety-six patients were studied. There were 87 males. Drivers were 65. Only one patient wore helmet. Majority of them were between 20 and 40 years. Fifty-three patients had mild head injuries. Favorable outcome among them was 84.35% while mortality was 12.5%. Severity of the injury affected the outcome significantly. Conclusion. Our study showed that the helmet use by motorcycle riders was close to zero despite the existing laws making its use compulsory in Nigeria. The outcome was related to severity of injuries.

Introduction: Infected wounds in particular, those associated with antimicrobial resistant microorganisms constitute a significant source of physical, psychological, and economic burden to patients in particular, and the society at large in terms of the huge resources spent in treating such wounds as well as time/days lost at workplaces leading to increased morbidity and mortality globally. The present study sought to investigate and identify the common bacteria associated with wound infections and their antibiotic sensitivity pattern. Material and Methods: A total of 130 wound samples were collected by doctors in ward using Sterile Swab Sticks over a period of 6 months from February-July 2019. Pathogenic bacteria were isolated, identified and their antibiotic susceptibility tests were performed. Results: Among 130 cases, 108 (83.08%) were culture positive for bacterial pathogens, while 22 (16.92%) were bacteriologically sterile (Negative). Rate of infection was high in males (56.15%) than females (43.85%). Of the 108-culture positive, 164 isolates were recovered of which 28 (17.07) were anaerobes, while 136 were aerobes of which 106 (64.64%) were Gram-negative species and 30 (18.29%) Gram-negative species. The predominant isolates among the facultative aerobes, were Pseudomonas aeruginosa 28 (17.07%), followed by E. coli 19 (11.58%), Klebsiella pneumonia 17 (10.37%) while the least were amongst Morganella morgani, Providencia rettgeri and Serretia marcescens with 2 (1.22%) individually. Among the Gram-positive, Staphylococcus aureus 10 (6.10%) were most common, followed by Enterococcus spp 4 (2.44%), Coagulase negative staphylococcus (CoNS) 4 (2.44%) while the least were amongst Streptococcus Group B, Streptococcus Group C, Streptococcus Group G with 2 (1.22%) separately. Amongst the anaerobes, Bacterioides fragilis 16 (9.75%) is the most common, followed by Peptostreptococcus spp., and Prevotella spp with 4 (2.44%) each, while Fusobacterium spp and Veillonella spp were the least, 2 (1.22%) each. Amikacin and nitrofurantoin are the most efficacious for managing wound infections, with all the isolates being susceptible to them. Resistance was moderate to Levofloxacin (49.39%). On the other hand, resistance were above average among Ciprofloxacin (96.34%), Cloxacillin (94.51%), Ceftriaxone (91.46%), Ceftazidine (91.46%), Cefotaxime (87.20%), Erythromycin (59.15%), Ofloxacin (58.54%) and Chloramphenicol (51.22%). The least resistance shown to Gentamicin (16.46%), Streptomycin (16.46%), Imipenem (7.93%), Metronidazole (7.93%), and Piperacillin-tazobactam (7.93%). Conclusion: Antibiotic susceptibility test is suggested prior to administration of antibiotics for successful treatment and intermittent monitoring is also encouraged to check emerging multidrug resistant trends as a guide to health authorities.

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The coronavirus disease 2019 (COVID-19) pandemic affected the delivery of surgical care and services. This review article aims to appraise the impact of COVID-19 on surgical care. The authors discuss the literature on surgery and COVID-19 under the following themes: emergency case triaging, elective surgery triaging, operating on a COVID-19-positive patient, surgical smoke, management of scarce resources, and restarting elective surgery. Most of the large surgical societies recommended and most surgical departments all over the world implemented the cancellation of elective surgeries, while emergency surgeries proceeded as usual. Elective surgeries were triaged taking into consideration the COVID-19 infection rate in the locality, availability of resources, and the need for intensive care unit beds and ventilators. A COVID-19-positive patient should not be denied surgery if indicated, and the recommended precautions and use of personal protective equipment should be adhered to. The generation of surgical smoke occurs in both laparoscopic and open surgeries, and it has not been shown to contain this novel virus. Smoke generation should be minimized and laid down guidelines followed. Laparoscopic surgery seems to have an advantage over open surgery in this regard. In resuming elective surgeries, the local infection rates, bed occupancy rate, and availability of resources should be taken into cognizance. We should learn from this pandemic so as to be prepared for future occurrences, which is a significant possibility.