A non-inferiority study comparing efficacy of preoperative prophylactic antibiotics for preventing infectious complications in patients with less severe burns

Hill, David M.; Guido, Alexandra; Sultan-Ali, Ibrahim; Arif, Faisal; Velamuri, Sai R

doi:10.1016/j.burns.2020.10.028

Cited by 11 publications

(6 citation statements)

References 24 publications

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“…Research has been inconclusive on the use of specific types of dressings after surgery and the timing of dressing removal as preventive measures. [21][22][23][24] In addition, this study demonstrated that smoking could cause delayed wound healing in patients after surgery, possibly because carbon monoxide produced by smoking interferes with the formation of new blood vessels and has a high affinity for hemoglobin, thereby reducing tissue oxygen supply, whereas the nicotine contained in cigarettes may cause platelet aggregation and inhibit RBC action, reduce tissue perfusion and affect wound healing. 25 Therefore, the effect of smoking on wound healing should be fully considered when formulating a treatment plan.…”

Section: Discussionmentioning

confidence: 86%

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A New Predictive Nomogram for the Risk of Delayed Incision Healing After Open Posterior Lumbar Surgery

Jiang

Peng

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: This was a primary research study. Objective: A risk nomogram was established and externally validated by exploring the related risk factors for delayed incision healing in patients undergoing open posterior lumbar surgery. Summary of Background Data: The use of a nomogram model to predict prognosis in patients with delayed incision healing is an evolving field given the complex presentation of patients with this condition. Patients and Methods: This study reviewed 954 patients with data collected from January 2017 to December 2021 who were randomized into a training set and a validation set (7:3). We built a prediction model based on a training set of 616 patients. The “least absolute shrinkage and selection operator” regression model was applied to screen out the optimal prediction features, and binary logistic regression was used to develop a prediction model. The discrimination, calibration, and clinical applicability of the prediction model were assessed by using the area under the curve, C-index, calibration curve, and decision curve analysis. Results: Postoperative delayed incision healing occurred in 214 (24.4%) patients. The least absolute shrinkage and selection operator regression model showed that smoking, white blood cell count, infection, diabetes, and obesity were involved in delayed incision healing (P ≠ 0). A binary logistic regression model confirmed that smoking [odds ratio (OR) = 3.854, 95% CI: 1.578~9.674, P = 0.003], infection (OR = 119.524, 95% CI: 59.430~263.921, P < 0.001), diabetes (OR = 3.935, 95% CI: 1.628~9.703, P = 0.003), and obesity (OR = 9.906, 95% CI: 4.435~23.266, P < 0.001) were predictors of delayed incision healing, and a nomogram model was established. The area under the curve was 0.917 (95% CI: 0.876–0.959). The calibration curve showed good consistency. Decision curve analysis showed that when the risk threshold of delayed incision healing was >5%, the use of this nomogram was more clinically valuable. Conclusions: Smoking, infection, diabetes, and obesity are risk factors for delayed incision healing. The nomogram model could be used to predict the risk of delayed incision healing and could provide a reference for early clinical intervention.

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Section: Discussionmentioning

confidence: 86%

“…Due to the special location and size of the incision in open spinal surgery, postoperative incision infection is an important factor leading to morbidity and mortality. Research has been inconclusive on the use of specific types of dressings after surgery and the timing of dressing removal as preventive measures 21–24 …”

Section: Discussionmentioning

confidence: 99%

A New Predictive Nomogram for the Risk of Delayed Incision Healing After Open Posterior Lumbar Surgery

Jiang

Peng

et al. 2023

Clinical Spine Surgery: A Spine Publication

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“…No se recomienda la profilaxis antibiótica sistémica en pacientes quemados (43)(44)(45)(46). Esta es una recomendación fuerte con alta calidad de evidencia actualizada por ISBI, en mayo de 2023 (22).…”

Section: Profilaxis Antibiótica En Quemadosunclassified

Prevenciòn de infecciones asociadas a cuidados de la salud en pacientes quemados

Biglia,

Clara,

Colque

et al. 2024

ASEI

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Las infecciones asociadas a cuidados de la salud(IACS) son una de las complicaciones más importantes que presentan los pacientes gran quemados. Aumentan su morbimortalidad, la duración de su estadía, el consumo de antimicrobianos, y los costos hospitalarios. Las tasas reportadas de IACS son muy variables entre los distintos países y centros de atención. El ánimo de ésta publicación es brindar el material necesario y actualizado de las medidas de control de infecciones que se deben implementar en la atención de los quemados ya que no es fácil disponer de información sobre este tema. En la presente revisión se analizaron estudios de distintas poblaciones, adultos y niños, con diferentes tipos quemaduras y diversos lugares de atención..Se utilizò como material de referencia las recomendaciones vigentes de la Sociedad Internacional de injurias por Quemaduras-ISBI- y se adicionaron publicaciones y experiencias de grupos de trabajo local e internacional referentes en el tema. Se describen cinco tipos de medidas de control y prevención de IACS:.Medidas generales, Medidas de higiene ambiental,Prevención de la infección de los lechos de las quemaduras,Profilaxis antibiótica y medidas de prevención de neumonía , infecciones asociadas a catèteres vasculares y vesicales en quemados. Conclusión: es esencial implementar un enfoque proactivo y multidisciplinario del control de infecciones en la atención de estos pacientes, generando recomendaciones adaptadas a la realidad de cada centro de salud, destinadas a disminuir las transmisiòn cruzada de microorganismos, utilizar los antimicrobianos tòpicos y sistémicos en forma adecuada, disminuir la multirresistencia, reducir las IACS y su mortalidad.

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“…However, current standard of care guidelines discourage the use of antibiotics on admission due to the rise of MDROs. Despite some surgical guidelines advocating for the use of pre-operative antibiotics, recent studies suggest that withholding antibiotics does not place the patient at any greater risk [84]. It should be emphasized that the timing and dosing of antibiotics need to be tailored to each patient and cannot be calculated without an in-depth understanding of the pharmacodynamic (PD) and pharmacokinetic (PK) properties of the drugs.…”

Section: Pharmacokinetics and Pharmacodynamics Of Antibioticsmentioning

confidence: 99%

Infection and Burn Injury

Kelly

Oliver

Carney

et al. 2022

EBJ

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Burn injury is debilitating and among one of the most frequently occurring traumas. Critical care improvements have allowed for increasingly positive outcomes. However, infection, whether it be localized to the site of the wound or systemic in nature, remains a serious cause of morbidity and mortality. Immune suppression predisposes the burn population to the development of invasive infections; and this along with the possibility of inhalation injury puts them at a significant risk for mortality. Emerging multi-drug-resistant pathogens, including Staphylococcus aureus, Enterococcus, Pseudomonas, Acinetobacter, Enterobacter, and yeast spp., continue to complicate clinical care measures, requiring innovative therapies and antimicrobial treatment. Close monitoring of antimicrobial regimens, strict decontamination procedures, early burn eschar removal, adequate wound closure, proper nutritional maintenance, and management of shock and resuscitation all play a significant role in mitigating infection. Novel antimicrobial therapies such as ultraviolet light, cold plasma and topical antiseptics must continue to evolve in order to lower the burden of infection in burn.

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A non-inferiority study comparing efficacy of preoperative prophylactic antibiotics for preventing infectious complications in patients with less severe burns

Cited by 11 publications

References 24 publications

A New Predictive Nomogram for the Risk of Delayed Incision Healing After Open Posterior Lumbar Surgery

A New Predictive Nomogram for the Risk of Delayed Incision Healing After Open Posterior Lumbar Surgery

Prevenciòn de infecciones asociadas a cuidados de la salud en pacientes quemados

Infection and Burn Injury

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