Obesity and the Risk for Surgical Site Infection in Abdominal Surgery

Winfield, Robert D.; Reese, Stacey; Bochicchio, Kelly; Mazuski, John E.; Bochicchio, Grant V.

doi:10.1177/000313481608200418

Cited by 110 publications

(70 citation statements)

References 19 publications

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“…Pada penelitian ini juga didapatkan pasien berat badan berlebih sebanyak 14 pasien (35%) dengan 9 pasien (22,5%) diantaranya terinfeksi. Hasil ini sejalan dengan penelitian Thelwall et al, (2015) dan Winfield et al, (2016). Pasien dengan berat badan berlebih dan obesitas memiliki oksigenasi lemak subkutan yang lebih rendah dibandingkan pasien dengan berat normal.…”

Section: Gambaran Status Gizi Pasien Infeksi Luka Operasi Pasca Bedahunclassified

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Gambaran Kejadian Infeksi Luka Operasi (Ilo) Pasca Bedah Abdomen Di Rsud Abdul Wahab Sjahranie Samarinda

Azis

Ompusunggu

Irawiraman

2020

jkmm

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Infeksi luka operasi (ILO) adalah infeksi pada bagian tubuh yang terpapar oleh ahli bedah saat prosedur invasive. ILO merupakan salah satu infeksi nosokomial yang paling umum dan paling dapat dicegah diantara infeksi nosokomial lainnya, namun kejadian infeksi luka operasi terutama pada bedah abdomen masih menunjukkan beban yang signifikan. Faktor resiko infeksi luka operasi meliputi usia tua, jenis luka operasi, penyakit penyerta seperti diabetes mellitus, pemberian antibiotik profilaksis yang tidak adekuat, status gizi pasien seperti obesitas dan malnutrisi serta durasi operasi yang panjang. Penelitian ini bertujuan untuk mengetahui gambaran kejadian infeksi luka operasi pasca bedah abdomen di RSUD Abdul Wahab Sjahranie Samarinda. Metode penelitian ini adalah penelitian deskriptif laboratorik. Data penelitian diambil dari swab luka operasi dan data rekam medik pada 40 pasien pasca bedah abdomen yang melakukan pergantian perban pertama kali serta memenuhi kriteria inklusi dan eksklusi. Hasil penelitian menunjukkan 30 orang (75%) pasien mendapatkan infeksi luka operasi. Mayoritas pasien terinfeksi berusia diatas 40 tahun, yaitu pada 15 pasien (37,5%). Sebagian besar pasien terinfeksi mendapatkan luka bersih terkontaminasi, yaitu 23 pasien (57,5%). Mayoritas pasien terinfeksi yaitu 27 pasien (67,5%) tidak memiliki penyakit penyerta. Bakteri gram positif, yaitu Staphylococcus epidermidis merupakan bakteri penginfeksi terbanyak yang teridentifikasi pada 10 orang (33,3%) pasien. Seluruh pasien terinfeksi, yaitu 30 pasien (75%) mendapatkan antibiotik profilaksis. Mayoritas pasien terinfeksi memiliki status gizi normal, yaitu 17 orang (42,5%), dan kejadian infeksi lebih banyak terjadi pada pasien dengan durasi <120 menit, yaitu 20 orang (50%) pasien. Kata Kunci : Infeksi Luka Operasi, ILO, Bedah Abdomen, Faktor Resiko Infeksi Luka Operasi Surgical site infection (SSI) is an infection at the part of the body that was exposed by a surgeon during an invasive procedure. SSI is one of the most common and most preventable nosocomial infection among other nosocomial infections, but the incidence of surgical site infections especially in abdominal surgery still shows a significant burden. Risk factors of surgical site infections include old age, type of surgical wound, comorbidities such as diabetes mellitus, inadequate prophylactic antibiotics, nutritional statuses such as obesity and malnutrition and long duration of surgery. This study aimed to explain an overview of the incidence of postoperative abdominal wound infection in Abdul Wahab Sjahranie General Hospital, Samarinda. This research method was a laboratory descriptive study. The research data was taken from surgical wound swabs and medical record data of 40 post-abdominal surgery patients who made the bandage changes for the first time and met the inclusion and exclusion criteria. The results showed 30 patients (75%) had surgical site infections. The highest percentage of infected patients aged over 40 years, i.e. in 15 people (37.5%). Most of the infected patients had clean contaminated wounds, i.e. in 23 patients (57.5%). The majority of infected patients did not have concomitant diseases, i.e. 27 people (67.5%). Gram-positive bacteria, specifically Staphylococcus epidermidis was the most infectious bacteria identified in 10 patients (33.3%). All infected patients, i.e. 30 patients (75%) received prophylactic antibiotics. The highest frequencies of infected patients had normal nutritional status, i.e.17 patients(42.5%), and the incidence of infection was more common in patients with duration <120 minutes, i.e. 20 patients (50%). Keywords : Surgical Site Infection, SSI, Abdominal Surgery, Risk Factors

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Section: Gambaran Status Gizi Pasien Infeksi Luka Operasi Pasca Bedahunclassified

“…Tingginya kadar lemak subkutan juga menyebabkan pemberian antibiotik profilaksis pada pasien obesitas memerlukan dosis yang lebih besar agar mencapai konsentrasi obat plasma yang sama dengan pasien dengan berat normal (Winfield et al, 2016).…”

Section: Gambaran Status Gizi Pasien Infeksi Luka Operasi Pasca Bedahunclassified

Gambaran Kejadian Infeksi Luka Operasi (Ilo) Pasca Bedah Abdomen Di Rsud Abdul Wahab Sjahranie Samarinda

Azis

Ompusunggu

Irawiraman

2020

jkmm

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“…По данным анализа инфекционных осложнений после абдоминальных операций у 89 148 больных с различными показателями ИМТ, Ож и морбидное Ож являлись независимым фактором риска локальных хирургических инфекций как при «чистых» (ОШ 1,757 и 2,544 соответственно; P<0,001), так и при «инфицированных» (ОШ 1,239 и 1,287 соответственно; P<0,001) хирургических процедурах [44].…”

Section: нозокомиальные инфекцииunclassified

Obesity and infection. Another comorbidity?

Дворецкий¹

2019

Obes. metabol.

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A literature review is devoted to the problem of comorbidity of obesity (Ob) and infections. At present, extensive material has been accumulated about the increased propensity of patients with Ob to various infections (respiratory, urinary, viral, nosocomial, postoperative). One of the pathogenetic mechanisms of infection development in patients with Ob is dysfunction of cellular and humoral immunity, induced by adipose tissue production of cytokines (adipokines), which have an immunomodulating effect in various directions. Further research is needed in the field of epidemiology, mechanisms of development and course of infections in patients with Ob, as well as developing tactics for conducting this category of patients (diagnosis, antibiotic therapy, preoperative preparation, etc.).

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“…One of the most dreaded complications of this operation is a staple line leak with consecutive local or general infection due to the outflow of gastric contents [6]. Patients who undergo sleeve gastrectomy are at high-risk for developing postoperative complications due to their severe obesity and other comorbidities [7,8].…”

Section: Introductionmentioning

confidence: 99%

CT Fluoroscopy-Guided Drain Placement to Treat Infected Gastric Leakage after Sleeve Gastrectomy: Technical and Clinical Outcome of 31 Procedures

Schwarz

Strobl

Paprottka

et al. 2019

Fortschr Röntgenstr

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Purpose To observe the technical and clinical outcome as well as safety of CT fluoroscopy-guided drain placement in the multimodal clinical complication management of superinfected gastric leakage after sleeve gastrectomy. Materials and Methods All consecutive patients who underwent CT fluoroscopy-guided drain placement to treat superinfected postoperative leakage after sleeve gastrectomy in our department between 2007 and 2014 were included in this retrospective study. All interventions were performed on a 16- or 128-row CT scanner under intermittent CT fluoroscopy guidance (15–25 mAs, 120 kV). The technical and clinical success rates as well as complications, additional therapies and patient radiation dose were analyzed. Results 14 patients (mean age: 43.8 ± 11.3 years, mean BMI: 52.9 ± 13.5, 7 women) who underwent a total of 31 CT fluoroscopy-guided drain placement procedures were included. 30 of 31 interventions (96.8 %) were technically successful. 7 patients underwent more than one intervention due to drain obstruction or secondary dislocation or as further treatment. During and after the intervention no procedure-associated complications occurred. In all patients, inflammation parameters decreased within days after the CT-guided intervention. The total interventional dose length product (DLP) was 1561 ± 1035 mGy*cm. Conclusion CT fluoroscopy-guided drain placement has been shown to be a safe minimally invasive procedure that rarely leads to complications for treating superinfected gastric leakage occurring after sleeve gastrectomy. We assume that operative revisions in a high-risk patient group can be avoided using this procedure. Key Points: Citation Format

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Obesity and the Risk for Surgical Site Infection in Abdominal Surgery

Cited by 110 publications

References 19 publications

Gambaran Kejadian Infeksi Luka Operasi (Ilo) Pasca Bedah Abdomen Di Rsud Abdul Wahab Sjahranie Samarinda

Gambaran Kejadian Infeksi Luka Operasi (Ilo) Pasca Bedah Abdomen Di Rsud Abdul Wahab Sjahranie Samarinda

Obesity and infection. Another comorbidity?

CT Fluoroscopy-Guided Drain Placement to Treat Infected Gastric Leakage after Sleeve Gastrectomy: Technical and Clinical Outcome of 31 Procedures

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