Randomized Controlled Trial to Reduce Bacterial Colonization of Surgical Drains with the Use of Chlorhexidine-Coated Dressings After Breast Cancer Surgery

Rivera‐Buendía, Frida; Franco-Cendejas, Rafael; Román-López, Cristina; Colín-Castro, Claudia Adriana; Becerra-Lobato, Noé; Hernández, María de Lourdes García; Cornejo‐Juárez, Patricia; Bargalló-Rocha, Juan Enrique; Medina‐Franco, Heriberto

doi:10.1245/s10434-019-07631-1

Cited by 8 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If this were true, then this would support the use for selective drain tube use. However, the converse argument is that our data supports other similar data in that drain tubes may promote wound infections through colonisation of the drain 30 . A well designed randomised controlled trial will be required to determine the true answer to this longdebated issue.…”

Section: Discussionsupporting

confidence: 86%

Do drain tubes help reduce risks of post‐operative complications in complex incisional hernia repair (as defined by a recent court ruling)?

Luo

Masood

Jinnaah

et al. 2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 86%

Do drain tubes help reduce risks of post‐operative complications in complex incisional hernia repair (as defined by a recent court ruling)?

Luo

Masood

Jinnaah

et al. 2020

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…[70][71][72][73] Drains may be a surrogate marker for more complex hernia surgery or high-risk patients, and thus be identified in univariate analyses as a risk factor for SSIs. [70][71][72][73] Colonization of drains by skin organisms or environmental pathogens, including multi-resistant organisms, occurs after 24 h. 74,75 Surgeons place drains in more than 50% of open VHR repairs. 69 However, the decision to place and subsequently remove CSD in VHR is often related to individual surgeon preference rather than evidence-based practise, due to the paucity of RCTs.…”

Section: Use Of Drains In Hernia Surgerymentioning

confidence: 99%

Risks and Prevention of Surgical Site Infection After Hernia Mesh Repair and the Predictive Utility of ACS-NSQIP

Wilson

Farooque

2022

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Aim The aim of this paper was to provide a narrative review of surgical site infection after hernia surgery and the influence of perioperative preventative interventions. Methods The review was based on current national and international guidelines and a literature search. Results Mesh infection is a highly morbid complication after hernia surgery, and is associated with hospital re-admission, increased health care costs, re-operation, hernia recurrence, impaired quality of life and plaintiff litigation. The American College of Surgeons National Surgical Quality Improvement Program is a particularly useful resource for the study and evidence-based practise of abdominal wall hernia repair. Discussion The three major modifiable patient comorbidities significantly associated with postoperative surgical site infection in hernia surgery are obesity, tobacco smoking and diabetes mellitus. Preoperative optimization includes weight loss, cessation of smoking, and control of diabetes. Intraoperative interventions relate, in particular, to the control of fomite mediated transmission in the operating theatre and prevention of mesh contamination with S. aureus CFUs. Risk management strategies should also target the niche ecological conditions which enable bacterial survival and subsequent biofilm formation on an implanted mesh. Outcomes of mesh infection after hernia surgery are closely related to mesh type and porosity, patient smoking status, presence of MRSA, bacterial adhesion and biofilm production. The use of suction drains and the timing of drain removal are controversial and discussed in detail. Finally, the utility of the ACS-NSQIP Surgical Risk Calculator in predicting complications and outcomes in individual patients and the importance of quality improvement initiatives in surgical units are emphasized.

show abstract

“…As such, serial evaluation of AD-1 concentration, possibly from closed suction drains, may inform infection trajectory and treatment response without the need for needle aspiration. 32,33 Given no prior literature existed utilizing AD-1 as a marker of infection severity, we solely evaluated AD-1 levels in breasts that were returning to the operating room, rather than use it as a tool to guide operative intervention. This may have skewed our patient population to more severe cases of infection.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alpha Defensin-1 Level Correlates with Periprosthetic Infection Severity following Implant-based Breast Reconstruction

Sobti,

Vishwanath,

Stead

et al. 2024

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Accurate diagnosis of periprosthetic infections following breast reconstructions is paramount to reduce morbidity. Alpha defensin-1 (AD-1) is an antimicrobial peptide released by neutrophils. This study evaluates the relationship between quantitative AD-1 levels and infection severity in patients with suspected periprosthetic infection. Methods: Retrospective review was conducted of patients with prior breast implant reconstruction undergoing surgery for either suspected infection or prosthesis exchange and revision. The AD-1 level in periprosthetic fluid was sent for quantitative analysis. Association between AD-1 levels with outcomes, management, systemic markers of infection, and overall infection severity was evaluated. Results: Thirty-eight breasts were included. Infected breasts had higher AD-1 levels (3.91 versus 0.14, P < 0.01), greater odds of erythema [odds ratio (OR) 2.98 (1.53–5.82), P = 0.01], purulence [OR 2.84 (1.51–5.35), P = 0.01], fever [OR 1.84 (1.15–2.93), P = 0.01], threatened implant exposure [OR 2.97 (1.48–5.95), P < 0.01], and true implant exposure [OR 1.79 (1.04–3.08), P = 0.04]. Increasing AD-1 was an independent risk factor for washout (P < 0.01), and explant [OR 2.48 (1.47–4.2), P < 0.01]. AD-1 positively correlated with white blood cell count (β = 1.81 cells/µL, P < 0.01), and serum lactate (β = 0.19 meq/L, P < 0.04). Increasing AD-1 level was an independent predictor of infection severity (χ² = 22.77, P < 0.01). Conclusions: AD-1 levels correlate with infection severity, highlighting its potential both when clinical examination is ambiguous and when treatment response is being monitored. Although further evaluation is warranted, AD-1 may demonstrate utility in novel breast implant salvage algorithms.

show abstract

Randomized Controlled Trial to Reduce Bacterial Colonization of Surgical Drains with the Use of Chlorhexidine-Coated Dressings After Breast Cancer Surgery

Cited by 8 publications

References 27 publications

Do drain tubes help reduce risks of post‐operative complications in complex incisional hernia repair (as defined by a recent court ruling)?

Do drain tubes help reduce risks of post‐operative complications in complex incisional hernia repair (as defined by a recent court ruling)?

Risks and Prevention of Surgical Site Infection After Hernia Mesh Repair and the Predictive Utility of ACS-NSQIP

Alpha Defensin-1 Level Correlates with Periprosthetic Infection Severity following Implant-based Breast Reconstruction

Contact Info

Product

Resources

About