Significant Reduction of Wound Infections With Daily Probing of Contaminated Wounds

Towfigh, Shirin

doi:10.1001/archsurg.2011.61

Cited by 19 publications

(7 citation statements)

References 14 publications

(15 reference statements)

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“…However, in moderate and high risk groups, primarily closing the wound should be done with caution. Other wound interventions such as wound edge protectors [ 28 ], subcutaneous wound drainage [ 29 ], or daily wound probing [ 30 ] should be considered to apply.…”

Section: Discussionmentioning

confidence: 99%

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

2018

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BackgroundSuperficial surgical site infection (SSI) is common after appendectomy. This study aims to determine a clinical prediction score for SSI after appendectomy in complicated appendicitis.MethodsData from randomized controlled trial of delayed versus primary wound closures in complicated appendicitis was used. Nineteen patient- and operative-related predictors were selected in the logit model. Clinical prediction score was then constructed using coefficients of significant predictors. Risk stratification was done by receiver operating characteristic (ROC) curve analysis. Bootstrap technique was used to internal validate the score.ResultsAmong 607 patients, the SSI incidence was 8.7% (95% CI 6.4, 11.2). Four predictors were significantly associated with SSI, i.e., presence of diabetes, incisional length > 7 cm, fecal contamination, and operative time > 75 min with the odds ratio of 2.6 (95% CI 1.2, 5.9), 2.8 (1.5, 5.4), 3.6 (1.9, 6.8), and 3.4 (1.8, 6.5), respectively. Clinical prediction score ranged from 0 to 4.5 with its discrimination concordance (C) statistic of 0.74 (95% CI 0.66, 0.81). Risk stratification classified patients into very low, low, moderate, and high risk groups for SSI when none, one, two, and more than two risk factors were presented with positive likelihood ratio of 1.00, 1.45, 3.32, and 9.28, respectively. A bootstrap demonstrated well calibration and thus good internal validation.ConclusionsDiabetes, incisional length, fecal contamination, and operative time could be used to predict SSI with acceptable discrimination. This clinical risk prediction should be useful in prediction of SSI. However, external validation should be performed.Trial registrationClinicalTrials.gov (ID NCT01659983), registered August 8, 2012Electronic supplementary materialThe online version of this article (10.1186/s13017-018-0186-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

2018

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“…Removing a dressing less than 48 hours after a procedure and showering early (ie, within 12 hours postoperatively) have not been found to affect the risk of SSIs 5 . Surgeons should consider using povidone‐iodine solution swabs daily to probe contaminated wounds closed with interrupted staples; one small RCT showed this practice reduced wound infections 47 …”

Section: Postoperative Periodmentioning

confidence: 99%

“…5 Surgeons should consider using povidone-iodine solution swabs daily to probe contaminated wounds closed with interrupted staples; one small RCT showed this practice reduced wound infections. 47…”

Section: Wound Carementioning

confidence: 99%

Preventing Surgical Site Infections: Implementing Strategies Throughout the Perioperative Continuum

Rosa¹,

Sposato²,

Abbo³

2023

AORN Journal

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Surgical site infections (SSIs) are a considerable cause of patient morbidity and mortality and are associated with increased hospital lengths of stay as well as increased health care costs to both patients and health care facilities. Substantial advances have been made in infection control practices throughout the perioperative setting to prevent SSIs and improve patient quality of care. Preventing and reducing SSIs requires a multifaceted approach encompassing the continuum of medical and surgical care. This article reviews four major infection prevention guidelines and provides an updated summary of effective strategies that perioperative team members can implement for the prevention of SSIs preoperatively, intraoperatively, and postoperatively.

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“…Delayed wound healing continues to be a serious clinical problem after surgery because it increases the risk of surgical site infections [1], [2], extends postoperative hospitalizations [3], and increases medical expenses [4]–[7]. Although many countermeasures exist, delayed wound healing and wound infection are still common occurrences, especially in patients with an advanced age, diabetes mellitus, chronic renal failure, or other systemic diseases.…”

Section: Introductionmentioning

confidence: 99%

The Mobilization and Recruitment of C-Kit+ Cells Contribute to Wound Healing after Surgery

Takemoto

Kubo

et al. 2012

PLoS ONE

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Delayed wound healing is a serious clinical problem in patients after surgery. A recent study has demonstrated that bone marrow-derived c-kit-positive (c-kit+) cells play important roles in repairing and regenerating various tissues and organs. To examine the hypothesis that surgical injury induces the mobilization and recruitment of c-kit+ cells to accelerate wound healing. Mice were subjected to a left pneumonectomy. The mobilization of c-kit+ cells was monitored after surgery. Using green fluorescent protein (GFP+) bone marrow-transplanted chimera mice, we investigated further whether the mobilized c-kit+ cells were recruited to effect wound healing in a skin puncture model. The group with left pneumonectomies increased the c-kit+ and CD34+ stem cells in peripheral blood 24 h after surgery. At 3 days after surgery, the skin wound size was observed to be significantly smaller, and the number of bone marrow-derived GFP+ cells and GFP+/c-kit+ cells in the wound tissue was significantly greater in mice that had received pneumonectomies, as compared with those that had received a sham operation. Furthermore, some of these GFP+ cells were positively expressed specific markers of macrophages (F4/80), endothelial cells (CD31), and myofibroblasts (αSMA). The administration of AMD3100, an antagonist of a stromal-cell derived factor (SDF)-1/CXCR4 signaling pathway, reduced the number of GFP+ cells in wound tissue and completely negated the accelerated wound healing. Surgical injury induces the mobilization and recruitment of c-kit+ cells to contribute to wound healing. Regulating c-kit+ cells may provide a new approach that accelerates wound healing after surgery.

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Significant Reduction of Wound Infections With Daily Probing of Contaminated Wounds

Abstract: Hypothesis: Local wound management using a simple wound-probing protocol (WPP) reduces surgical site infection (SSI) in contaminated wounds, with less postoperative pain, shorter hospital stay, and improved patient satisfaction.

Cited by 19 publications

References 14 publications

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

Preventing Surgical Site Infections: Implementing Strategies Throughout the Perioperative Continuum

The Mobilization and Recruitment of C-Kit+ Cells Contribute to Wound Healing after Surgery

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