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Results for “Surgical Procedures, Operative”

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At least 613 records · Page 34Linked to original sources
PubMed2001

[Changing susceptibility patterns of surgical site infection pathogens after the introduction of modern perioperative chemotherapy in the emergency surgery clinic].

993 surgical site infection aerobic pathogens are isolated over a six-year period (I.1994-I.2000) by the Microbiology Laboratory at University Hospital "Tzaritza Joana". 224 (22.6%) of them are isolated from patients undergoing abdominal surgery in the Emergency Surgery Clinic. The period covers 3 years before the introduction of current single-dose perioperative prophylaxis (i.e. under the conditions of long-term one) as well as the next 3 years following its introduction in the Emergency Surgery Clinic. The changes of pathogens susceptibility patterns to single-dose drug schemes in both hospital elective abdominal surgery and emergency surgery clinics are followed during the whole period. Our microbial susceptibility data support the ecological expedience of single-dose approach categorically.

Abdomen↗
PubMed2002

[Complications of inguinal hernia repair].

It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results.

Adult↗
PubMed1975

[The blunt pancreatic trauma].

A personal observation prompted study of the diagnosis and treatment of blunt trauma to pancreas. By comparison of the differing therapeutic approaches of various authors, an attempt was made to establish guidelines for optimal management of this lesion. Therapeutic considerations suggest a division of pancreas lesions into three groups: I. lesions to the left of the spine, II. lesions to the right of the spine, and III. ruptures of the neck. Each group calls for a different surgical procedure. Operative tactics involve three essential steps: 1. meticulous hemostasis, 2. management of the parenchymal lesion, and 3. efficient suction drainage.

Accidents, Traffic↗
PubMedDate not supplied

[Antimicrobial prophylaxis in surgery].

Antimicrobial prophylaxis in surgery refers to a very brief course of an antimicrobial agent initiated just before the start of the procedure. The efficacy of antimicrobials to prevent postoperative infection at the site of surgery (incisional superficial, incisional deep, or organ/space infection) has been demonstrated for many surgical procedures. Nevertheless, the majority of studies centering on the quality of preoperative prophylaxis have found that a high percentage of the antimicrobials used are inappropriate for this purpose. This work discusses the scientific basis for antimicrobial prophylaxis, provides general recommendations for its correct use and specific recommendations for various types of surgery. The guidelines for surgical antimicrobial prophylaxis are based on results from well-designed studies, whenever possible. These guidelines are focussed on reducing the incidence of infection at the surgical site while minimizing the contribution of preoperative administration of antimicrobials to the development of bacterial resistance.

Antibiotic Prophylaxis↗
PubMed2002

Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery.

The increasing number of patients with coronary artery disease undergoing major non-cardiac surgery justifies guidelines concerning preoperative evaluation, stress testing, coronary angiography, and revascularization. A review of the recent literature shows that stress testing should be limited to patients with suspicion of a myocardium at risk of ischaemia, and coronary angiography to situations where revascularization can improve long-term survival. Recent data have shown that any event in the coronary circulation, be it new ischaemia, infarction, or revascularization, induces a high-risk period of 6 weeks, and an intermediate-risk period of 3 months. A 3-month minimum delay is therefore indicated before performing non-cardiac surgery after myocardial infarction or revascularization. However, this delay may be too long if an urgent surgical procedure is requested, as for instance with rapidly spreading tumours, impending aneurysm rupture, infections requiring drainage, or bone fractures. It is then appropriate to use perioperative beta-block, which reduces the cardiac complication rate in patients with, or at risk of, coronary artery disease. The objective of this review is to offer a comprehensive algorithm to help clinicians in the preoperative assessment of patients undergoing non-cardiac surgery.

Adrenergic beta-Antagonists↗
PubMed2002

[Antibiotic prophylaxis in surgery: news and controversies].

Preoperative administration of antibiotics to prevent possible post-surgical infections represents a cornerstone of modern medicine. Although the general principles of surgical prophylaxis have been quite clearly defined during the last few decades, advenaces in surgical techniques, the changes in bacterial ecology in hospital, the spread of bacterial resistance and the substantial increase in the surgical population at risk, suggest that several aspects of surgical prophylaxis should be reviewed and new controlled studies should be carried on. The American guidelines for surgical prophylaxis, worked out recently by the CDC, have not modified their general structure, and have strongly influenced the protocols and the prescriptive behaviour of other countries, including Italy. The following points suggest that these guidelines are probably no longer adeguate for the situation in question: evidence from several sources would extend the advisability of antibiotic prophylaxis to other clean surgeries; the current classification of surgical procedures does not consider the "new" population of risk patients; the duration of prophylaxis and its role in preventing post-surgical infections "at a distance" infections has not been carefully defined; the evolution of bacterial epidemiology and bacterial resistance and the contemporary availability of new antibiotics has moved the fear of a post-antibiotic era In the clinical practice, according to these considerations and whilst awaiting the results of new clinical trials, in some cases and for some at risk patients it would appear justified to use third generation cephalosporins and especially ceftriaxone that, because of its peculiar pharmacokinetcs characteristics, guarantees with a single dose the same efficacy of three doses of other cephalosporins.

Anti-Bacterial Agents↗
PubMed2003

[The comparison of incision and drainage with skin excision and curettage in the treatment of acute pilonidal abscess].

BACKGROUND: To compare therapeutic values of incision and drainage, with skin excision and curettage in surgical treatment of the patients with acute pilonidal abscess. METHODS: In this prospective study, patients with acute pilonidal abscess were divided into two groups. The first group of patients were treated with incision and drainage and the second with skin excision and curettage. Two treatment modalities were compared in terms of healing time, time of returning to active work and development of chronic pilonidal sinus rates with chi-square and student-t test. RESULTS: Development of chronic pilonidal sinus rate was 76% in incision and drainage group and 24% in skin excision and curettage group (p<0.001). Healing time and time of returning to active work were 27 and 35 days in skin excision and curettage group, 19 and 26 days in incision and drainage group, respectively (p<0.001). CONCLUSION: Skin excision and curettage, which is associated with lower rates of development of chronic pilonidal sinus, may be the treatment of choice in acute pilonidal abscess.

Abscess↗
PubMedDate not supplied

Major reasons to prescribe antimicrobial prophylaxis in surgery.

Based on the Belgian recommendation for antimicrobial prophylaxis (AMP) in surgery in 1996, a prospective survey of 3 months was carried out in 10 acute care hospitals in Lebanon to describe the major reasons to prescribe AMP in surgery. Of 961 surgical procedures, 767 (80%) received one or several antibiotics; the surgical site infection rate was 4%. Results indicate that duration of procedures over 1 hour and patient older than 60 years represent the main reasons for prescribing AMP in Lebanese hospitals.

Adolescent↗
PubMed2003

Pattern of aerobic bacteria with their drug susceptibility of surgical inpatients.

The pattern of aerobic bacteria with their antibiotic susceptibility isolated from infected patients in one of the surgical units at Mymensingh Medical College Hospital during the period from September to November' 2000 were reported in the present study. Out of 74 clinical samples, 52 were wound swabs, 18 were pus and 4 were urine. Bacterial growth was yielded in 43 samples and the distribution of isolates was as follows: Pseudomonas spp 16, Esch.coli 13, Staphylococcus aureus 08, Klebsiella spp. 03 and others 03. Majority (61.5 %) of culture positive results were found in wound swabs. Antibiotic susceptibility pattern showed considerable variation within Gram negative bacterial isolates. All the Esch.coli and Klebsiella isolates were resistant to amoxicillin. Ceftriaxone (65.6% and 100% respectively) and ciprofloxacin (71.4% and 100%) still appeared to be highly sensitive for both species. Over 93% strains of Pseudomonas were sensitive to Ceftazidime and aztreonam. Whereas, over 43% of same strains were resistant to ciprofloxacin. Over 87% strains of Staph.aureus were resistant to penicillin but sensitive to erythromycin. Whereas, 100% of those strains were sensitive to cloxacillin. Over 50% of all isolates were sensitive to gentamicin but resistant to cefalexin and cotrimoxazole. It was suggested to be careful regarding selection of antibiotic regime in surgical cases to minimize incoming higher magnitude of drug resistance among bacteria in near future.

Anti-Bacterial Agents↗
PubMed2003

Management of infection in the surgical patient: an update.

Management of severe surgical infections remains difficult and requires a multifaceted approach. In this review, we briefly summarise our approach to surgical infection, concentrating on the underlying pathological processes of intraabdominal infection. Two promising new therapies--activated protein C (ACP) and stress-dose hydrocortisone--are reviewed as adjunctive management in treatment of patients with septic shock.

Anti-Bacterial Agents↗