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Patients are often advised to keep the initial postoperative dressings dry and undisturbed for 24 to 72 hours. However, these requirements may result in significant disruption of patients' activities of daily living, such as bathing, leisure, and exercise. Compare standard management of keeping wounds dry and covered (48 hours) with early (6 hours) postoperative water exposure. Investigator-blinded, randomized (1:1), controlled trial evaluating rate of infection and additional outcomes of interest. Overall, 437 patients were randomized to either the early (6-hour) water exposure (n = 218) intervention group or the standard cohort (n = 219). The incidence of culture-proven infection in the intervention group (1.8%) was similar to the standard group (1.4%) (P >.99). There was also no difference in rates of bleeding or bruising. Scar assessment using the Patient and Observer Scar Assessment Scale revealed similar scar outcomes. Single site, academic center. Surgical wounds can be allowed to get wet in the immediate postoperative period with no increased incidence of infection or other complications and with similar cosmesis. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the postoperative infection and graft success rates, and the hearing improvement, after endoscopic cartilage underlay myringoplasty with versus without antibiotic ointment coating. Materials and methods: This was a retrospective case-control study. The clinical records of patients who underwent endoscopic cartilage underlay myringoplasty and who met the selection criteria were retrieved and divided based on middle ear packing status into groups with antibiotic ointment packing (AOP group) and with no antibiotic ointment packing (no-AOP group). The operation time, postoperative infection, graft success status, and hearing improvement were compared between the 2 groups. Results: Patients with 166 perforations constituted the AOP group, and patients with 141 perforations comprised the no-AOP group. At 3 months postoperatively, middle ear infections had occurred in 24 (14.5%) ears in the AOP group and 4 (2.8%) ears in the no-AOP group (P <.01). At 12 months postoperatively, the graft success rate was 81.3% in the AOP group and 97.9% in the no-AOP group (P <.01). No significant group differences were observed, preoperatively (P =.657) or postoperatively (P =.578), in the air-bone gap (ABG) values or mean ABG gains (P =.758). Conclusion: Middle ear packing without antibiotic ointment coating does not increase the postoperative infection rate or reduce the graft success rate after endoscopic cartilage underlay myringoplasty compared to antibiotic ointment coating. On the contrary, coating with antibiotic ointment increases the risk of postoperative infection given the complexity of middle ear manipulation. [ABSTRACT FROM AUTHOR]

To investigate the changes of serum neuron-specific enolase (NSE), lactate and C-reactive protein (CRP) in patients with postoperative infection after acute craniocerebral injury and their predictive value for prognosis. 71 patients with postoperative infection after acute craniocerebral injury were selected as infection group, and 56 patients without postoperative infection were selected as non-infection group. NSE, CRP and blood lactic acid levels were detected in all patients. The relationship between each index and thecondition and prognosis of patients was analyzed. The levels of serum NSE, lactic acid and CRP in infected group were higher than those in non-infection group (P<0.05). The levels of serum NSE, lactic acid and CRP in severe group were higher than those in mild group (P<0.05). Serum levels of NSE, lactic acid and CRP were positively correlated with the severity of infection (P<0.05), the area under the curve (AUC) of the receiver operating characteristic curve (ROC) was greater than that of the NSE level (P<0.05). The levels of serum NSE, lactate and CRP in the good prognosis group were lower than those in the poor prognosis group (P<0.05). The area under the curve (AUC) of receiver operating characteristic curve (ROC) of lactate level in predicting the prognosis of patients with infection was higher than that of NSE and CRP (P<0.05). Serum NSE, lactic acid and CRP have predictive value in patients with acute craniocerebral injury. [ABSTRACT FROM AUTHOR]

Background: There are currently no guidelines on peri-arthroscopic management of immunosuppressive (IS) treatment in rheumatic disease patients. Purpose: The purpose of this study is to characterize the rheumatic disease patient population undergoing arthroscopy, compare the incidence of postoperative complications among patients who either remained on IS perioperatively, held IS perioperatively or were not on IS at baseline, and compare the incidence of postoperative complications by rheumatic disease type, medication type, and procedure. Methods: We conducted a retrospective review of all arthroscopic sports medicine surgeries in patients with a rheumatic disease diagnosis at our institution over an 11-year period. Patients on IS at baseline were grouped into those who remained on IS perioperatively or held all IS before the date of their surgery. These two groups were compared to patients who were not on IS at baseline. Incidence of postoperative complications was calculated for the three cohorts and by medication class, rheumatic disease type, and procedure risk. Analysis of variance (ANOVA), chi-squared, and Fisher's exact tests were used to determine the statistical significance of between-group differences in postoperative complication incidence. Results: We identified 1,316 rheumatic disease patients undergoing arthroscopy, with 214 of them taking IS medications at baseline. In total, 8.4% (n = 110) remained on IS perioperatively, 7.9% (n = 104) held IS perioperatively, and 83.7% (n = 1102) were not on IS at baseline. In all cohorts, seven patients experienced postoperative complications; six of whom experienced infections. Two (1.82%) occurred in patients remaining on IS perioperatively, zero infections occured in patients who held all IS, and four (0.36%) occured in patients who were not on any IS at baseline. There was no statistically significant difference in postoperative infections or complication rates among the three cohorts or further subgroups. Conclusion: The risk of postoperative complications including infectious, major, and minor complications in patients on IS at the time of arthroscopy is low and acceptable. [ABSTRACT FROM AUTHOR]

Objective To analyze the risk factors for postoperative infection in patients with oral and maxillofacial malignancies treated in stomatological hospitals, providing a reference for preventing postoperative infections. Methods The medical records of patients with oral and maxillofacial malignancies admitted to the Stomatological Hospital of Chongqing Medical University from January 2020 to January 2023 were collected. Univariate analysis and binary logistic regression analysis were performed on relevant factors using SPSS 22.0 statistical software. Results Univariate analysis showed statistically significant differences in hospital stay, gender, operative time, postoperative drainage duration, and intraoperative blood loss between infected and uninfected patients (P＜0.05). Binary logistic regression analysis revealed that postoperative drainage duration of 10 days or more and operative time of 6 hours or more were independent risk factors for postoperative infection (P＜0.05). Conclusion Postoperative drainage duration of 10 days or more and operative time of 6 hours or more are independent risk factors for postoperative infection in patients with oral and maxillofacial malignancies. Preventive measures such as early bacterial culture and drug sensitivity tests, and monitoring of albumin levels in the first 3 days after surgery, should be implemented. [ABSTRACT FROM AUTHOR]

Postoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration of nationwide registry data is a practical option for the accumulation of cases. Data on malignant soft tissue tumor resection were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The incidence of postoperative infection and its risk factors were analyzed. A total of 14,460 cases were included. The incidence of infection was 2.6%. Significant risks for infection were male sex, lower extremity or trunk location, tumor diameter of over 10 cm, trans -compartmental invasion, high grade, autologous bone graft, myocutaneous flap, vascular reconstruction, reconstruction by prosthesis, postoperative radiotherapy, and delayed wound healing. The incidence was lower than those in the previous studies, perhaps because of less frequent radiotherapy application. Some of the significant risk factors represented local invasiveness of the tumor, suggesting the importance of the preservation of soft tissue for infection prevention. The administration of nationwide registry data was informative for the analysis of infection in malignant soft tissue tumor resection. [ABSTRACT FROM AUTHOR]

La fasciite nécrosante est une infection rapidement progressive des tissus mous s'étendant de la peau au fascia et entraînant des nécroses étendues. Il s'agit d'une complication très rare mais grave avec une mortalité variant de 10 à 15 %. La prise en charge optimale relève d'un diagnostic précoce suivi d'un traitement associant antibiothérapie et parage chirurgical large dans les plus brefs délais. La localisation au niveau du sein est peu fréquente. Bien qu'il s'agisse le plus souvent de fasciites nécrosantes mammaires primaires, plusieurs cas de fasciites nécrosantes ont été rapportés dans les suites postopératoires d'une chirurgie mammaire. Nous présentons le cas d'une fasciite nécrosante du sein survenu après un geste de mastectomie par voie sous-mammaire avec reconstruction immédiate par implant prépectoral en silicone, ayant abouti à une défaillance multiviscérale suivi du décès de la patiente malgré une prise en charge médicochirurgicale intrahospitalière optimale. Il s'agit du premier cas survenu après une reconstruction mammaire immédiate. Necrotizing fasciitis is a rapidly progressive soft tissue infection extending from the skin to the fascia, resulting in extensive necrosis. It is a very rare but serious complication, with mortality ranging from 10 to 15%. Optimal management involves early diagnosis followed by treatment combining antibiotic therapy and wide surgical removal as soon as possible. Localisation in the breast is uncommon. Although most cases are primary necrotizing fasciitis of the breast, several cases of necrotizing fasciitis have been reported in the post-operative aftermath of breast surgery. We present a case of necrotizing fasciitis of the breast following submammary mastectomy with immediate reconstruction using a pre-pectoral silicone implant, which resulted in multiple organ failure and the death of the patient despite optimal medical and surgical management. This is the first case to occur after immediate breast reconstruction. [ABSTRACT FROM AUTHOR]

Objective: To analyze the types and causes of complications following orbital fracture reconstruction and enhance clinicians' capacity to manage or prevent such complications. Methods: We conducted a retrospective case series analysis, retrospectively collecting and analyzing clinical data of patients with orbital fractures who received surgical treatment at the Affiliated Eye Hospital of Nanchang University from May 2012 to May 2022. Descriptive statistics were employed to document common postoperative complications, and we recorded complications persisting after a minimum 6-month follow-up period. Results: Among the 227 patients who underwent orbital fracture surgery, they were followed up for 6 to 36 months, and complications occurred in 15 cases, resulting in an incidence rate of 6.61%. These complications included implant material infections and rejections (4 cases), persistent diplopia (3 cases), intraorbital hematomas (2 cases), epiphora (2 cases), lower eyelid eversion or retraction (2 cases), and skin scars (2 cases). The primary cause of postoperative infection was chronic inflammation in the paranasal sinuses or closed cavities within the fracture area. Postoperative complications in orbital fractures were associated with various factors, including the timing of surgery, surgical approach, repair materials, surgical skills, and auxiliary techniques. Conclusion: Standardizing surgical techniques and implementing precise auxiliary technologies may reduce the incidence of complications and enhance the operation's success rate. Precis: This study systematically analyzed the complications and underlying causes of orbital fracture surgery. By mitigating these factors, it aims to decrease or manage surgical complications, thereby enhancing patients' treatment outcomes. [ABSTRACT FROM AUTHOR]

Abstract The aim of this study is to evaluate the ability of infrared wavenumber of calculus to predict postoperative infection in patients with upper urinary tract calculus (UUTC), and to establish a predictive model based on this. From March 2018 to March 2023, 480 UUTC patients from Fujian Provincial Hospital were included in this study. The infrared-wavenumbers related infection score (IR-infection score) was constructed by univariate analysis, multicollinearity screening, and Lasso analysis to predict postoperative infection. Continually, the Delong test was used to compare the predictive power between the IR-infection score and traditional indicators. Afterward, we performed urine metagene sequencing and stone culture to prove the correlation between calculus toxicity and IR-infection score. Finally, logistic regression was used to build a nomogram. IR-infection score composed of four independent wavenumbers could precisely predict postoperative infection (AUCvalidation cohort = 0.707) and sepsis (AUCvalidation cohort = 0.824). IR-infection score had better predictive ability than commonly used clinical indicators. Moreover, metagenomics sequencing and calculus culture confirmed the correlation between IR-infection score and calculus toxicity (all P 0.803). Our study first developed a novel infrared spectroscopy marker and nomogram, which can help urologists better predict postoperative infection in UUTC patients.

Abstract Background The Internal Fixator (INFIX) is a popular method, known for its minimal invasiveness and short operation time, for treating anterior pelvic ring fractures. Studies have shown that postoperative complications may occur, including anterolateral femoral cutaneous nerve injury, the femoral nerve paralysis, and delayed fracture healing. These complications are believed to be related to surgical stimulation, an excessively long lateral end of the connecting rod, a small distance between the screw and bone surface, insufficient pre-bending of the connecting rod, and difficulties in fracture reduction. Case presentation We report two unique cases of lower abdominal pseudocyst complicated with suspected infection after INFIX treatment of pelvic fractures at our trauma center. Following surgical removal of the internal fixation, resolution of the cysts was observed in both patients, and subsequent postoperative follow-up revealed the absence of any residual sequelae. These cases have not been reported in previous literature reviews. Discussion The lower abdominal cysts, potentially arising from the dead space created during intraoperative placement of the INFIX rod, may increase infection risk. The etiology remains uncertain, despite the presence of abnormal inflammation markers in both cases, and staphylococcus aureus found in one. These cysts were confined to the lower abdomen, not involving the internal fixation, and hence, only the INFIX was removed. Postoperative oral cefazolin treatment was successful, with resolved pseudocysts and no subsequent discomfort. Conclusion We report two unprecedented cases of post-INFIX abdominal cysts, with a suspected link to intraoperative dead space. Despite uncertain etiology, successful management involved INFIX removal and oral cefixime therapy. These findings necessitate further exploration into the causes and management of such complications.

Abstract Background Ochrobactrum anthropi is widely distributed and primarily infects patients with compromised immune functions . Historically, O. anthropi has been considered to possess low toxicity and pathogenicity; however, recent studies suggest that it may in fact cause severe purulent infections. In this case study, we examine a case of O. anthropi infection following corneal transplantation, exploring the occurrence and outcomes of such post-operative infections. Case presentation A retrospective analysis of cases involved examinations, genetic testing for diagnosis, and subsequent treatment. In patients undergoing partial penetrating keratoplasty with a fungal corneal ulcer perforation, anterior chamber exudation and purulence were observed post-surgery. Despite antifungal treatment, genetic testing of the anterior chamber fluid and purulent material confirmed O. anthropi infection. The use of antimicrobial treatment specifically targeting O. anthropi was found to be effective in treating the infection. Conclusion Inflammatory reactions following corneal transplantation should be should be monitored for the presence of other infections. Genetic testing has significant implications for clinical diagnosis and treatment.

Background: The discovery of penicillin marked a paradigm shift in medicine with the ability to treat previously life-threatening infections. Increasing antibiotic resistance as well as the risk of adverse reactions to antibiotics, however, creates pressures for judicious use. There continues to be debate about the role of prophylactic antibiotics in facial plastic surgery. This study explores the role of prophylactic antibiotic administration in elective outpatient facial plastic surgery by comparing 5 days versus 24 hours of antibiotic prophylaxis. Method: A retrospective cohort study of all consecutive patients undergoing cosmetic procedures at an outpatient facial plastic surgical center who received either 5 days or 24 hours of prophylactic antibiotics was performed. The primary outcome was the need for postoperative antibiotics within 6 weeks of surgery. Results: 204 patients met the inclusion criteria: 104 in the 5-day group and 100 in the 24-hour prophylaxis group. The overall infection rate was 3.4%: 3% in the 24-hour group and 3.8% in the 5-day group (p = 0.77). Subgroup analysis of clean-contaminated cases (n = 85) showed the rate of postoperative infections was 4.3%, all within the 5-day group. In clean cases (n = 119), the rate of postoperative infections was 4.2% (n = 5): 4.8% (n = 3) in the 24-hour group versus 3.5% (n = 2) in the 5-day group. Conclusions: The results show that decreasing the duration of antibiotics was not associated with an increased risk of postoperative infection. Given that antibiotics are an increasingly precious commodity with rising rates of resistance, this study supports the use of decreasing postoperative antibiotics to 24 hours.

The aim of this study is to evaluate the ability of infrared wavenumber of calculus to predict postoperative infection in patients with upper urinary tract calculus (UUTC), and to establish a predictive model based on this. From March 2018 to March 2023, 480 UUTC patients from Fujian Provincial Hospital were included in this study. The infrared-wavenumbers related infection score (IR-infection score) was constructed by univariate analysis, multicollinearity screening, and Lasso analysis to predict postoperative infection. Continually, the Delong test was used to compare the predictive power between the IR-infection score and traditional indicators. Afterward, we performed urine metagene sequencing and stone culture to prove the correlation between calculus toxicity and IR-infection score. Finally, logistic regression was used to build a nomogram. IR-infection score composed of four independent wavenumbers could precisely predict postoperative infection (AUCvalidation cohort = 0.707) and sepsis (AUCvalidation cohort = 0.824). IR-infection score had better predictive ability than commonly used clinical indicators. Moreover, metagenomics sequencing and calculus culture confirmed the correlation between IR-infection score and calculus toxicity (all P < 0.05). The nomogram based on the IR-infection score had high predictive power (all AUCs > 0.803). Our study first developed a novel infrared spectroscopy marker and nomogram, which can help urologists better predict postoperative infection in UUTC patients. [ABSTRACT FROM AUTHOR]

Background: The Internal Fixator (INFIX) is a popular method, known for its minimal invasiveness and short operation time, for treating anterior pelvic ring fractures. Studies have shown that postoperative complications may occur, including anterolateral femoral cutaneous nerve injury, the femoral nerve paralysis, and delayed fracture healing. These complications are believed to be related to surgical stimulation, an excessively long lateral end of the connecting rod, a small distance between the screw and bone surface, insufficient pre-bending of the connecting rod, and difficulties in fracture reduction. Case presentation: We report two unique cases of lower abdominal pseudocyst complicated with suspected infection after INFIX treatment of pelvic fractures at our trauma center. Following surgical removal of the internal fixation, resolution of the cysts was observed in both patients, and subsequent postoperative follow-up revealed the absence of any residual sequelae. These cases have not been reported in previous literature reviews. Discussion: The lower abdominal cysts, potentially arising from the dead space created during intraoperative placement of the INFIX rod, may increase infection risk. The etiology remains uncertain, despite the presence of abnormal inflammation markers in both cases, and staphylococcus aureus found in one. These cysts were confined to the lower abdomen, not involving the internal fixation, and hence, only the INFIX was removed. Postoperative oral cefazolin treatment was successful, with resolved pseudocysts and no subsequent discomfort. Conclusion: We report two unprecedented cases of post-INFIX abdominal cysts, with a suspected link to intraoperative dead space. Despite uncertain etiology, successful management involved INFIX removal and oral cefixime therapy. These findings necessitate further exploration into the causes and management of such complications. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between the storage time of transfused red blood cells (RBCs) and risks of infections after cleancontaminated surgery. Background: Storage lesions of RBCs can aggravate transfusion-related immunomodulation. Very few randomized controlled trials have investigated the impacts of storage time on postoperative outcomes in noncardiac patients. Methods: We included adult patients who had undergone cleancontaminated surgery from 2014 to 2018 and received allogeneic RBC transfusion. In transfusion episode-level analysis, the exposure was the storage time of each transfusion episode. In patient-level analysis, the exposures were the mean, weighted mean, maximum storage time, and Scalar Age of Blood Index of RBCs transfused into each patient. The primary outcome was infections that developed after transfusions within postoperative day 30. Results: The 4046 patients were included who received 11604 transfusion episodes. Of these, 1025 (25.3%) patients developed postoperative infections. An increased storage time of transfused RBCs was not associated with increased odds of postoperative infections in either transfusion episode-level analysis [odds ratio (OR), 1.03 per 5 days, 95% CI, 0.95-1.11] or patient-level analysis (mean: OR, 1.02, 95% CI, 0.95-1.10; weighted mean: OR, 1.02, 95% CI, 0.95-1.10; maximum: OR, 1.06, 95% CI, 0.98-1.14; Scalar Age of Blood Index: OR, 0.99, 95% CI, 0.96-1.03), after adjusting 17 confounders. Conclusions: Prolonged storage time of transfused RBCs was not associated with increased risks of infections after clean-contaminated surgery. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop machine learning algorithms for identifying predictive factors associated with the risk of postoperative surgical site infection in patients with lower extremity fractures. Methods: A machine learning analysis was conducted on a dataset comprising 1,579 patients who underwent surgical fixation for lower extremity fractures to create a predictive model for risk stratification of postoperative surgical site infection. We evaluated different clinical and demographic variables to train four machine learning models (neural networks, boosted generalised linear model, naïve bayes, and penalised discriminant analysis). Performance was measured by the area under the curve score, Youdon's index and Brier score. A multivariate adaptive regression splines (MARS) was used to optimise predictor selection. Results: The final model consisted of five predictors. (1) Operating room time, (2) ankle region, (3) open injury, (4) body mass index, and (5) age. The best-performing machine learning algorithm demonstrated a promising predictive performance, with an area under the ROC curve, Youdon's index, and Brier score of 77.8%, 62.5%, and 5.1%-5.6%, respectively. Conclusion: The proposed predictive model not only assists surgeons in determining high-risk factors for surgical site infections but also empowers patients to closely monitor these factors and take proactive measures to prevent complications. Furthermore, by considering the identified predictors, this model can serve as a reference for implementing preventive measures and reducing postoperative complications, ultimately enhancing patient outcomes. However, further investigations involving larger datasets and external validations are required to confirm the reliability and applicability of our model. [ABSTRACT FROM AUTHOR]

Background: We aim to study the impact of postoperative Stenotrophomonas maltophilia infections among cancer patients undergoing major surgery. Methods: Ambispective, observational study. Study period from 1st November 2019 to 31st March 2024. The study population included patients with a definite diagnosis of cancer who underwent a major surgical procedure in a single, dedicated surgical unit and developed postoperative infection which showed a documented growth of Stenotrophomonas maltophilia. Clinical and laboratory parameters were collected and data represented as median values, percentages and range. Results: Nine patients were identified to have Stenotrophomonas maltophilia infection in the postoperative period among a total of 2506 patients. Co-morbid illnesses were noted in 33.3% patients; all were nosocomial infections. Fever was a manifestation in 77.8% patients, 44.4% had leukocytosis. Of all samples, 33.3% were respiratory ones. Co-infection was noted in 44.4% patients. Sensitivity to trimethoprim-sulphamethoxazole was seen in 44.4% and to levofloxacin in 66.7% isolates. Mortality rate was 11.1%. Conclusion: Stenotrophomonas maltophilia causes uncommon but clinically significant infections among cancer patients in the postoperative period. [ABSTRACT FROM AUTHOR]

Background/Aims: Surgical site infections following cardiac surgery pose significant risks and financial burdens to both patients and healthcare systems. This study aimed to explore the implementation and outcomes of a novel surgical wound monitoring system using patient smartphones for post-discharge surveillance. Methods: The study was conducted at a London-based cardiothoracic tertiary referral centre, where 1358 patients undergoing cardiac surgery between January 2021 and March 2023 were enrolled onto the surgical wound monitoring system. Data were collected from the National Cardiac Audit Programme dataset, the monitoring syste and Hospital Episode Statistics data. Comparisons between patients who did or did not respond to surveillance requests were performed. A nested confirmatory analysis assessed antibiotics reported by patients through the digital route compared with antibiotics given by GPs or in outpatients. Results: The overall response rate for surgical wound monitoring using patient smartphones was 86.6%. Patients who were female, from areas of higher deprivation and lived closer to the hospital were less likely to engage with surgical wound monitoring. Although not statistically significant, the current study suggests that patients with surgical site infections who used smartphones for surgical wound monitoring were less likely to be re-admitted or have further surgery and had shorter readmission stays. The accuracy of antibiotic use for surgical site infections using the surgical wound monitoring system was 96.5%. Conclusions: This study underscores the potential of digital technologies, particularly smartphones, in efficient and accurate post-surgical monitoring. The findings suggest that the use of digital monitoring systems may improve patient outcomes, with potential for wider system-level benefits. [ABSTRACT FROM AUTHOR]

To analyze the application value of infection probability score (IPS) combined with monocyte count, procalcitonin (PCT) and C-reactive protein (CRP) in the early evaluation of postoperative infection in patients with spinal trauma. A total of 31 patients with infection and 31 patients without infection after spinal trauma surgery in the hospital were enrolled as infection group and non-infection group between March 2016 and October 2023, respectively. The changes of IPS, monocyte count, PCT and CRP in the two groups were compared. The correlation among IPS, monocyte count, PCT and CRP was analyzed by Spearman correlation analysis. The evaluation value of IPS, monocyte count, PCT, CRP and combined detection for postoperative infection in patients with spinal trauma was analyzed by receiver operating characteristic (ROC) curves. IPS, monocyte count, PCT and CRP levels in infection group were significantly higher than those in non-infection group (P<0.05). The results of Spearman correlation analysis showed that IPS was positively correlated with monocyte count, PCT and CRP levels (r=0.268, 0.697, 0.437, P<0.05). The results of ROC curves analysis showed that AUCROC of IPS combined with monocyte count, PCT and CRP for predicting postoperative infection was 0.891, greater than that of single index (0.781, 0.683, 0.752, 0.708). Combined detection of the four indexes can improve predictive value of postoperative infection in patients with spinal trauma. [ABSTRACT FROM AUTHOR]

Background: Ochrobactrum anthropi is widely distributed and primarily infects patients with compromised immune functions. Historically, O. anthropi has been considered to possess low toxicity and pathogenicity; however, recent studies suggest that it may in fact cause severe purulent infections. In this case study, we examine a case of O. anthropi infection following corneal transplantation, exploring the occurrence and outcomes of such post-operative infections. Case presentation: A retrospective analysis of cases involved examinations, genetic testing for diagnosis, and subsequent treatment. In patients undergoing partial penetrating keratoplasty with a fungal corneal ulcer perforation, anterior chamber exudation and purulence were observed post-surgery. Despite antifungal treatment, genetic testing of the anterior chamber fluid and purulent material confirmed O. anthropi infection. The use of antimicrobial treatment specifically targeting O. anthropi was found to be effective in treating the infection. Conclusion: Inflammatory reactions following corneal transplantation should be should be monitored for the presence of other infections. Genetic testing has significant implications for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

"Objective To investigate the predictive value of multiple hematological markers in postoperative infection after hepatic carcinectomy, such as neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR). Methods A total of 326 hepatocellular carcinoma (HCC) patients received hepatectomy in the First Affiliated Hospital of Harbin Medical University from January 2019 to June 2023 were retrospectively included, and were divided into 72 cases (22.09%) in the infection group and 254 cases (77.91%) in the non-infection group, according to whether infection occurred during the postoperative hospitalization. Multivariate logistic regression was used to screen the independent risk factors for postoperative infections in HCC patients, and ROC curves were used to analyze the clinical value of each hematological marker in predicting postoperative infections in HCC patients. Results The results of multivariate logistic regression analysis showed that open surgery (OR=1.401, 95%CI: 1.043-1.881), drain placement time ＞7d (OR=1.344, 95%CI: 1.052-1.718), and increased PCT (OR=1.335, 95%CI: 1.005-1.773), NLR (OR=1.554, 95%CI: 1.216-1.986) and controlling nutritional status (COUNT) score (OR=1.465, 95%CI: 1.141-1.882) were risk factors for infection after hepatic carcinectonay (P＜0.05). The ROC curves showed that NLR had the highest predictive value for infection after hepatic carcinectomy (AUC: 0.781), followed by COUNT score (AUC: 0.675) and PCT had the lowest predictive performance (AUC: 0.602). Conclusion PCT, NLR and CONUT scores are all correlated with postoperative infection after hepatic carcinectomy and have predictive ability for postoperative infection, with NLR having the relatively highest predictive value."

Objective To investigate the effect of perioperative individualized nutritional intervention on the changes of nutritional indicators and prognosis of elderly patients with nutritional risk after posterior lumbar interbody fusion. Methods From January 2018 to December 2019,a total of 181 elderly patients over 75 years old with posterior lumbar interbody fusion in Xuanwu Hospital Capital Medical University were included in this study.85 patients with≥3 points of NRS2002 were included in the intervention group,and 96 patients with0.05).The age of the intervention group was higher than that of the control group,the body mass index,intraoperative blood loss,preoperative serum total protein,albumin,prealbumin and hemoglobin levels were lower than those of the control group,and the operation time was shorter than that of the control group,with statistical significance(P0.05). Conclusion For elderly patients with nutritional risk,preoperative nutritional intervention can reduce the decline of postoperative nutritional indicators.

Objective Based on the clinical study of patients infected after percutaneous vertebral augmentation procedures (PVAP), the infection related factors and clinical characteristics were analyzed to provide basis for early prevention and diagnosis. Methods A retrospective study was conducted to analyze the diagnosis and treatment process and prognosis of 5 patients with infection after PVAP in Shanghai Ninth Peaple's Hospital from December 2017 to November 2023. Results There were 3 males and 2 females, aged 68-81 years, with an average age of 74.8 years. The time from operation to infection was 5-24 months. All patients presented with low back pain, the visual analogue scale (VAS) score was 7-8. All patients had imited thoracolumbar movement, local tenderness and percussion pain. Four patients had nerve symptoms such as decreased muscle strength in both lower limbs to varying degrees, 2 of which accompanied by defecation disorder. In laboratory tests, white blood cell (WBC) count was (4.0-7.3）×109/L, C-reactive protein (CRP) was 1.51-66.00 mg/dL, erythrocyte sedimentation rate (ESR) was 2-94 mm/1 h, and procalcitonin (PCT) was 0.10-0.40 ng/mL. X-ray, CT and MRI indicated the manifestations of infection, etiology and pathology confirmed 4 cases of Mycobacterium tuberculosis, of which 1 case was complicated with Acinetobacter baumannii, and the other case was diagnosed with Staphylococcus epidermidis. At the last follow-up, 2 patients died of complications, 3 patients were relieved of low back pain after surgery combined with drug treatment, body temperature was normal and inflammatory indicators were within the normal reference value range, and imaging examination showed no signs of infection. Conclusion Adequate preoperative assessment， symptomatic treatment of complications, and standard operation during the operation can reduce the incidence of infection after PVAP. If infection occurs, early diagnosis and systematic treatment can obtain good results.

Introduction Postoperative Legionella pneumonia is very rare. Case presentation A 71‐year‐old male patient with prostate cancer (cT2bN0M0) underwent a robotic‐assisted radical prostatectomy. On the 5th postoperative day, the patient developed chills and a fever of 39.2°C. Chest radiography revealed decreased permeability in the right middle lung field, leading to the diagnosis of postoperative pneumonia. Antimicrobial therapy was initiated immediately. Blood tests on postoperative day 10 revealed mild liver function abnormalities, electrolyte abnormalities, and a markedly elevated inflammatory response. Legionella pneumonia was suspected based on blood sample results and systemic symptoms, such as diarrhea and nausea. Furthermore, Legionella antigens were detected in the patient's urine, prompting further administration of levofloxacin. The patient's subsequent clinical course was favorable. Conclusion When bacterial pneumonia fails to respond to antimicrobial therapy and systemic symptoms develop, atypical pneumonia, caused by pathogens such as Legionella pneumophila, should be considered even in cases of postoperative pneumonia.

Intra-abdominal arterial reconstructions in the setting of reoperative, contaminated, or frankly infected fields can be a challenging undertaking for even the most experienced vascular surgeons. Open surgical arterial transpositions have been less commonly performed than other methods of reconstruction in the current era of vascular surgery despite many historical reports of successful outcomes. Autologous artery transpositions represent a viable option in the case of an infected or a contaminated operative field. We have described the cases of three patients treated at our institution who had required intra-abdominal revascularization in a contaminated or frankly infected surgical field. All three patients were successfully treated using open native visceral artery transposition procedures. These cases presented multiple challenges secondary to the ongoing infections, infected operative field, and, sometimes, a history of multiple vascular bypasses involving the aorta and visceral arteries. In such circumstances, we have demonstrated the effectiveness of native visceral arterial transposition as a feasible technique.

Objective: To estimate preoperative risk of postoperative infections using structured electronic health record (EHR) data. Background: Surveillance and reporting of postoperative infections is primarily done through costly, labor-intensive manual chart reviews on a small sample of patients. Automated methods using statistical models applied to postoperative EHR data have shown promise to augment manual review as they can cover all operations in a timely manner. However, there are no specific models for risk-adjusting infectious complication rates using EHR data. Methods: Preoperative EHR data from 30,639 patients (2013–2019) were linked to the American College of Surgeons National Surgical Quality Improvement Program preoperative data and postoperative infection outcomes data from 5 hospitals in the University of Colorado Health System. EHR data included diagnoses, procedures, operative variables, patient characteristics, and medications. Lasso and the knockoff filter were used to perform controlled variable selection. Outcomes included surgical site infection, urinary tract infection, sepsis/septic shock, and pneumonia up to 30 days postoperatively. Results: Among >15,000 candidate predictors, 7 were chosen for the surgical site infection model and 6 for each of the urinary tract infection, sepsis, and pneumonia models. Important variables included preoperative presence of the specific outcome, wound classification, comorbidities, and American Society of Anesthesiologists physical status classification. The area under the receiver operating characteristic curve for each model ranged from 0.73 to 0.89. Conclusions: Parsimonious preoperative models for predicting postoperative infection risk using EHR data were developed and showed comparable performance to existing American College of Surgeons National Surgical Quality Improvement Program risk models that use manual chart review. These models can be used to estimate risk-adjusted postoperative infection rates applied to large volumes of EHR data in a timely manner. [ABSTRACT FROM AUTHOR]

The aim of this narrative review is to describe the various surgical management strategies employed in fracture-related infection (FRI), to explore how they are selected and discuss the rationale for early surgical intervention. Surgical treatment options in patients with FRI include debridement, antibiotics and implant retention (DAIR), revision (exchange) or removal. In selecting a treatment strategy, a variety of factors need to be considered, including the condition of the bone, soft tissues, host and causative microorganism. Irrespective of the selected treatment strategy, prompt surgical intervention should be considered in order to confirm the diagnosis of an FRI, to identify the causative organism, remove necrotic or non-viable tissue that can serve as a nidus for ongoing infection, ensure a healthy soft tissue envelope and to prevent the vicious cycle of infection associated with skeletal and/or implant instability. Ultimately, the objective is to prevent the establishment of a persistent infection. Urgent surgery may be indicated in case of active, progressive disease with systemic deterioration, local progression of infection, deterioration of soft tissues, or progressive fracture instability. In case of static disease, the patient should be monitored closely and surgery can be performed on an elective basis, allowing adequate time for optimisation of the host through risk factor modification, optimisation of the soft tissues and careful planning of the surgery. [ABSTRACT FROM AUTHOR]

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Introduction  Improved evidence-based guidelines on the optimal type and duration of antibiotics for patients undergoing endoscopic endonasal transsphenoidal surgery (EETS) are needed. We analyze the infectious complications among a large cohort of EETS patients undergoing a standardized regimen of cefazolin for 24 hours, followed by cephalexin for 7 days after surgery (clindamycin if penicillin/cephalosporin allergic). Methods  A retrospective review of 132 EETS patients from 2018 to 2020 was conducted. Patient, tumor, and surgical characteristics were collected, along with infection rates. Multivariate logistic regression determined the variable(s) independently associated with infectious outcomes. Results  Nearly all patients (99%) received postoperative antibiotics with 78% receiving cefazolin, 17% receiving cephalexin, 3% receiving clindamycin, and 2% receiving other antibiotics. Fifty-three patients (40%) had an intraoperative cerebrospinal fluid (CSF) leak, and three patients (2%) developed a postoperative CSF leak requiring surgical repair. Within 30 days, no patients developed meningitis. Five patients (4%) developed sinusitis, two patients (3%) developed pneumonia, and one patient (1%) developed cellulitis at a peripheral intravenous line. Two patients (2%) developed an allergy to cephalexin, requiring conservative management. After adjustment for comorbidities and operative factors, presence of postoperative infectious complications was independently associated with increased LOS ( β  = 3.7 days; p  = 0.001). Conclusion  Compared with reported findings in the literature, we report low rates of infectious complications and antibiotic intolerance, despite presence of a heavy burden of comorbidities and high intraoperative CSF leak rates among our cohort. These findings support our standardized 7-day perioperative antibiotic regimen.

Whether prophylactic abdominal drainage tube is routinely placed in patients after hepatobiliary surgery remains controversial. To evaluate the effect of prophylactic abdominal drainage tube placement after hepatobiliary surgery on postoperative infection. Randomized controlled trials on the placement of prophylactic abdominal drainage tube after hepatobiliary surgery were collected through a computerized search of PubMed, Embase, Conchrane Library and Web of Science databases, with a time range from the establishment of the database to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies. Finally, 13 studies were included, including 3620 patients, and the results showed that there was no statistically significant difference in postoperative infection rate between the drainage group (1840 patients and the non‐drainage group [1783 patients] [relative risk, RR = 1.17, 95% confidence interval, CI: 0.94–1.47, p = 0.16]. Compared with the drainage group, the incidence of infectious abdominal fluid in the non‐drainage group was lower (RR = 2.09, 95% CI: 1.57–2.80, p < 0.00001), and the incidence of postoperative bile leakage was lower (RR = 1.77, 95% CI: 1.27–2.47, p < 0.001) and shorter hospital stays after surgery (mean difference = 1.27, 95% CI: 0.32–2.22, p = 0.009). In conclusion, placing a prophylactic abdominal drainage tube after hepatobiliary surgery does not reduce postoperative infection rates compared with no drainage. [ABSTRACT FROM AUTHOR]

Introduction: Postoperative infections in pediatric cardiac intensive care units (PCICU) are a challenge for healthcare professionals and a problem for patients and affect their quality of life. Aim: The aim of the study was to investigate postoperative infections in PCICU and to determine the pathogenic microorganisms responsible for them. Material-Methods: This is a systematic review of the literature carried out from 2016 to 2022, with a search for articles using the keywords: "PCICU", "cardiac surgery", "nosocomial infection", "congenital heart disease", "risk factors" in international bibliographic databases (PubMed, Scopus and Google Scholar) as well as synonyms or combinations of words. The criteria for the inclusion of the articles in the study were: To be written in the English language, to be published in valid scientific journals in the databases PubMed, Scopus, Google Scholar, to concern children in ICU (cardiac surgery or not) after cardiac surgery, to be about the post-operative infections of these children and to mention in them the micro-organisms responsible for these infections. Results: postoperative infections occur in a large percentage of children (>4.7%) who underwent cardiac surgery, while mortality from them ranges from 13.7-35.7%. The most common infections are bloodstream infections (BSI), respiratory tract infections, urinary tract infections and surgical wound infections. The pathogens isolated from these infections are more often Gram(+) pathogens. The most frequent pathogens isolated were Staphylococcus aureus, Streptococcus spp., Candida spp., Escherichia coli, Klebsiella, Acinetobacter, Pseudomonas aeruginosa. The most frequent risk factors for the development of infections are intubation, prolonged duration of mechanical ventilation, length of stay in the PCICU, delayed sternal convergence, urinary catheter and body weight. Conclusions: Postoperative infections in PCICUs are a major problem in these patients, and efforts to address it should focus on greater investigation of reported risk factors. [ABSTRACT FROM AUTHOR]

Objectives: Postoperative antibiotic therapy is a common practice following septoplasty with intra‐septal splints placement (ISS), even though there is a lack of evidence to support it. We sought to investigate the role of antibiotic therapy in septal surgeries with the placement of ISS. Design: A retrospective comparative study was conducted using the electronic charts of adult patients who underwent septoplasty with the placement of ISS with or without turbinate reduction. Nasal cultures were taken routinely during surgery as part of the department's protocol for monitoring infectious diseases. The ISS were also routinely examined for the presence of bacteria after their removal on the eighth day following surgery. Setting: A large otolaryngology department in a tertiary medical center. Participants: Adult patients who underwent septoplasty in our institution. Main outcome measures: We analyzed all post‐operative infections to search for risk factors in the cohort. Results: Post‐operative infection rates following septoplasty with ISS were low at 6%, which is consistent with previously published rates. Infection rates were significantly higher in patients who were not treated with antibiotics (OR = 8.2, 95%CI: 1.63–41.1; p =.01, φ = 0.04). Diabetes was associated with an increased risk of postoperative infection regardless of prophylactic antibiotic therapy (OR = 5.2, 95%CI: 1.15–23.5; p =.032, φ =.04). The detection of Klebsiella pneumonia before surgery was associated with an increased rate of postoperative infection (OR = 16.6, 95%CI: 3.02–91.54; p =.001, φ = 0.12). Conclusions: Patients undergoing septoplasty with the placement of ISS are at increased risk of gram‐negative bacterial colonisation, and development of postoperative nasal infection. A single preoperative dose of IV antibiotic therapy should be considered a potential prophylactic option for septoplasty with ISS. [ABSTRACT FROM AUTHOR]

Background: Previous studies about antibiotic prophylaxis in foot and ankle surgery have focused on perioperative intravenous administration, with few studies reporting on the efficiency of postoperative oral antibiotics. The purpose of this study is to investigate differences in the rate of postoperative infection and wound complications between patients with and without postoperative oral antibiotics and to identify independent risk factors for these complications following foot and ankle surgeries. Methods: A retrospective review of all elective foot and ankle surgeries with at least a 6-month follow-up was performed over a 2-year time span. Patients were divided into 2 groups based on if they received postoperative oral antibiotics. We compared the rates of postoperative infections and wound complications between the 2 groups. The surgical site, the number of Current Procedural Terminology codes, and the number of surgical incisions were also noted. Multivariable logistic regression analysis was performed to identify independent risk factors of postoperative infection and wound complications. Results: A total of 366 patients were included in this study--240 with antibiotics and 126 without antibiotics. There was no significant difference in the rates of postoperative infection and wound complications between the 2 groups. The rate of superficial infection, deep infection, and wound complications was 1.7%, 0.8%, and 5.8% in the antibiotic group vs 3.2%, 0.0%, and 4.0% in patients without antibiotics, respectively. Multivariable logistic regression analysis identified independent risk factors of postoperative infection and wound complications as follows: smoking (OR: 4.7), male (OR: 4.0), history of neoplasm (OR: 6.7), and multiple incisions (OR: 4.1). Conclusion: Our results suggest that routine postoperative prophylactic oral antibiotics are not needed following elective foot and ankle surgeries. However, certain risk factors may increase the risk for postoperative infection and wound complications in foot and ankle surgery. [ABSTRACT FROM AUTHOR]

Background: Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative. Hypothesis: Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection. Study Design: Cohort Study; Level of evidence, 3. Methods: All patients between the ages of 10 and 65 years who underwent primary bone–patellar tendon–bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals—measured in days—between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort. Results: There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3). Conclusion: Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective cohort study. Objective. The purpose of this study was to characterize the infection risk of preoperative epidural steroid injection (ESI) in patients undergoing posterior cervical surgery. Summary of Background Data. ESI is a helpful tool for alleviating pain and is often used as a diagnostic tool before cervical surgery. However, a recent small-scale study found that ESI before cervical fusion was associated with an increased risk of postoperative infection. Materials and Methods. Patients from 2010 to 2020 with cervical myelopathy, spondylosis, and radiculopathy who underwent posterior cervical procedure including laminectomy, laminoforaminotomy, fusion, or laminoplasty were queried from the PearlDiver database. Patients who underwent revision or fusion above C2 or who had a diagnosis of neoplasm, trauma, or preexisting infection were excluded. Patients were divided on whether they received an ESI within 30 days before the procedure and subsequently matched by age, sex, and preoperative comorbidities. The χ² analysis was used to calculate the risk of postoperative infection within 90 days. Logistic regression controlling for age, sex, Elixhauser Comorbidity Index, and operated levels was conducted within the unmatched population to assess infection risk for injected patients across procedure subgroups. Results. Overall, 299,417 patients were identified with 3897 having received a preoperative ESI and 295,520 who did not. Matching resulted in 975 in the injected group and 1929 in the control group. There was no significant difference in postoperative infection rate in those who received an ESI within 30 days preoperatively and those who did not (3.28% vs. 3.78%, odds ratio = 0.86, 95% CI: 0.57-1.32, P = 0.494). Logistic regression accounting for age, sex, Elixhauser Comorbidity Index, and levels operated demonstrated that injection did not significantly increase infection risk in any of the procedure subgroups. Conclusions. The present study found no association between preoperative ESI within 30 days before surgery and postoperative infection in patients undergoing posterior cervical surgery. [ABSTRACT FROM AUTHOR]

This study assessed the efficacy and safety between broad spectrum penicillin (P2) with or without beta-lactamase inhibitors (P2+) versus first and second generation cephalosporins (C1&C2) in the prevention of post-cesarean infections. Relevant randomized controlled trials (RCTs) were searched in English and Chinese databases: nine RCTs were involved. Six trials compared P2+ vs C1&C2, no differences were found between interventions for endometritis, wound infection, urinary tract infection, febrile morbidity and maternal rashes. Four trials compared P2 vs C1&C2, no differences were found between interventions for endometritis, febrile morbidity, wound infection and urinary tract infection. Postoperative hospitalization was longer for women in P2 than C1&C2. Based on these results, P2/P2+ and C1&C2 may have similar efficacy on postoperative infections after cesarean section, there is no data on infant outcomes. PROSPERO Registration Number: CRD42022345721. [ABSTRACT FROM AUTHOR]

It remains unclear whether antibiotic prophylaxis (AP) should be recommended or discouraged in robot-assisted laparoscopic radical prostatectomy (RALP) for prostate cancer (PCa). The development of microbial resistance and side effects are risks of antibiotic use. This systematic review (SR) investigates the evidence base for AP in RALP. A systematic literature search was conducted until 12 January 2023, using Embase, MEDLINE, Cochrane CENTRAL, Cochrane CDSR (via Ovid) and CINAHL for studies reporting the effect of AP on postoperative infectious complications in RALP. Of 436 screened publications, 8 studies comprising 6378 RALP procedures met the inclusion criteria. There was no evidence of a difference in the rate and severity of infective complications within 30 days after RALP surgery between different AP protocols. No studies omitted AP. For patients who received AP, the overall occurrence of postoperative infectious complications varied between 0.6% and 6.6%. The reported urinary tract infection (UTI) rates varied from 0.16% (4/2500) to 8.9% (15/169). Wound infections were reported in 0.46% (4/865) to 1.12% (1/89). Sepsis/bacteraemia and hyperpyrexia were registered in 0.1% (1/1084) and 1.6% (5/317), respectively. Infected lymphoceles (iLC) rates were 0.9% (3 of 317) in a RALP cohort that included 88.6% pelvic lymph node dissections (PLND), and 3% (26 of 865) in a RALP cohort where all patients underwent PLND. Our findings underscore that AP is being administered in RALP procedures without scientifically proven evidence. Prospective studies that apply consistent and uniform criteria for measuring infectious complications and antibiotic-related side effects are needed to ensure the comparability of results and guidance on AP in RALP. [ABSTRACT FROM AUTHOR]

Abstract Background Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for pseudomyxoma peritonei (PMP). It can significantly prolong the survival of patients, but at the same time may increase the risk of postoperative infection. Method Patients with PMP who underwent CRS + HIPEC at our center were retrospectively analyzed. According to PMP patients, basic clinical data and relevant information of postoperative infection, we analyzed the common sites of postoperative infection, results of microbial culture and the antibiotics sensitivity. Univariate and multivariate analysis were performed to explore infection-related risk factors. Result Among the 482 patients with PMP, 82 (17.0%) patients were infected after CRS + HIPEC. The most common postoperative infection was central venous catheter (CVC) infection (8.1%), followed by abdominal-pelvic infection (5.2%). There were 29 kinds of microbes isolated from the culture (the most common was Staphylococcus epidermidis), including 13 kinds of Gram-positive bacteria, 12 kinds of Gram-negative bacteria, and 4 kinds of funguses. All the antibiotics sensitivity results showed that the most sensitive antibiotics were vancomycin to Gram-positive bacteria (98.4%), levofloxacin to Gram-negative bacteria (68.5%), and fluconazole to fungus (83.3%). Univariate and multivariate analysis revealed the infection independent risk factors as follow: intraoperative blood loss ≥ 350 mL (P = 0.019), ascites volume ≥ 300 mL (P = 0.008). Conclusion PMP patients may have increased infection risk after CRS + HIPEC, especially CVC, abdominal-pelvic and pulmonary infections. The microbial spectrum and antibiotics sensitivity results could help clinicians to take prompt prophylactic and therapeutic approaches against postoperative infection for PMP patients.

Introduction: Ventral Hernia Repair (VHR) is one of the most frequently performed surgical procedures worldwide. The two commonly used surgical techniques for ventral hernia are onlay and sublay repairs. The use of drains in hernioplasty is controversial, as some studies suggest an increased incidence of surgical site infections. Aim: This study aims to compare the postoperative outcomes between patients who had drains placed and those who did not, undergoing elective open VHR. Materials and Methods: A prospective interventional study was conducted at the Department of General Surgery, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India. The study duration was one year, from September 2020 to September 2021. A total of 50 hernia patients participated, with 25 undergoing drainless and 25 undergoing drain onlay mesh hernioplasty. Surgical complications such as surgical site infection, seroma formation, and duration of hospital stay were observed and compared between the two groups. Independent t-tests and Chi-square tests were used to compare continuous and categorical variables, respectively. Results: Out of 50 patients, 15 (60%) in the drain group were aged between 11 to 60 years, while 11 (44%) in the drainless group were aged between 18 to 40 years. Postoperative seroma was present in 6 (12%) patients, with an equal distribution in both groups (p-value >0.05). Surgical site infection was present in 3 (60%) and 2 (40%) patients in group A and group B, respectively (p-value >0.05). The mean duration of hospital stay was 6.36±1.89 and 4.92±1.91 days in group A and group B, respectively (p-value=0.010). Conclusion: The presence or absence of a drain did not significantly affect the formation of seroma among the participants. The incidence of infection did not vary significantly with or without the use of a drain.

In this paper, survival curves and Cox regression models were used to form an integrated disease risk factor model. Stepwise Cox regression models using the AIC criterion and the BIC criterion were included in the comparative models, penalties were imposed on the regression parameters for variable selection, and important covariates were selected to analyze censored data so as to analyze the dependence of dichotomous outcome events and survival time on the covariates. Applying the model of this paper to investigate postoperative infection and seizure risk in glioma, the results showed that 104 strains of pathogenic bacteria were detected. Gram-positive bacteria were the most prevalent infection-causing organisms with 67 strains, with Streptococcus grass-green and Staphylococcus epidermidis being the most common. There were 34 strains (32.69%) of gram-negative bacteria, and Acinetobacter baumannii was the most common one. 3 strains (2.88%) of fungi were present. Cox regression analysis was used to screen for five independent risk factors for surgical site infections in patients undergoing glioma surgery: neutrophil ratio, lymphocyte ratio, surgical grade (III), duration of antibiotic use, and postoperative day three temperature. The presence or absence of preoperative epilepsy has an impact on the prognosis of glioma patients, with fluctuating seizures being the most common postoperative condition in patients with grade II-III gliomas, which often recur after 12 months of seizure-free epilepsy. To sum up, the findings of this report are highly instructive in determining the prognosis for glioma treatment.

Swabs were taken from 340 different sites of skin divided into four groups including; group 1/160 swabs, group 2/50 swabs, group 3/100 swabs, group 4/30 swabs, taken from 100 female patients’ skin before surgery at the site of cesarean incision from several positions before and after sterilization with 10% povidone-iodine and with 10% povidone-iodine mixed with 70% ethanol, and from infected surgical sites. The bacterial isolates were identified by phenotypic examination, biochemical tests, as well as VITEK-2 assay. Staphylococcus epidermidis was the prevalent bacteria isolated from skin sample sources in group 1,2, and 3 with a total rate 81% followed by Staphylococcus aureus which was dominant in group 4 that included surgical site infection swabs. In addition, other bacteria species were isolated from different skin sites such as Staphylococcus haemolyticus, Kocuria kristinae, Enterobacter cloacae, Aerococcus viridans, Pantoea, and Burkholderia cepacian. Most isolates had hemolytic activity and all of them showed Beta hemolysis except Aerococcus viridans that expressed alpha hemolysis. Most isolates from numerous bacterial groups showed moderate biofilm production.

The successful operative management of spinal infections necessitates a thoughtful approach. Ideal treatment combines the universal goals of any spine operation, which are decompression of the neural elements and stabilization of instability, with source control and eradication of infection. Techniques to treat infection have evolved independently and alongside advances in implant technology and surgical techniques. This review will seek to outline current thinking on approaches to both primary and secondary spinal infections.

This study assessed the efficacy and safety between broad spectrum penicillin (P2) with or without beta-lactamase inhibitors (P2+) versus first and second generation cephalosporins (C1&C2) in the prevention of post-cesarean infections. Relevant randomized controlled trials (RCTs) were searched in English and Chinese databases: nine RCTs were involved. Six trials compared P2+ vs C1&C2, no differences were found between interventions for endometritis, wound infection, urinary tract infection, febrile morbidity and maternal rashes. Four trials compared P2 vs C1&C2, no differences were found between interventions for endometritis, febrile morbidity, wound infection and urinary tract infection. Postoperative hospitalization was longer for women in P2 than C1&C2. Based on these results, P2/P2+ and C1&C2 may have similar efficacy on postoperative infections after cesarean section, there is no data on infant outcomes. PROSPERO Registration Number: CRD42022345721.

Introduction and hypothesis: The aim of this study was to explore if antibiotic prophylaxis prevents postoperative infection after a posterior colporrhaphy. Methods: In this register-based nationwide cohort study data were collected from the "The Swedish National Quality Register of Gynecological Surgery" (GynOp). Women 18 years or older who underwent a primary posterior colporrhaphy between 1 January 2015 and 31 December 2020 were included. Patients undergoing any concomitant prolapse procedure, mesh surgery, or incontinence procedure were excluded. The cohort was divided into two groups based on administration of antibiotic prophylaxis (n = 1,218) or not (n = 4,884). The primary outcome of this study was patient-reported infectious complication requiring antibiotic treatment. Secondary outcome measures included patient satisfaction and prolapse-related symptoms at 1 year postoperatively. Results: A total of 7,799 patients who underwent posterior colporrhaphy and met the inclusion criteria and did not meet the exclusion criteria were identified in the register database. Of these patients 6,102 answered the primary outcome question (79%). In the antibiotic prophylaxis group a total of 138 reported a postoperative infection (11%) and in the no antibiotic prophylaxis group the corresponding data were 520 (11%). There were no significant differences regarding either the primary or the secondary outcomes between the study groups. Conclusion: In this nationwide Swedish register study antibiotic prophylaxis was not associated with a reduced risk of postoperative infection after a posterior colporrhaphy. [ABSTRACT FROM AUTHOR]