Surgical infections最新文献

{"title":"Esmarch Exsanguination in Acute Hand Infections: Evaluating Risk of Infection Spread.","authors":"Jacob Zeitlin, Sebastian D Arango, Jason C Flynn, Jon E Hammarstedt, Tristan B Weir, Andrew J Miller","doi":"10.1177/10962964251360249","DOIUrl":"https://doi.org/10.1177/10962964251360249","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to evaluate the infection-related complication rates associated with the use of Esmarch exsanguination compared with gravitational exsanguination in patients undergoing surgery for acute hand and forearm infections. <b><i>Patients and Methods:</i></b> A retrospective cohort study was conducted from December 2020 to March 2024 at a level 1 trauma center. Adult patients with acute hand or forearm infections who underwent irrigation and debridement (I&D) within 21 days of symptom onset were included. Patients with systemic infection at admission were excluded. The incidence of infection-related complications, including repeat I&D, hematological spread of infection, and 30-day readmission, was compared between those who underwent Esmarch exsanguination and those who did not, using Fisher exact test. <b><i>Results:</i></b> The study included 80 patients, 33 in the Esmarch group and 47 in the non-Esmarch group. The overall complication rate was 15.2% in the Esmarch group compared with 8.5% in the non-Esmarch group. Repeat I&D was required in 12.1% of Esmarch patients versus 6.4% of non-Esmarch patients. Hematological spread occurred in one patient in each group, and readmissions were 9.1% in the Esmarch group compared with 2.1% in the non-Esmarch group. There was no statistically significant difference in the rates of infectious complications between the Esmarch and non-Esmarch groups. <b><i>Conclusions:</i></b> This study challenges the longstanding avoidance of Esmarch exsanguination in the context of acute hand infections, suggesting that its use does not significantly increase the risk of infection-related complications. These findings suggest that surgeons may consider the use of Esmarch exsanguination in hand surgery without a significant increase in infection-related risks, potentially improving surgical visualization and outcomes. Further studies are needed to confirm these results.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Surgical Site Infection in Orthopedic Surgery: A Multi-Site Prevalence Day Exercise in the United Kingdom and Ireland.","authors":"Rhidian Morgan-Jones, Nichola McLaughlin, Danielle Briggs, Tim Styche","doi":"10.1177/10962964251360133","DOIUrl":"https://doi.org/10.1177/10962964251360133","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To highlight the burden of surgical site complications (SSCs) across inpatients who have recently undergone orthopedic surgery by undertaking surgical site infection (SSI) prevalence days. <b><i>Patients and Methods:</i></b> Sites from the United Kingdom and Ireland enrolled in a single day's data collection (either March or September 2022) to capture inpatient prevalence of SSIs and other SSCs. Data were collected from patients recovering from primary and revision hip or knee surgery and neck of femur (NOF) fracture surgery. <b><i>Results:</i></b> Data were collected on 851 inpatients across the two days, with NOF fracture surgery representing 50% of overall procedures, followed by primary hip (25.4%) and primary knee (12.8%) procedures, with 11.9% of patients in the hospital following revision procedures. The majority of patients documented across both days had at least one risk factor (76% overall). The overall prevalence of SSCs was 8% (n = 68). Revision surgical procedures had significantly higher complication rates than primary surgical procedures in both hips and knees (p < 0.01). The highest observed odds ratios (ORs) for SSCs were in patients who listed immunosuppression (OR = 2.47), previous SSI (OR = 4.59), and smoking (OR = 2.34) among their risk factors. Higher overall lengths of stay were observed in patients with complications. <b><i>Conclusion:</i></b> These prevalence days were a successful initiative to help hospital sites understand their own burden, benchmark against national averages, and contribute to a better national understanding of the burden of SSC, both to healthcare systems and, most importantly, patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Mucormycosis: An Infrequent Guest in Breast Infections.","authors":"Jianping Mao, Yongmao Huang, Ying Si","doi":"10.1177/10962964251360247","DOIUrl":"https://doi.org/10.1177/10962964251360247","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dirty Truth About Resuscitative Endovascular Balloon Occlusion of the Aorta: A Descriptive Analysis of Infection Rates in a High-Risk Population.","authors":"James Walker, Courtney Meyer, Victoria Wagner, Vanessa Arientyl, Eunice Aworanti, Ryan Fransman, Christine Castater, S Rob Todd, Randi N Smith, Jason D Sciarretta, Jonathan Nguyen","doi":"10.1089/sur.2024.294","DOIUrl":"https://doi.org/10.1089/sur.2024.294","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become a viable alternative to open aortic occlusion for hemorrhage control. It is often performed without maximal barrier precautions, and sterility is not consistently ensured. As REBOA usage increases, a knowledge gap exists in its infectious risks. We sought to characterize the type and incidence of infectious complications in patients undergoing REBOA. <b><i>Patients and Methods:</i></b> A retrospective review of all REBOA patients at an urban, American College of Surgeons-verified Level I Trauma Center was conducted from November 2016 to September 2023. The trauma registry was queried for all patients who underwent REBOA placement. Data pertaining to patient demographics and infectious complications were obtained for descriptive analysis. The medical record was then examined for the source of bacteremia and other infectious complications. Patients who did not survive beyond hospital day two were excluded. <b><i>Results:</i></b> Seventy patients met the inclusion criteria. The median age was 40.3 years (IQR 29.5), and patients were predominantly male (72.8%). The overall mortality rate was 19.1%. Among all patients, 37% (<i>n</i> = 26) developed pneumonia, 17% (<i>n</i> = 12) had a deep or organ-space surgical site infection (SSI), and 12.8% (<i>n</i> = 9) had a blood stream infection. None were bacteremic within 48 hours of REBOA placement. All blood stream infections could be associated with concurrent infections such as intra-abdominal sepsis, pneumonia, or soft tissue infection. No SSIs were identified at the site of vascular access. <b><i>Conclusions:</i></b> Our findings demonstrate a modest rate of infectious complications among patients undergoing REBOA placement, comparable with published historical data, but no evidence to suggest infectious complications directly related to REBOA placement. Although limited by small sample size and single-institution experience, this study serves as one of the first studies to describe the infection rates in patients undergoing REBOA. Further prospective multi-center studies are required to evaluate the true infectious risks associated with REBOA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a Single Strand of Hair Contaminate a Surgical Instrument Set? A Controlled Experimental Study.","authors":"Nurgül Arpag, Hamdiye Banu Katran, Sevgi Gür, Zeynep Çizmeci","doi":"10.1177/10962964251359184","DOIUrl":"https://doi.org/10.1177/10962964251359184","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infections account for a substantial proportion of hospital-acquired infections, and the proper sterilization of surgical instruments is crucial for their prevention. Hair strands detected in sterile surgical sets are generally considered sufficient grounds for rejection, leading to delays in surgical procedures. The present study evaluates the impact of hair strands on the efficacy of sterilization and the potential for contamination. <b><i>Patients and Methods:</i></b> This controlled experimental study was conducted in the sterilization unit of a public hospital in Istanbul between January 15 and February 15, 2023. It was hypothesized that no microbial growth would occur in hair strands or on surgical instruments after sterilization, regardless of the contamination status or sterilization method. The surgical sets obtained for the study were divided into three groups: experiment group 1, to which uncontaminated hair strands were applied (n = 6); experiment group 2, to which hair strands contaminated with one of five bacterial pathogens were applied (<i>Escherichia coli</i>, <i>Staphylococcus aureus</i>, <i>Pseudomonas aeruginosa</i>, <i>Candida albicans</i>, and <i>Enterococcus faecalis</i>; n = 30); and the control group, to which no hair strands were applied (n = 6). The soft tissue surgical instruments in each group were standardized by weight (3-3.5 kg) and sterilized using one of three methods: pressurized steam, ethylene oxide, or hydrogen peroxide. After sterilization, microbiological samples were collected by culturing swabs from the hair strands and surgical instruments under appropriate conditions in tryptic soy broth and various agar media. <b><i>Results:</i></b> No microbial growth was observed in any group after sterilization, regardless of the presence or contamination of hair strands or the sterilization method used. The biological indicators also identified no growth after sterilization. <b><i>Conclusion:</i></b> The present highlights the effectiveness of proper sterilization techniques, even in the presence of hair strands, and suggests that hair should not be treated as a potential source of contamination in all surgical settings. It should be noted, however, that the present study was conducted under controlled clinical microbiology laboratory conditions and so does not consider the complexity and variability of clinical environments. Surgical units should thus be encouraged to replicate these data or carry out similar studies and revise their practices based on their own results.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Why the Surgical Site Infection Rate in China Is Reported Lower than that in the United States.","authors":"Jiao Shan, Xiaoyuan Bao, Meng Jin, Yulong Cao","doi":"10.1177/10962964251359211","DOIUrl":"https://doi.org/10.1177/10962964251359211","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery Wards' Health Caregivers' Knowledge, Attitude, and Practices Regarding the Pre-Operative Shower: A French Multi-Center Descriptive Survey.","authors":"Agnès Cottalorda, Juliette Monteil, Mélanie Consiglio, Marion Lefebvre, Hélène Marini, Véronique Merle","doi":"10.1089/sur.2024.311","DOIUrl":"https://doi.org/10.1089/sur.2024.311","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgery ward caregivers are responsible for educating patients about the pre-operative shower (POS), assisting with the shower as necessary, and evaluating skin cleanliness before transport to the operating theater to mitigate the risk of surgical site infections. <b><i>Aim:</i></b> To describe the knowledge, attitudes, and declared practices of surgery ward caregivers concerning the POS. <b><i>Methods:</i></b> A multi-center prospective survey was performed on a random sample of nurses and nurse assistants from five French surgical facilities. Caregivers were asked about their training regarding POS, their ward protocol, knowledge of current French guidelines, attitudes, self-reported practices, and challenges pertaining to the POS. <b><i>Results:</i></b> All selected caregivers agreed to participate. Of the 72 respondents, 39% declared having received POS-related initial training, whereas 49% indicated the presence of a POS protocol within their ward. Both nurses and nurse assistants reported a lack of clear delineation in their tasks regarding the POS. Knowledge of the existing POS guidelines was found suboptimal, with superfluous precautions wrongly deemed mandatory. With regard to personal practices, caregivers highlighted the need to tailor communication to the patient's age, dependence, and body size. The predominant declared method for assessing skin cleanliness was verification of POS completion, occasionally supplemented by visual inspection of the incision site. Skin cleanliness assessment was poorly organized and perceived as intrusive by caregivers, especially for surgical procedures involving genital areas, with the patient's gender markedly impacting this perception. <b><i>Discussion:</i></b> This survey corroborates substantial deficiencies in POS process training, implementation, and caregiver perceptions.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps and Opportunities in Antimicrobial Stewardship and Surgical Site Infection Surveillance Across India.","authors":"Abhinay Tumati, Harjot K Singh, Divya Kewalramani, Manjari Joshi, Philip S Barie, Mayur Narayan","doi":"10.1089/sur.2025.043","DOIUrl":"https://doi.org/10.1089/sur.2025.043","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infections (SSIs) constitute major yet preventable complications. Antimicrobial stewardship programs (ASPs) are evidence-based interventions recommended to reduce SSI incidence, yet their implementation and impact in India remain poorly characterized. This study aimed to assess current ASP implementation and SSI surveillance practices in Indian hospitals to identify gaps and inform future interventions. <b><i>Methods:</i></b> A prospective cross-sectional survey of five geographically diverse Indian academic medical centers was conducted between 2017 and 2021, assessing existing ASPs, surgical volume, SSI incidence and surveillance protocols, prevalence of multi-drug-resistant organisms (MDRO), and microbiology laboratory capability. Data were collected using REDCap® and analyzed for inter-center variations. <b><i>Results:</i></b> Three of five (60%) centers completed the survey. All reported SSI surveillance, with heterogenous monitoring frequency (i.e., daily to monthly). Two had formal patient safety and infection prevention committees; none had an ASP committee. Only one provided formalized education on pre-operative patient preparation or ASP principles. All had an accessible microbiology laboratory, but only one had pharmacy informatics to track antimicrobial agent utilization. Across hospitals, the mean (range) MDRO prevalence was as follows: methicillin-resistant <i>Staphylococcus aureus</i> 3.9% (1.5%-11.5%); extended-spectrum beta-lactamase producers 32.7% (15.1%-57.4%); and carbapenem-resistance 16.0% (3.7%-30.0%). <b><i>Conclusions:</i></b> ASP implementation and SSI surveillance practices vary widely across Indian academic hospitals, with key gaps in committee oversight, clinician education, informatics infrastructure, and subspeciality-based data. High MDRO rates highlight the urgent need for standardized, scalable stewardship frameworks tailored to the Indian healthcare context. Multiple opportunities exist to address these gaps and combat antimicrobial agent resistance at a national level, but a lack of infrastructure poses barriers.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Risk Factors for Organ/Space Infections Following Appendectomy for Complicated Appendicitis in Children.","authors":"Mohamed Zouari, Manel Belhajmansour, Manar Hbaieb, Hamdi Louati, Wiem Rhaiem, Najoua Ben Kraiem, Mahdi Ben Dhaou, Riadh Mhiri","doi":"10.1089/sur.2025.088","DOIUrl":"https://doi.org/10.1089/sur.2025.088","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound Complications in Patients with Overweight, Obesity, and Gynecologic Cancer: A Retrospective Analysis of Staple Versus Suture Closure.","authors":"Fatma Ceren Güner, Elif Iltar, Selen Doğan, Hasan Aykut Tuncer, Tayup Şimşek","doi":"10.1089/sur.2024.320","DOIUrl":"https://doi.org/10.1089/sur.2024.320","url":null,"abstract":"<p><p><b><i>Background:</i></b> Wound complications in gynecologic oncology, especially among patients with overweight and obesity, can significantly impact post-operative recovery and delay the initiation of adjuvant treatment. Although staples are commonly used for vertical incisions, sutures may offer clinical advantages; however, direct comparative data remain limited. This study aimed to compare post-operative wound complication rates between staples and non-absorbable sutures in patients with gynecologic cancer with a body mass index ≥25 kg/m² and undergoing a vertical incision surgical procedure. <b><i>Patients and Methods:</i></b> A retrospective review was conducted at a gynecologic oncology center between January 2022 and September 2023. Patients who underwent midline laparotomy with either staples or 3-0 non-absorbable monofilament sutures for skin closure were included. Patients with prior chemotherapy, benign pathology, or age <18 were excluded. Wound complications-including seroma, hematoma, dehiscence (superficial and fascial), and infection-were recorded within eight weeks postoperatively. <b><i>Results:</i></b> Of 72 patients, 29 received staples and 43 received sutures. Wound complications occurred in 41% of the staple group and 21% of the suture group (p = 0.061). Fascial dehiscence was observed in four cases (two in each group). Although rates of dehiscence and infection were higher with staples, differences were not statistically significant. Hospital stay was significantly longer in the staple group (p = 0.045). <b><i>Conclusion:</i></b> Although not statistically significant, suture closure was associated with fewer wound complications and a shorter hospital stay, suggesting potential advantages in wound healing. These findings may inform future recommendations, and further prospective studies are warranted.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}