Surgical infections最新文献

{"title":"Predictors of Infectious Complications Following Emergency Colectomy: A Nationwide Analysis.","authors":"Yasmin Arda, Josip Plascevic, John F Jachimiak, Jack H A Miller, Riley B Brackin, Charudutt N Paranjape, John O Hwabejire, Haytham M A Kaafarani, George C Velmahos, Michael P DeWane","doi":"10.1177/10962964261437620","DOIUrl":"https://doi.org/10.1177/10962964261437620","url":null,"abstract":"<p><strong>Background: </strong>Infectious complications following emergency colectomy are a significant cause of morbidity and mortality. We aimed to identify predictors of infection after emergency colectomy.</p><p><strong>Patients and methods: </strong>We analyzed the 2013-2017 American College of Surgeons National Surgical Quality Improvement Program database to identify patients ≥ 18 years undergoing emergency colectomy. The primary outcome was post-operative infectious complication rate, defined as the presence of sepsis, septic shock, surgical site infection, pneumonia, or urinary tract infection. Multivariable logistic regression was used to investigate the effect of pre-operative/operative factors on infection risk.</p><p><strong>Results: </strong>Of 40,913 included patients, 17,481 (42.7%) developed infectious complications. On multivariable analyses, pre-operative factors associated with increased odds of infectious complications were body mass index ≥30, chronic obstructive pulmonary disease, bleeding disorder, ascites, smoking, dependent functional status, American Society of Anesthesiologists ≥3, blood urea nitrogen ≥ 20 mg/dL, and albumin ≤ 3 g/dL. Additionally, dirty wound class and open, delayed, or prolonged surgical procedure were associated with increased infection risk.</p><p><strong>Conclusions: </strong>Identifying predictors of infection following emergency colectomy may inform perioperative decision-making and guide strategies to reduce infection-related morbidity.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261437620"},"PeriodicalIF":1.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654913","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":"Renal Pelvic Urine Density for Early Prediction of Post-Decompression Systemic Inflammatory Response in Stone-Related Obstruction.","authors":"Ali Ayten, Oguzhan Cura, Mert Kahraman, Ferhat Berker, Mucahit Gelmis, Burak Arslan","doi":"10.1177/10962964261440869","DOIUrl":"https://doi.org/10.1177/10962964261440869","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to evaluate the prognostic value of renal pelvic urine density (RPUD) measured by computed tomography (CT) in predicting systemic inflammatory response syndrome (SIRS) after decompression in patients with non-infectious obstructive uropathy associated with stones.</p><p><strong>Patients and methods: </strong>Patients who underwent emergency decompression due to non-infectious obstructive uropathy caused by urinary stones between January 2018 and July 2025 were retrospectively analyzed. Cases with clinical, laboratory, or radiological findings of infection were excluded from the study. Demographic characteristics, stone characteristics, degree of hydronephrosis, RPUD, and perioperative parameters were recorded. Patients were divided into SIRS (+) and SIRS (-) groups on the basis of postoperative clinical findings. Independent predictors of SIRS were determined using multi-variable logistic regression, and the diagnostic performance of RPUD was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>A total of 247 patients were included in the study, and 36 (14.6%) developed SIRS after decompression. RPUD values were significantly higher in SIRS (+) patients (12.5 vs. 9.4 HU, p < 0.001). Multi-variable analysis identified RPUD as an independent predictor of SIRS (odds ratios [OR] = 2.061, 95% CI: 1.586-2.679, p < 0.001). ROC analysis showed that an RPUD cutoff value of 10.5 HU predicted SIRS development with 77.8% sensitivity and 74.9% specificity, area under the curve (AUC) = 0.830.</p><p><strong>Conclusion: </strong>RPUD is a strong and independent prognostic marker for the early prediction of SIRS after decompression in non-infectious obstructive uropathy associated with stones.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261440869"},"PeriodicalIF":1.4,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628760","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":"Emergency Cesarean Section Pre-operative Antibiotic Agent Prophylaxis-Opportunities for Improvement.","authors":"Gabriela Cortese, Stefka Fabbri, Daniel Dante Yeh, Robyn Bronshtein, Heather Young, Alex Kaizer","doi":"10.1177/10962964261438107","DOIUrl":"https://doi.org/10.1177/10962964261438107","url":null,"abstract":"<p><strong>Background: </strong>Surgical Care Improvement Project (SCIP) recommends prophylactic antibiotic agents (abx) within 60 min before incision. This quality improvement study assessed SCIP compliance in emergent cesarean sections (CSs) to identify opportunities for improvement.</p><p><strong>Methods: </strong>This retrospective study included patients undergoing emergent CSs at our institution between May 2016 and December 2023. Maternal demographic, obstetric, medical, and labor outcomes were abstracted. The primary outcome was the incidence of timely (within 60 min of incision) administration of abx. Secondary outcomes included maternal intensive care unit (ICU) admission, hospital length of stay (LOS), loss to follow-up, surgical site infection (SSI), and 30-day outcomes. Logistic regression analyses were performed to identify predictors of SCIP compliance.</p><p><strong>Results: </strong>A total of 876 patients were included in the study. The most common indication for CSs was non-reassuring fetal status, and the most common form of anesthesia was epidural. Abx were administered in 98% of cases, but only 73% were SCIP compliant. Chlorhexidine-alcohol was most commonly used for abdominal skin preparation. There were significant differences between the SCIP Not Compliant versus Compliant group, but multiple logistic regression identified only American Society of Anesthesiologists (ASA) Class 3 (OR: 0.69 95% CI: 0.49-0.97, p = 0.034), ASA Classes 4/5 (OR: 0.22 95% CI: 0.04-0.96, p = 0.047), and prolapsed cord as indication for CSs (OR: 0.22 95% CI: 0.10-0.49, p < 0.001) as predictors of SCIP Not Compliant. Maternal morbidity was low, with only 2% ICU admission and median hospital LOS 4 days. Only (5%) were lost to follow-up. SSI rate was low (4%).</p><p><strong>Conclusion: </strong>We identified timeliness of pre-operative abx administration, abdominal skin preparation agent, and post-discharge follow-up as opportunities for improvement. SCIP non-compliance was significantly associated with emergent cesarean indication and higher ASA class. Post-operative SSI rates were low, though bias may be present because of the high loss-to-follow-up.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261438107"},"PeriodicalIF":1.4,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634370","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: Cryptococcus</i> Infection of the Acromion: A Rare Presentation.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1177/10962964261440865","DOIUrl":"https://doi.org/10.1177/10962964261440865","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261440865"},"PeriodicalIF":1.4,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628725","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> Paragonimiasis Presenting as an Abdominal Mass.","authors":"Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou","doi":"10.1177/10962964261442060","DOIUrl":"https://doi.org/10.1177/10962964261442060","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261442060"},"PeriodicalIF":1.4,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634313","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":"Surgical Management of Necrotizing Pneumonia in Pediatric Patients. A Retrospective Analysis in a Third-Level Center.","authors":"Mónica Martínez-Ferman, Amelia Fernández-Avendaño, Pablo Gomes-da Silva de Rosenzweig, Luis Fernando Arana-Bolaños, Xcaret Luna-Vargas, Johana Ramírez-Cruz, Christian Elena Archivaldo-García, Francina Valezka Bolaños-Morales","doi":"10.1177/10962964261436961","DOIUrl":"https://doi.org/10.1177/10962964261436961","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing pneumonia (NP) is a rare entity seen to occur in 0.9%-7% of cases of community-acquired pneumonia in the pediatric population. Medical management remains the cornerstone of treatment. However, the destruction of both parenchyma and blood vessels impairs blood flow, limiting antibiotic concentrations and allowing the infection to persist. Although surgical management remains debated, some authors advocate for it in cases of medical treatment failure or extensive disease. The objective of this study was to present the surgical outcomes of our experience in treating NP in the pediatric population.</p><p><strong>Methods: </strong>A retrospective and observational study was conducted on all cases of NP in children who required surgical management between January 2022 and June 2024.</p><p><strong>Results: </strong>During the study period, a total of 142 pediatric thoracic surgeries were performed, of which 25 involved patients with NP, who were included in our analysis. The median age was 3 years (2-4), with a nearly equal gender distribution (52% female, n = 13). The median duration of symptoms prior to the surgical procedure was 27 days (22-36), antibiotic therapy duration ranged from 5 to 18 days. On the basis of computed tomography findings regarding the extent of parenchymal involvement, 17 patients underwent sublobar resections, while 8 required lobar resections. While no statistically significant differences were observed in post-operative outcomes between groups, it is noteworthy that patients who underwent lobectomy experienced a higher frequency of complications.</p><p><strong>Conclusion: </strong>Surgical intervention, typically involving resection of necrotic lung tissue, may be considered in carefully selected pediatric patients who demonstrate persistent clinical deterioration despite optimized medical therapy and exhibit extensive parenchymal destruction on imaging. It is critical to tailor the treatment plan to the patient's clinical status and disease progression.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261436961"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594967","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":"A Real-World Analysis of Hydrocortisone and Fludrocortisone Prescribing in Surgical Patients with Septic Shock.","authors":"Arnav Mahajan, Nick Beattie, Nilam Patel, Andrew Tran, Vanessa P Ho, Justin E Dvorak","doi":"10.1177/10962964261437315","DOIUrl":"https://doi.org/10.1177/10962964261437315","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroid use in septic shock remains controversial, with trials showing conflicting results. Most studies have been conducted in mixed medical-surgical populations, limiting generalizability to surgical patients who face unique risks. We examined how timing of steroid administration affects outcomes in surgical intensive care unit patients with septic shock.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed data from 13,512 surgical patients with septic shock using the TriNetX platform. Patients were categorized into four cohorts: no steroids (n = 8,180), any steroid therapy (n = 5,332), early therapy (≤24 h, n = 2,911), and late therapy (>24 h, n = 2,421). We conducted propensity-matched analyses examining 90-day mortality, infectious complications, and surgical complications.</p><p><strong>Results: </strong>Early steroid administration was associated with lower 90-day mortality compared with no steroids (31.5% vs. 33.3%; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.62-0.88; p = 0.006), whereas late administration correlated with higher mortality (34.1% vs. 27.1%; HR: 1.26; 95% CI: 1.11-1.43; p < 0.001). Steroids were associated with lower rates of surgical site infections (relative risk [RR]: 0.63; p = 0.032) and wound dehiscence (RR: 0.73; p = 0.019), but higher rates of pneumonia (RR: 1.22; p = 0.003), myopathy (RR: 2.25; p < 0.001), and bowel ischemia (RR: 2.29; p = 0.008).</p><p><strong>Conclusions: </strong>In surgical ICU patients with septic shock, the timing of steroid administration impacts outcomes. Early administration was associated with reduced mortality, whereas late administration correlated with increased mortality. Steroids demonstrated a complex profile of beneficial and adverse effects on post-surgical complications. These findings highlight the importance of timing of therapy in surgical septic shock and may help explain conflicting results from previous trials in mixed populations.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261437315"},"PeriodicalIF":1.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594942","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: Fusobacterium necrophorum</i> Subdural Empyema and Considerations for Hinge Craniotomy.","authors":"Hiroshi Yokota, Kenta Kounushi, Takehito Kasamatsu, Jumpei Nishii, Hidetsugu Maekawa, Kenta Fujimoto","doi":"10.1177/10962964251381639","DOIUrl":"10.1177/10962964251381639","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"235-236"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065538","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":"Detecting Surgical Glove Breaches: Evaluation of Double Glove Indicator System Performance Using an In Vitro Glove Perforation Method.","authors":"Katherine Dziak","doi":"10.1177/10962964261430395","DOIUrl":"https://doi.org/10.1177/10962964261430395","url":null,"abstract":"<p><strong>Background: </strong>Surgical glove breaches may compromise the aseptic barrier and pose risks to surgical staff. Double gloving with an indicator system improves breach detection compared with similar colored double gloves or single gloving. This study evaluates the performance of market-leading indicator gloves for breach detection.</p><p><strong>Methods: </strong>Liquid was introduced between layers of breach indicating polyisoprene double gloves (Brands A [six styles], B [three styles], and C [two styles]). Indication area was measured using a calibrated camera at two time points (immediate = 9.8 sec; final = 49 sec). Performance differences between styles and brands were analyzed using Games-Howell and Mood's tests (95% confidence interval).</p><p><strong>Results: </strong>Brand A had a larger and faster immediate median indication area (544 mm²; 55.5 mm²/sec; p < 0.05), compared with Brand B (61 mm²; 6.2 mm²/sec) and Brand C (115 mm²; 11.7 mm²/sec); this was 9.0 and 4.7 times faster than Brands B and C, respectively. Brand A also displayed a larger final median indication area (597 mm²; p < 0.05), compared with Brands B (124 mm²) and C (314 mm²), with a 4.8 and 1.9 times larger area, respectively. Brand A immediately reached 91% of its final indication area compared with only 49% and 37% for Brands B and C, respectively.</p><p><strong>Conclusions: </strong>Indicator glove performance influences breach visualization. Brand A gloves, which have unique surface characteristics, displayed the fastest and largest breach indication among the brands tested. Faster and larger breach indication enables rapid detection and response, protecting the aseptic barrier between the wearer and patient.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"10962964261430395"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594944","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":"Actinomycosis of the Sigmoid Colon Mimicking Malignancy and Presented with Bowel Obstruction.","authors":"George Pappas-Gogos, Maria Kouroupi, Helen Bolanaki, Ioannis Tzimagiorgis, Alexandra Giatromanolaki, Anastasios J Karayiannakis","doi":"10.1177/10962964251401452","DOIUrl":"10.1177/10962964251401452","url":null,"abstract":"<p><strong>Background: </strong>Actinomycosis is a chronic inflammatory condition caused by <i>Actinomyces israelii</i> or other <i>Actinomycetes</i> species, with primary abdominopelvic involvement being the most important form of the disease, especially when there is splanchnic infiltration. In cases of colonic involvement, the disease is often misdiagnosed as a neoplasm by imaging studies, and surgery is undertaken.</p><p><strong>Case presentation: </strong>We report the case of a 48-year-old male living in a rural area in whom a computed tomography (CT) scan showed a large, irregular abdominopelvic mass infiltrating the urinary bladder, the left ureter, and the sigmoid colon with luminal obstruction. He was referred with the presumptive diagnosis of abdominal sarcoma for surgical evaluation and treatment. He underwent a Hartmann's procedure with resection of the sigmoid colon and formation of an end colostomy. Multiple tissue samples were taken from the mass for histopathological examination. The correct diagnosis was made after pathological examination by detection of actinomycetes colonies. Penicillin-based therapy was commenced and continued for six months, when a CT revealed complete resolution of the pre-operative findings without any evidence of a mass.</p><p><strong>Conclusion: </strong>Although rare, actinomycosis should be considered in the differential diagnosis of colonic neoplastic lesions. Proper long-term antibiotic treatment is necessary for complete eradication of the infection and resolution of tissue alterations.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"231-234"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145639981","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}