Surgical infections最新文献

{"title":"<i>Letter:</i> Outcomes of the Subsequent Periprosthetic Joint Infection Revisions after a Failed Debridement, Antibiotics, and Implant Retention: A Multicentric Study of 197 Patients.","authors":"Xiangji Liu, Hao Wu","doi":"10.1089/sur.2025.004","DOIUrl":"10.1089/sur.2025.004","url":null,"abstract":"","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"451-452"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650886","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":"Closed Incisional Negative Pressure Wound Therapy is Cost-Effective at Reducing Superficial Surgical Site Infections.","authors":"Lauren T Kerivan, Katherine A Vilain, Terra M Hill, Christopher A Guidry","doi":"10.1089/sur.2024.286","DOIUrl":"10.1089/sur.2024.286","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical site infections (SSIs) have a significant health economic burden, accounting for more than US $3.3 billion in costs, and lead to increased microbial resistance, prolonged hospital stays, elevated 30-day mortality rates, greater incidences of reoperation, and decreased quality of life. Recently, evidence has emerged suggesting that prophylactic closed incision negative pressure wound therapy (ciNPWT) may substantially reduce the risk of post-operative wound complications, specifically SSIs. This study aimed to evaluate whether ciNPWT is cost-effective compared with routine incision care for the prevention of superficial SSIs. <b><i>Hypothesis:</i></b> We hypothesized that ciNPWT is cost-effective compared with routine incision care for the prevention of superficial SSIs. <b><i>Methods:</i></b> A cost-effectiveness decision analytic model was created comparing the use and non-use of ciNPWT. Superficial SSI probabilities, cost of care for patients with and without post-operative infection, and quality of life Short Form (SF)-36 survey data were obtained from a literature review. Cost of ciNPWT was obtained from health administrative data. A decision tree was constructed using TreeAge Software Pro Version 2020 (TreeAge Software, Inc., Williamstown, MA). Deterministic and probabilistic sensitivity analyses were performed to evaluate the robustness and reliability of the model. <b><i>Results:</i></b> One-way sensitivity analysis with a willingness-to-pay threshold of $5,000 demonstrated that above a baseline infection rate of approximately 6.4%, ciNPWT is cost-effective at reducing superficial SSI. Probabilistic sensitivity analysis indicated that even with uncertainty present in the parameters analyzed, the majority of simulations (95.4%) favored ciNPWT as the more effective tactic. <b><i>Conclusions:</i></b> Despite the added device cost, ciNPWT is cost-effective for superficial SSI prevention across a variety of surgical infection risk profiles.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"413-419"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664609","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 Infection Society Guidelines for Use of Antimicrobial Agent-Coated Suture to Reduce the Risk of Surgical Site Infection after Abdominal Operation.","authors":"Joseph D Forrester, Anu Seshadri, Nimitt Patel, Najiha Farooqi, Janice Lester, Phil Barie, Jared Huston","doi":"10.1089/sur.2025.011","DOIUrl":"10.1089/sur.2025.011","url":null,"abstract":"<p><p><b><i>Background:</i></b> Abdominal operation is common as are surgical site infections (SSIs). Triclosan (polychlorophenoxyphenol) is an antimicrobial antiseptic used in a variety of consumer products, including suture. The Surgical Infection Society's Therapeutics and Guidelines Committee convened to perform a systematic review and develop pragmatic recommendations for use of triclosan-coated suture in prevention of SSI after an abdominal surgical procedure. <b><i>Methods:</i></b> A research librarian designed and performed searches of three bibliographic databases: PubMed, Embase, and Web of Science. Methodology for this practice management guideline conformed to Reporting Items for practice Guidelines in HealThcare Working Group standards. Covidence was used for study selection and quality and certainty of published evidence was evaluated using GRADE. The clinical question assessed was: \"For adult patients undergoing abdominal surgery, does triclosan-coated suture vs. non-triclosan-coated suture reduce the risk of post-operative SSI?\" <b><i>Results:</i></b> A total of 3,616 studies were identified, with 30 studies involving 97,807 patients informing the clinical question response. Among included studies, 13 (43%) were randomized controlled trials (RCTs) and 17 (57%) were meta-analyses. Seventeen (57%) studies comprising 67,445 (69%) patients demonstrated reduction in SSI, with 13 (43%) studies comprising 30,362 (31%) patients demonstrating no benefit. Estimated cumulative adjusted absolute risk reduction associated with triclosan-coated sutures, among studies demonstrating benefit, was 3.2% (standard deviation ±6.2%). Overall quality of evidence was high. We recommend triclosan-coated suture for incision closure after an abdominal operation to reduce risk of SSI <i>(Grade 1A)</i>. <b><i>Conclusions:</i></b> Higher-level evidence suggests a small but significant benefit for triclosan-coated suture in reducing SSI risk following an abdominal surgical procedure.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"441-450"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027016","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":"Predictive Value of Stone Management According to Size-Hardness (SMASH) Score for Post-Operative Fever after Ureteroscopy.","authors":"Rıdvan Kayar, Kemal Kayar, Emrah Özsoy, İlker Artuk, Samet Demir, Emre Tokuc, Metin Öztürk","doi":"10.1177/10962964251365523","DOIUrl":"https://doi.org/10.1177/10962964251365523","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Post-operative fever (POF) is a common infectious complication following ureteroscopy (URS). Early identification of high-risk patients may help reduce morbidity and optimize peri-operative management. This study aimed to evaluate the predictive value of the Stone Management According to Size-Hardness (SMASH) score-a composite index based on stone size and density-for forecasting POF after URS. <b><i>Patients and Methods:</i></b> We retrospectively analyzed 143 patients who underwent semi-rigid and flexible URS for unilateral ureteral stones between January 2023 and January 2025. Demographic, radiological, and operative parameters were recorded, including SMASH score, Hounsfield unit (HU), stone size and location, operative time, and hydronephrosis. POF was defined as a body temperature ≥38.3°C with a positive urine culture. Comparative and receiver operating characteristic curve analyses were performed to assess predictors of POF. <b><i>Results:</i></b> POF occurred in 17 patients (11.9%). The febrile group had significantly higher SMASH scores (median: 8.08 vs. 5.09, p = 0.001), HU values (720 vs. 626, p = 0.006), and longer operative times (41 vs. 34 min, p = 0.001). Proximal stone location was also more common in the febrile group (p = 0.001). No significant differences were observed in age, gender, comorbidities, or hydronephrosis. <b><i>Conclusions:</i></b> Elevated SMASH scores, longer operative time, and proximal stone location were independently associated with POF after URS. The SMASH score may serve as a useful tool for pre-operative risk stratification, allowing for enhanced peri-operative precautions in high-risk patients.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754358","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":"Impact of Penicillin Allergy on Antibiotic Prophylaxis Selection and Surgical Site Infection Rates in Plastic Surgery: A Systematic Review.","authors":"Salman Khan, Malia Voytik, Margaret M Hornick, Sharbel Elhage, Kristina McShea, Robyn B Broach, John P Fischer, Saïd C Azoury","doi":"10.1177/10962964251362355","DOIUrl":"https://doi.org/10.1177/10962964251362355","url":null,"abstract":"<p><p><b><i>Background:</i></b> Patients undergoing plastic and reconstructive procedures with penicillin allergies (PAs) often receive second-line antibiotic agents. Evidence from other surgical specialties suggests this can lead to increased complications and greater morbidity. However, limited research exists in plastic surgery regarding this issue. This systematic review consolidates existing literature on the impact of PAs and alternative antibiotic agent use in plastic surgery, highlighting findings and future research directions. <b><i>Methods:</i></b> A systematic search of SCOPUS, PubMed (including MEDLINE), EMBASE, and the Cochrane Library was conducted on January 7, 2025, to identify studies evaluating the effects of PAs or second-line antibiotic agents on plastic surgery outcomes. Studies were included if full-text English articles were available. Five studies, comprising 2,318 patients, met the inclusion criteria. <b><i>Results:</i></b> Of the five studies included, two focused on head and neck procedures, one on general plastic surgery, and two on abdominal wall reconstruction. Four studies compared first-line versus second-line antibiotic agents, reporting higher infection and complication rates with second-line agents. No allergic reactions were reported. One study evaluated the implementation of a PA protocol, demonstrating increased first-line antibiotic agent adherence and a reduction in complication rates. <b><i>Conclusion:</i></b> Research on the impact of PAs in plastic and reconstructive surgery is limited. However, existing evidence aligns with findings from other surgical fields, suggesting that patients receiving second-line antibiotic agents experience worse outcomes. Further research is needed to optimize prophylactic antibiotic agent selection in patients with PAs undergoing a plastic surgery.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745122","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":"Disparities in Emergent Surgical Care in People Living with HIV.","authors":"McKay J Meyer, Savannah H Skidmore, Heather L Evans, Mike M Mallah","doi":"10.1177/10962964251361316","DOIUrl":"https://doi.org/10.1177/10962964251361316","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> People living with HIV (PLWHIV) have historically faced discrimination and unequal access to healthcare in the United States. This study aims to investigate differences in surgical intervention for common surgical emergencies among this population, specifically cholecystitis and appendicitis. <b><i>Methods:</i></b> This study utilized the TriNetX® database to compare the rate of cholecystectomies and appendectomies among PLWHIV with diagnosed cholecystitis or appendicitis, respectively, compared with HIV-negative patients. Inclusion criteria were an indication for surgical intervention, cholecystitis (K81) or appendicitis (K35-37). Cohorts were defined by HIV status, and analysis was stratified by procedure. Cohorts were propensity matched for age, race, leukocyte count, HIV 1 RNA volume, and substance abuse disorders. Outcomes were defined as patients receiving cholecystectomy or appendectomy in two separate analyses. Relative difference (RD) and relative risk (RR) were compared with between HIV+ and HIV- cohorts. <b><i>Results:</i></b> The cholecystectomy analysis had 609,127 total patients, with 3,597 per cohort after matching. The appendectomy analysis had 641,395 total patients, with 2,368 per cohort after matching. HIV-positive patients with cholecystitis had a 16.736% risk of undergoing cholecystectomy compared with 23.019% risk in HIV-cholecystitis patients (RD: -6.283% [95% confidence interval (95% CI): -8.122%, -4.444%], p < 0.0001, RR 0.727 [95% CI: 0.662, 0.799]). HIV-positive patients with appendicitis had a 14.147% risk of undergoing appendectomy compared with 17.272% in HIV-appendicitis patients (RD: -3.125%% [95% CI: -5.196%, -1.054%], p < 0.0031, RR 0.819, [95% CI 0.717, 0.935]). <b><i>Conclusions:</i></b> This study demonstrates a significant disparity in timely surgical intervention for PLWHIV. Further investigation is needed to elucidate the etiology of demonstrated incongruencies and their clinical relevance.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718703","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":"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}