L V PRASAD EYE INSTITUTE’s Post

🏥 Intra-abdominal infections management: a survival guide for #surgeons Complicated #IAIs are conditions difficult to manage, and a personalized approach is essential to optimize outcomes. Assessment of available treatment options should be always performed. Management of patients should be based on multiple aspects requiring a careful clinical assessment of ✅ The origin of the #infection. ✅ The anatomic extent of infection. ✅ The presumed pathogens and risk factors for #AMR. ✅ The patient’s clinical condition. ✅ The host’s immune status. In order to describe the best practices for complicated IAIs management, an evidence-based Position Statement was signed by an international multidisciplinary working group of physicians from several different disciplines representing the Global Alliance for Infections in Surgery 🌍 The paper has been recently published in the World Journal of Emergency Surgery.

The Conversation bring us this important new research. Infections after surgery are more likely due to bacteria already on your skin than from microbes in the hospital − new research. Health care providers and patients have traditionally thought that infections patients get while in the hospital are caused by superbugs they’re exposed to while they’re in a medical facility. Genetic data from the bacteria causing these infections – think CSI for E. coli – tells another story: Most health care-associated infections are caused by previously harmless bacteria that patients already had on their bodies before they even entered the hospital.  Research comparing bacteria in the microbiome – those colonizing our noses, skin and other areas of the body – with the bacteria that cause pneumonia, diarrhea, bloodstream infections and surgical site infections shows that the bacteria living innocuously on our own bodies when we’re healthy are most often responsible for these bad infections when we’re sick. Our newly published research in Science Translational Medicine adds to the growing number of studies supporting this idea. We show that many surgical site infections after spinal surgery are caused by microbes that are already on the patient’s skin. Surgical infections are a persistent problem Among the different types of heath care-associated infections, surgical site infections stand out as particularly problematic. A 2013 study found that surgical site infections contribute the most to the annual costs of hospital-acquired infections, totaling over 33% of the US$9.8 billion spent annually. Surgical site infections are also a significant cause of hospital readmission and death after surgery. https://lnkd.in/ec-9W9Dw

The aim of this systematic review and meta-analysis is to explore the effect of topical vancomycin powder (VP) in surgical site infection (SSI) prevention and adverse events after joint arthroplasty and to provide a specific theoretical basis for clinical treatment. The review process was conducted according to the PRISMA guidelines. Two independent researchers meticulously screened the literature based on predefined inclusion and exclusion criteria, evaluated the quality of the selected studies, and extracted relevant data. Data analysis was conducted using RevMan 5.4 software. This meta-analysis included 24 studies encompassing a total of 34 811 patients. The pooled analysis showed that the topical administration of VP significantly reduced the incidence of SSI. Subgroup analyses by doses, type of joint (hip and knee), and type of surgery (primary and revision) confirmed that vancomycin consistently lowered SSI rates. Moreover, the incidence of SSI caused by gram-negative germs and gram-positive germs decreased following the use of VP, although the reduction was not significant for infections caused by MRSA. However, the use of VP was associated with a significant increase in sterile complications at the incision site and delayed incision healing. The topical application of VP is effective in reducing the incidence of infections following joint arthroplasty. Despite an increased risk of complications such as delayed healing of incisions, the pros and cons should be weighed in clinical decision-making. However, it should not be discarded due to side effects. Read more on 📄 Efficacy and safety of vancomycin for local application in the prevention of surgical site infection after joint arthroplasty: a systematic review and meta-analysis https://bit.ly/3YnrXpP ✒️ Chengxin Xie, Liwei Zhang, Dehua Zhang, Lingjian Tao, Yong Zhao, and Hua Luo #arthroplasty #jointarthroplasty #infection #vancomycin #surgicalsiteinfection #hip #knee #OpenReviews #orthopedics #orthopaedics #surgery #openaccess

🔬 Essential Review on PJI Treatment! 🔬 Explore this Review "Antimicrobial treatment of patients with a #periprosthetic joint infection: basic principles" by Wouter Rottier, Jessica Seidelman, and Marjan Wouthuyzen-Bakker. Congratulation that this paper has already garnered1️⃣1️⃣citations! 🌟 Key Highlights: ✅Understanding antibiotic tolerance due to #biofilm formation ✅The role of biofilm-active #antibiotics from in vitro and in vivo perspectives ✅Clinical evidence on the effectiveness of #rifampicin and fluoroquinolones ✅Optimal treatment duration and the timing of switching to oral therapy 📚 Read the full review here: https://lnkd.in/gacEYWP7 #Orthopedics #PJI #MedicalResearch #Arthroplasty #Antibiotics #Biofilm #SSI #JointInfection

💡 Reshaping Wound Care: Chitosan-Based Hemostatic Sponges 💡🩸   In the realm of wound care, innovation is key to addressing the evolving needs of patients and healthcare professionals. Traditional hemostatic agents present limitations that hinder their efficacy and usability. However, Anhui Wound Solutions is revolutionizing wound management with its chitosan-based Hemostatic Sponges, offering a solution that surpasses the constraints of existing alternatives. Limitations of Existing Hemostatic Agents: 🚫 The use of various hemostatic materials poses challenges in their application. Fibrin hemostats may cause allergic reactions, collagen hemostats lack mechanical strength, and cellulose hemostats may lead to inflammation. Gelatin sponges, while effective, have limited efficacy, and zeolite hemostatic agents present risks due to non-degradability and poor biocompatibility. The Solution: ✨ Anhui Wound Solutions addresses these limitations through innovative enhancements to chitosan-based Hemostatic Sponges. By integrating hydrophobic alkyl chains into the chitosan backbone, the company enhances hemostatic and anti-infective properties. This modification ensures rapid clot formation and effective bleeding control, crucial in critical situations. Moreover, the introduction of hydrophobic chains empowers the sponge with potent antimicrobial activity, combating wound infections effectively. Advantages of Chitosan-Based Hemostatic Sponges: 🔍 Swift Hemostasis: Enhanced with hydrophobic alkyl chains, chitosan-based sponges stop bleeding swiftly, minimizing blood loss and expediting the healing process. Antimicrobial Activity: The incorporation of hydrophobic chains improves the sponge's ability to combat infections, reducing the risk of complications and promoting successful wound healing. 🌱 Biocompatibility: Chitosan-based sponges are biocompatible and sustainable, aligning with the increasing demand for environmentally friendly wound care solutions. 🔬 Comprehensive Approach: These sponges offer a comprehensive approach to wound management, addressing multiple aspects including hemostasis, infection control, and tissue repair. Conclusion: 🏥 Anhui Wound Solutions' chitosan-based Hemostatic Sponges are reshaping the landscape of wound care. By overcoming the limitations of existing hemostatic agents through innovative enhancements, they offer a holistic solution that meets the evolving needs of patients and healthcare professionals. With improved hemostatic and antimicrobial properties, these sponges accelerate healing, reduce infection risks, and pave the way for more successful outcomes in wound management. For deeper insights and additional reading: https://lnkd.in/dWBAHxp2        

2.Title: “Post-Cardiovascular Surgery Complications: Investigating Fever, Chest Pain, and Leukocytosis after Triple Bypass Surgery – Diagnostic Research and Infection Management” Potential Causes of Post-CABG Infections: Infections following CABG surgery are not uncommon and can stem from several sources, including surgical site infections, sternal wound infections, endocarditis, or mediastinitis. The presence of fever, chest pain, and high WBC counts after two months warrants the investigation of these complications. 1. Surgical Site Infection (SSI): Infections at the incision site are a known risk after CABG, particularly in patients with comorbidities like diabetes or obesity. SSIs may be superficial or deep, extending into the sternum and chest cavity. Symptoms include localized redness, swelling, discharge, and tenderness. 2. Sternal Wound Infection (SWI): A more serious form of infection, SWI, may result from the disruption of the sternum during surgery. These infections can lead to osteomyelitis (bone infection) if not treated promptly. Fever, pain at the wound site, and elevated WBC counts are common indicators. 3. Mediastinitis: Mediastinitis is a deep infection of the mediastinum (the space between the lungs) that may occur after CABG. This is a life-threatening condition that requires immediate medical intervention. It typically presents with systemic symptoms such as fever, chest pain, and high WBC counts. 4. Endocarditis: Endocarditis, an infection of the heart valves or inner lining of the heart chambers, can occur post-surgery due to bacterial contamination. This can cause fever, malaise, heart murmurs, and systemic embolic events. It can be diagnosed through blood cultures and echocardiography. Courtesy to Dr. Natasha Alterman ,Cardiologist,Auckland City Hospital,USA

Periprosthetic Joint Infection (PJI) remains one of the most devastating complications in orthopedic surgery, with infection rates after primary hip and knee prosthesis implantation at 1% and 2%, respectively.¹ Comorbidities and related circumstances may increase the individual risk of infection.²⁻⁵ According to the National Joint Registry UK, infections belong to the most common reasons for revisions.⁶ The pathogenesis of PJI is related to microorganisms growing in biofilms rendering it difficult to eradicate the infection. Essential strategies are needed to minimize the overall incidence of infection in orthopedic surgery. The combination of two antibiotics in bone cement can provide local effective antimicrobial therapy against PJI associated pathogens.⁷⁻⁸ Stay tuned for our next big advancement in infection management—because sometimes, two can be better than one. Mark your calendars for Thursday, August 29th, 2024 and discover how we are taking infection management to the next level. 📆 #New #Orthopedics #Infection 1. 𝐶𝑜𝑟𝑣𝑒𝑐 𝑆. 𝑒𝑡 𝑎𝑙. 𝐸𝑝𝑖𝑑𝑒𝑚𝑖𝑜𝑙𝑜𝑔𝑦 𝑎𝑛𝑑 𝑛𝑒𝑤 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑚𝑒𝑛𝑡𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑑𝑖𝑎𝑔𝑛𝑜𝑠𝑖𝑠 𝑜𝑓 𝑝𝑟𝑜𝑠𝑡ℎ𝑒𝑡𝑖𝑐 𝑗𝑜𝑖𝑛𝑡 𝑖𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛. 𝐼𝑛𝑡 𝐽 𝐴𝑟𝑡𝑖𝑓 𝑂𝑟𝑔𝑎𝑛𝑠. 2012 𝐼 2. 𝐵𝑒𝑟𝑏𝑒𝑟𝑖𝑐ℎ 𝑒𝑡 𝑎𝑙. 𝐷𝑢𝑎𝑙 𝑎𝑛𝑡𝑖𝑏𝑖𝑜𝑡𝑖𝑐 𝑙𝑜𝑎𝑑𝑒𝑑 𝑏𝑜𝑛𝑒 𝑐𝑒𝑚𝑒𝑛𝑡 𝑖𝑛 𝑝𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑎𝑡 ℎ𝑖𝑔ℎ 𝑖𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛 𝑟𝑖𝑠𝑘𝑠 𝑖𝑛 𝑎𝑟𝑡ℎ𝑟𝑜𝑝𝑙𝑎𝑠𝑡𝑦: 𝑅𝑎𝑡𝑖𝑜𝑛𝑎𝑙𝑒 𝑜𝑓 𝑢𝑠𝑒 𝑓𝑜𝑟 𝑝𝑟𝑜𝑝ℎ𝑦𝑙𝑎𝑥𝑖𝑠 𝑎𝑛𝑑 𝑠𝑐𝑖𝑒𝑛𝑡𝑖𝑓𝑖𝑐 𝑒𝑣𝑖𝑑𝑒𝑛𝑐𝑒 2021. 𝐼 3. 𝐿𝑒𝑛𝑔𝑢𝑒𝑟𝑟𝑎𝑛𝑑 𝐸 𝑒𝑡 𝑎𝑙. 𝑁𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐽𝑜𝑖𝑛𝑡 𝑅𝑒𝑔𝑖𝑠𝑡𝑟𝑦 𝑓𝑜𝑟 𝐸𝑛𝑔𝑙𝑎𝑛𝑑, 𝑊𝑎𝑙𝑒𝑠, 𝑁𝑜𝑟𝑡ℎ𝑒𝑟𝑛 𝐼𝑟𝑒𝑙𝑎𝑛𝑑 𝑎𝑛𝑑 𝑡ℎ𝑒 𝐼𝑠𝑙𝑒 𝑜𝑓 𝑀𝑎𝑛. 𝑅𝑖𝑠𝑘 𝑓𝑎𝑐𝑡𝑜𝑟𝑠 𝑎𝑠𝑠𝑜𝑐𝑖𝑎𝑡𝑒𝑑 𝑤𝑖𝑡ℎ 𝑟𝑒𝑣𝑖𝑠𝑖𝑜𝑛 𝑓𝑜𝑟 𝑝𝑟𝑜𝑠𝑡ℎ𝑒𝑡𝑖𝑐 𝑗𝑜𝑖𝑛𝑡 𝑖𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛 𝑓𝑜𝑙𝑙𝑜𝑤𝑖𝑛𝑔 𝑘𝑛𝑒𝑒 𝑟𝑒𝑝𝑙𝑎𝑐𝑒𝑚𝑒𝑛𝑡: 𝑎𝑛 𝑜𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝑐𝑜ℎ𝑜𝑟𝑡 𝑠𝑡𝑢𝑑𝑦 𝑓𝑟𝑜𝑚 𝐸𝑛𝑔𝑙𝑎𝑛𝑑 𝑎𝑛𝑑 𝑊𝑎𝑙𝑒𝑠 𝐿𝑎𝑛𝑐𝑒𝑡 𝐼𝑛𝑓𝑒𝑐𝑡 𝐷𝑖𝑠 2019. 𝐼 4. 𝑀𝑎𝑟𝑚𝑜𝑟 𝑒𝑡 𝑎𝑙. 𝑃𝑎𝑡𝑖𝑒𝑛𝑡-𝑠𝑝𝑒𝑐𝑖𝑓𝑖𝑐 𝑟𝑖𝑠𝑘 𝑓𝑎𝑐𝑡𝑜𝑟𝑠 𝑓𝑜𝑟 𝑖𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛 𝑖𝑛 𝑎𝑟𝑡ℎ𝑟𝑜𝑝𝑙𝑎𝑠𝑡𝑦 𝑝𝑟𝑜𝑐𝑒𝑑𝑢𝑟𝑒. 𝑂𝑟𝑡ℎ𝑜𝑝 𝑇𝑟𝑎𝑢𝑚𝑎𝑡𝑜𝑙 𝑆𝑢𝑟𝑔 𝑅𝑒𝑠 2016. 𝐼 5. 𝐾𝑢𝑛𝑢𝑡𝑠𝑜𝑟 𝑆𝐾 𝑒𝑡 𝑎𝑙. 𝑃𝑎𝑡𝑖𝑒𝑛𝑡-𝑅𝑒𝑙𝑎𝑡𝑒𝑑 𝑅𝑖𝑠𝑘 𝐹𝑎𝑐𝑡𝑜𝑟𝑠 𝑓𝑜𝑟 𝑃𝑒𝑟𝑖𝑝𝑟𝑜𝑠𝑡ℎ𝑒𝑡𝑖𝑐 𝐽𝑜𝑖𝑛𝑡 𝐼𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛 𝑎𝑓𝑡𝑒𝑟 𝑇𝑜𝑡𝑎𝑙 𝐽𝑜𝑖𝑛𝑡 𝐴𝑟𝑡ℎ𝑟𝑜𝑝𝑙𝑎𝑠𝑡𝑦: 𝐴 𝑆𝑦𝑠𝑡𝑒𝑚𝑎𝑡𝑖𝑐 𝑅𝑒𝑣𝑖𝑒𝑤 𝑎𝑛𝑑 𝑀𝑒𝑡𝑎-𝐴𝑛𝑎𝑙𝑦𝑠𝑖𝑠. 𝑃𝐿𝑜𝑆 𝑂𝑛𝑒 2016. 𝐼 6. 𝑁𝐽𝑅 20𝑡ℎ 𝐴𝑛𝑛𝑢𝑎𝑙 𝑟𝑒𝑝𝑜𝑟𝑡 2023, 𝑝. 125 𝑎𝑛𝑑 𝑝. 206. 𝐼 7. 𝑆𝑝𝑟𝑜𝑤𝑠𝑜𝑛 𝑒𝑡 𝑎𝑙. 𝐵𝑜𝑛𝑒 𝐽𝑜𝑖𝑛𝑡 𝐽. 2016. 𝐼 8. 𝐵𝑒𝑟𝑏𝑒𝑟𝑖𝑐ℎ 𝑒𝑡 𝑎𝑙. 𝑃𝑎𝑡𝑖𝑒𝑛𝑡𝑠 𝑎𝑡 𝑎 ℎ𝑖𝑔ℎ 𝑟𝑖𝑠𝑘 𝑜𝑓 𝑃𝐽𝐼: 𝐶𝑎𝑛 𝑤𝑒 𝑟𝑒𝑑𝑢𝑐𝑒 𝑡ℎ𝑒 𝑖𝑛𝑐𝑖𝑑𝑒𝑛𝑐𝑒 𝑜𝑓 𝑖𝑛𝑓𝑒𝑐𝑡𝑖𝑜𝑛 𝑢𝑠𝑖𝑛𝑔 𝑑𝑢𝑎𝑙 𝑎𝑛𝑡𝑖𝑏𝑖𝑜𝑡𝑖𝑐 𝑙𝑜𝑎𝑑𝑒𝑑 𝑏𝑜𝑛𝑒 𝑐𝑒𝑚𝑒𝑛𝑡 2022.

15 U.S. Patients Infected with #Mycobacteria -- As a follow-up to a recent post of mine, today I published my complete perspectives of an investigation of 15 bacterial infections in Florida that health officials recently authored in Morbidity and Mortality Weekly Report (or, #MMWR). Link: https://lnkd.in/d7455_NS Read my commentary -- "15 Patients Infected with Mycobacteria After Undergoing Cosmetic Surgery at a South Florida Clinic" at this link: https://lnkd.in/dYQVFUXg My article and comments are intended: * to bring attention to surgical infections caused by mycobacteria * encourage critical thinking * and discuss that findings disclosed in a federal or state report discussing an investigation of healthcare-associated infections may not always be complete or consistent with other similar investigations, which in some instances can raise as many questions as the report might answer. ARTICLE EXCERPT -- May 6, 2024 (by: Lawrence F Muscarella, PhD) – Fifteen patients in nine states developed mycobacterial infections following cosmetic surgery performed at the same Florida clinic, according to a recent report by the #CDC. The 15 infected patients resided in nine (9) different states, including California and Massachusetts. The CDC’s report identifies this Florida facility only as “clinic A.” Last week, The Tampa Bay Times newspaper published an article about these 15 Mycobacterium abscessus infections linked to a single Florida clinic, and it included an interview with the first author of the CDC report, who is an officer at the CDC. Link: https://lnkd.in/d-NaeeBj M. abscessus is a species of nontuberculous mycobacteria ("NTM"). It is rapidly growing, opportunistic, and intrinsically multidrug–resistant. ANOTHER ARTICLE EXCERPT -- The CDC's January report discussing this cluster of 15 M. abscessus infections in nine states, however, is as noteworthy for bringing the risks of M. abscessus infection following cosmetic surgery to the public's attention as it is for some questions it raises. The CDC's report, for instance, does not identify the south Florida clinic linked to these 15 #NTM infections by its name or address (only referring to it as "clinic A"). This decision raises a number of reasonable questions, including inquiries about its justification and whether the omission could conflict with the principles of transparency and impartiality in public health. Disclosure of the location of an infection outbreak, whether in a medical facility or somewhere else in the community, can provide a more complete understanding of the outbreak, as well as contribute to ... ARTICLE CONTINUES AT: https://lnkd.in/dYQVFUXg

Following on from our paper entitled, a practical definition of pin site infection, published in Injury last November, we have published a series of cases with severe complications of pin site infections, all requiring surgery excision of the infection. We demonstrate that a ring sequestrum following pin or wire placement is not always benign. However, with our orthoplastic MDT and the use of local antibiotics these cases can be successfully treated. The key is avoiding problematic pin sites and infection in the first place is with thoughtful wire positioning, careful insertion technique, and good pin site aftercare. If you want to see the paper please follow the link: https://lnkd.in/eD9htrNA

While Thoracic Endovascular Aortic Repair (TEVAR) is generally considered safer and less invasive than traditional open surgical procedures for treating thoracic aortic conditions, there are still potential complications associated with the TEVAR procedure. Some of these complications can include: 1. **Endoleak**: This occurs when blood leaks around or through the stent graft. It can lead to persistent pressure on the aneurysm sac and may require additional intervention. 2. **Migration**: The stent graft may move from its intended position, potentially leading to inadequate sealing of the aneurysm and necessitating repositioning or further procedures. 3. **Endograft infection**: Although rare, infection of the stent graft can occur. This is a serious complication that may require removal of the infected graft and possible open surgical repair. 4. **Aortic dissection or rupture**: In some cases, TEVAR can lead to new aortic dissections or ruptures, either due to the procedure itself or complications post-surgery. 5. **Organ ischemia**: Blockage of blood flow to various organs can occur, leading to organ damage or dysfunction. 6. **Spinal cord ischemia**: Insufficient blood flow to the spinal cord can result in paralysis or other neurological deficits. 7. **Access site complications**: Complications related to the groin incisions used to access the femoral arteries, such as bleeding, infection, or pseudoaneurysm formation. 8. **Contrast-induced nephropathy**: The contrast dye used during the procedure can sometimes cause kidney damage, especially in patients with pre-existing kidney problems. 9. **Stent graft-related complications**: These can include stent fracture, kinking, or collapse, which may require further intervention. 10. **Delayed complications**: Some complications may arise several months or years after the procedure, such as stent graft degradation, continued aneurysm growth, or development of new aortic problems. It's important to note that while these complications are possible, TEVAR is generally associated with lower rates of mortality and morbidity compared to open surgical repair for thoracic aortic conditions. The specific risks and benefits should be discussed with a physician on a case-by-case basis.