Surgical site infection(SSI) is one of post-operative complications in gastrointestinal surgery. SSI may increase the morbidity and mortality of surgical patients and increase their hospital stay and expense. The risk factors can come from patients, physicians and hospital environments. Improving patients nutritional status and organ function, appropriate control of blood sugar level and abstinence from smoking can reduce the occurrence of SSI. Compare to current practice in China, the following recommendations have been identified as priorities for implementation: hair removal done immediately before operation; maintenance of normothermia intraoperatively; the abdominal wall should be closed with an absorbable suture and drains should be removed as early as possible. SSI could be diagnosed by symptoms, local signs and lab examinations and confirmed by physician. Source control is the key point in the management of SSI. Ultrasound and CT guided percutaneous abscess drainage is effective in the localized deep space surgical site infection and critically ill patients. Antibiotics should be used following clinical assessment and evidence based on local formulary.
Digestive System Surgical Procedures ; adverse effects ; Humans ; Infection Control ; Risk Factors ; Surgical Wound Infection ; diagnosis ; etiology ; prevention & control ; therapy

Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.
Female ; *Hand/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous/*diagnosis/etiology/radiography ; Mycobacterium avium-intracellulare Infection/*diagnosis/etiology/radiography ; *Mycobacterium marinum ; Surgical Wound Infection/complications ; Tenosynovitis/diagnosis/*microbiology/radiography ; Wound Infection/complications

No abstract available.
Aged ; Conjunctiva/*surgery ; Dacryocystorhinostomy/*adverse effects ; Eye Infections, Fungal/diagnosis/*etiology/microbiology ; Female ; Humans ; Keratitis/diagnosis/*etiology/microbiology ; Lacrimal Duct Obstruction/*diagnosis ; Paecilomyces/*isolation & purification ; Recurrence ; Surgical Wound Infection/diagnosis/*etiology/microbiology

OBJECTIVETo explore the reason,diagnose outline,therapeutic tool of the incisions deep infections at early stage after lumber internal fixation.

METHODSFrom January 2001 to December 2011, 10 patients with incisions deep infections at the early stage after the posterior lumber internal fixation were treated with intervertebral space lavaging. There were 1 male and 9 females with an average age of 63 years, and an average infection started at the 6th day after operation. The main clinical features including backleg pain aggravating, fervescence, fresh seepage from the wound, and blood inflammatory index increased, etc. According to whether the wound could heal at the first treatment stage as a evaluation standard of curative effect.

RESULTSTen cases were followed up with an average period of 17 months. The wounds of 9 cases healed at the first stage and no recurrence and complications were found. One case underwent debridgement of many times with the therapic period of 7 months,at last,after taking out the vertebral pedicle bolt,the wound healed,and no recurrence after follow-up of 18 months.

CONCLUSIONThe deep wound infections after the lumber internal fixation should receive intervertebral space lavaging as soon as possible. The method can finally remain internal fixations and obtain satisfactory effects, but avoiding too much tissue cutting and tube setting in the deep intervertebral space are the keys to the successful fixation.

Aged ; Female ; Fracture Fixation, Internal ; adverse effects ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Prognosis ; Surgical Wound Infection ; diagnosis ; etiology ; therapy ; Therapeutic Irrigation

We retrospectively reviewed the complete medical records of 30 patients with a diagnosis of liver cirrhosis who had undergone hip arthroplasty at three academic institutions between October 1994 and May 2001. There were 26 males and 4 females with a mean age of 60 yr at index operation. Surgical procedures included 17 primary total hip arthroplasties (THA), 8 bipolar hemiarthroplasties, and 5 revision THAs. According to the Child-Pugh scoring system, 19 cirrhotic patients were categorized as class A, 9 as class B, and 2 as class C. Eight (26.7%) of the 30 patients had one or more perioperative complications. Of these, wound infection was the most common, with a rate of 10% (3 of 30 hips). Other perioperative complications included surgical site bleeding, coagulopathy, encephalopathy, gastrointestinal bleeding, pneumonia, and arrhythmia. Death occurred in 2 (6.7%) of the 30 patients; both were Child-Pugh's C cirrhotics. A higher Child-Pugh score (p=0.0001) and a high level of creatinine (p=0.0499) were associated with significantly increased perioperative complications or death. Our findings suggest that surgeons should be vigilant about perioperative complications in patients with advanced cirrhotic liver disease who undergo hip arthroplasty, albeit the mortality rates are relatively low in less severe cirrhotics.
Surgical Wound Infection/diagnosis/*etiology ; Risk Factors ; Risk Assessment/*methods ; Prosthesis-Related Infections/diagnosis/*etiology ; Middle Aged ; Male ; Liver Cirrhosis/*complications ; Humans ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Female ; Arthroplasty, Replacement, Hip/*adverse effects ; Adult ; Adolescent

PURPOSE: To evaluate the factors affecting treatment outcome of graft infection following penetrating keratoplasty (PKP). METHODS: In this retrospective study, 28 patients who underwent PKP between January 2005 and January 2013 and who were diagnosed with graft infection were classified into a treatment success group or a treatment failure group. Demographic and clinical characteristics, as well as the results of the microbiologic investigation, were analyzed and compared. A subsequent binary logistic regression analysis was performed to identify the prognostic factors affecting treatment outcome. RESULTS: Graft infection occurred at a mean of 38.29 +/- 36.16 months (range, 1 to 96 months) after PKP. Seventeen patients developed bacterial keratitis, and 11 patients developed fungal keratitis. Overall, of the 28 patients, nine (32.1%) were classified in the treatment failure group. Multivariate analysis identified pre-existing graft failure (p = 0.019), interval longer than 72 hours between donor death and PKP (p = 0.010), and fungal infection (p = 0.026) as significant risk factors for treatment failure. CONCLUSIONS: Pre-existing graft failure, extended interval between donor death and PKP, and fungal infection were important risk factors for treatment failure of graft infection following PKP.
Adult ; Aged ; Aged, 80 and over ; Eye Infections, Bacterial/diagnosis/*etiology ; Eye Infections, Fungal/diagnosis/*etiology ; Female ; *Graft Survival ; Humans ; Keratoplasty, Penetrating/*adverse effects ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection/diagnosis/*etiology ; Treatment Outcome