No abstract available.
Wound Infection*

Wound Infection

Background: Surgical site infection (SSI) poses a serious threat in Neurosurgery. The mere presence of SSI would warrant a prompt medical and/ or surgical intervention for the outcome is very poor. This study aims to establish whether a pre-operative hospital stay of >7 days & other risk factors predisposes to surgical site infections. Methods: Retrospective, cross-sectional study of all pediatric patients who underwent clean neurosurgical procedures for the first time from January 1, 2011- June 30, 2014, in the Philippine General Hospital. The primary outcome was the development of a surgical site infection within 30 days from spine surgery or 90 days from intracranial surgery. Univariate and multivariate logistic regression analyses were performed to show the association of demographic and clinical factors with the development of SSI. Results: 279 medical charts were available for review. Median age was 1 year(5 days to 18 years old). The overall prevalence rate of SSI was 11.26%. Patients with >7 days pre-operative hospital stay had an incidence rate for SSI of 76.47% compared to 23.53% in patients with <7 days pre-operative hospital stay (OR 1.61, CI 0.68-3.84, p=0.280). Conclusions The incidence of SSI is high compared to other centers. There was no association of preoperative hospital stay with SSI. The association was significant only for the history of nosocomial infection. Early pre-operative clearance and surgery are recommended. Further prospective studies and surveillance are warranted
Surgical Wound Infection ; Cross Infection

No abstract available.
Wound Infection ; Wounds and Injuries

We report the case of a deep sternal wound infection with sternal osteomyelitis caused by Gordonia bronchialis after open-heart surgery. The isolate was identified as a G. bronchialis by 16S rRNA and hsp65 gene sequencing, having initially been misidentified as a Rhodococcus by a commercial phenotypic identification system.
Osteomyelitis* ; Rhodococcus ; Wound Infection

Background: Mastectomy is a common surgical procedure done worldwide. Surgical site infection (SSI) is a common healthcare-associated infection. Mastectomy SSIs are frequently under-reported.

Objectives: The study aimed to determine the incidence of SSI among mastectomy cases of the Department of Surgery, University of the Philippines - Philippine General Hospital (UP-PGH) during one year of full implementation of the Surgical Site Infection Surveillance Program and evaluate the program's surveillance follow-up rate.

Methods: This study was an observational practice audit research that included all adult patients who underwent a mastectomy in UP-PGH from January 1, 2018, to January 31, 2019, when the SSI Surveillance Program was fully implemented. SSI was monitored and assessed during the patient's hospital stay, on the day of hospital discharge, and at 30 days (± 2 days) after surgery, either during an outpatient visit or via phone call by a nurse navigator. SSI frequency for mastectomy was computed both during the in-hospital stay and at 30 days after surgery. Surveillance follow-up rate, defined as the proportion of patients who could follow-up up to 30 days after surgery, was determined.

Results: The 30-day SSI rate for mastectomy was 6.8% (19/279). All 279 patients were followed up to 30 days after surgery. Of the 279 patients, 277 (99.3%) were through clinic visits, one was through phone calls, and one was still admitted to the hospital.

Conclusion: Full implementation of the SSI Surveillance Program for mastectomy in UP-PGH for one year showed a higher SSI rate than in published international literature. The program had a complete 30-day patient follow-up, contributing to more accurate SSI reporting. Implementing an SSI surveillance program with standardized protocols, dedicated personnel, patient education component, and the analysis of the information derived from such programs can improve an institution's quality of surgical care.

Objective: The use of antimicrobial prophylaxis to prevent surgical site infections (SSI) is well established. This study examined the association of adherence to antimicrobial prophylaxis for clean neurosurgeries with post-operative surgical site infection (SSI) rates. Methods: A retrospective descriptive study was conducted at the Philippine General Hospital (PGH) among pediatric patients who underwent clean neurosurgical procedures between January 1, 2018 – December 31, 2019. The outcome measured was the development of SSI. Univariate and multivariate analysis was performed to show the association of risk factors with SSI. Compliance to existing antibiotic prophylaxis recommendation was assessed. Results: One hundred eighty-nine (189) medical charts were reviewed. Overall prevalence of SSI was 9.5% and fever was the most common initial symptom of SSI. Staphylococcus species was identified from cultures of surgical sites, consistent with existing literature, however gram-negative organisms including multidrug-resistant organisms (MDRO) were noted. All cases received prophylactic antibiotics, but adherence to all parameters (antimicrobial choice, dose, timing, route, re-dosing and duration of prophylaxis) was low at 7.9%. Appropriate antibiotics were prescribed in only 15.9% and antibiotics were discontinued beyond 24 hours post-surgery in 45.5% of cases. Patients who received a regimen fully compliant with antimicrobial prophylaxis recommendations did not develop SSI. Conclusion Adherence to existing antimicrobial prophylaxis protocol for neurosurgeries is low at 7.9%. Patients who received a regimen fully compliant with the recommendations did not develop SSI. Interventions to improve compliance to antimicrobial prophylaxis guidelines are needed.
Surgical Wound Infection

Background and Objectives: Surgical site infection (SSI) makes up the largest single group of postoperative infective complications. For surgeries classified as clean surgeries of the head and neck, such as a thyroidectomy, the routine administration of antimicrobial prophylaxis is not recommended. Despite this, extended usage of antibiotics is common in developing countries. This study evaluated the need for antibiotics in elective transcervical thyroidectomy for the prevention of SSI in a tertiary government hospital in a developing country. Methods: This is a retrospective cohort study that included patients who have undergone elective transcervical thyroidectomy at the Department of Otolaryngology - Head and Neck Surgery (ORL-HNS) of the University of the Philippines - Philippine General (UP-PGH) Hospital from August 1, 2020 to June 30, 2022. Data collection was conducted through review of both in-patient and out-patient records. Results: The data of 58 patients were analyzed. The mean (±SD) age was 42.5±14.5 years, with approximately 2:27 male to female ratio. Of the 58 patients, 26 were given postoperative antibiotics while 32 did not receive postoperative antibiotics. None of the 58 were noted to have SSI on the 3rd postoperative day. Only 54 patients completed the 7-day follow-up of the study and their data were further analyzed. One patient had SSI. There was no significant difference between the presence and absence of postoperative antibiotics in relation to SSI (p-value>0.05). Conclusion This study shows that in patients undergoing transcervical thyroidectomies, there is no significant difference in the occurrence of SSI among patients who received and did not receive postoperative antibiotics. Therefore, there is no need to administer postoperative antibiotics, as long as a sterile surgical technique is ensured.
Surgical Wound Infection ; Thyroidectomy

The occurrence of post-operative wound infection was studied respectively over an eight month period in the University Hospital, Kuala Lumpur. One hundred and seventy four (3.4%) surgical wounds out of 5129 operations became infected. The clean wound infection rate was 2.9%, rising to 5.4% and 12.2% for clean-contaminated and contaminated surgical wounds respectively. Of the wound infections, 80.8% occurred within the first two weeks post-operatively. Bacteriological studies revealed that the commonest bacterial isolates were Staphylococcus aureus (36.1%), Pseudomonas aeruginosa (15.4%) and Klebsiella species (10.1%).
seconds ; Wound Infection ; After values ; Surgical wound ; Surgical Wound Infection

PURPOSE: To evaluate the usefulness of wire fixation in displaced acetabular fractures. MATERIALS AND METHODS: From January 2000 to December 2005, 19 cases of displaced acetabular fracture were treated with wire fixation. According to Letournel's classification there were 9 both column fracture, 5 transverse fracture, 3 anterior column with posterior hemitransverse and 2 T-type fracture. Only wire fixation in 13 cases and wire with plate or wire with screw fixation in 6 cases. RESULTS: We evaluate the accuracy of reduction by Matta' criteria, anatomical reduction in 12 cases, incomplete reduction in 4 cases, poor reduction in 2 cases and surgical secondary congruence in 1 case. The clinical results showed excellent in 12 cases, good in 4 cases, fair in 2 cases and poor in 1 case. The radiological results showed excellent in 10 cases, good in 4 cases, fair in 3 cases and poor in 2 cases. There were 4 cases of complication; wound infection in 1case, post-traumatic arthritis in 1 case and heterotopic ossification in 2 cases. CONCLUSION: The cerclage wiring is a preferable method in internal fixation of displaced acetabular fractures that can facilitate reduction and achieve stable fixation.
Arthritis ; Ossification, Heterotopic ; Wound Infection