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Gu JT, Wang TD, Loyo M. Direct Neck Lift for Men. Facial Plast Surg Clin North Am 2024; 32:353-360. [PMID: 38936992 DOI: 10.1016/j.fsc.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Direct neck lift offers an excellent surgical technique for men seeking to rejuvenate the neck and avoid a full rhytidectomy. In this chapter, we provide an overview of direct submentoplasty techniques, as well as clinical pearls to consider in the preoperative, intraoperative, and postoperative periods. Different surgical incisions and resultant scars in the anterior neck are discussed and illustrated with figures. Given the degree of variation of submental fullness with which patients present, it is beneficial to be familiar with several different techniques to address the submental and submandibular areas.
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Affiliation(s)
- Jeffrey T Gu
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Tom D Wang
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Myriam Loyo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR 97239, USA.
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Face Lift Practice Patterns: An American Society of Plastic Surgeons Member Survey, 2000 and 2020. How Much Have We Changed? Plast Reconstr Surg 2022; 149:1096e-1105e. [PMID: 35383689 DOI: 10.1097/prs.0000000000009097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In 2000, Matarasso et al. performed a survey of American Society of Plastic Surgeons members' face lift practice patterns. Since that publication, the aesthetic marketplace has changed dramatically, as have ancillary face lift techniques. In an attempt to detail these changes, we repeated that original survey, adding questions to address more recent technical issues and advances. The goal of this report was to define current face lift practice patterns, compare current patterns to the previous ones, and define recent advances. METHODS A 38-question survey assessing face lift techniques, perioperative management, complications, and concomitant procedures was electronically distributed to a random cohort of American Society of Plastic Surgeons members. Data were recorded and statistically analyzed utilizing the Pearson chi-square test. RESULTS A total of 251 forms were returned and analyzed. Details of demographics, face lift techniques, ancillary procedures, perioperative care, and complications are presented. Current results were compared to the previously published society member practice patterns delineated in the 2000 Plastic and Reconstructive Surgery publication. CONCLUSIONS The basic approach of American Society of Plastic Surgeons members to the face lift operation has not changed dramatically over the past 20 years. The development of operative adjuncts, however, has been positive, including fat grafting techniques, concomitant use of skin resurfacing, and means of minimizing blood loss with tranexamic acid. In certain instances, respondents do not follow evidence-based guidelines for perioperative care. Finally, common complications of practicing members appear to coincide with published retrospective reviews.
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Sinclair NR, Coombs DM, Kwiecien G, Zins JE. How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications. Aesthet Surg J Open Forum 2021; 3:ojab007. [PMID: 34212140 PMCID: PMC8240741 DOI: 10.1093/asjof/ojab007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 12/21/2022] Open
Abstract
This article provides a review of available evidence with regard to short-term complications in facelift surgery. The article reviews both the most common complications and less common, but well-described ones. The goal is to offer objective means to minimize postoperative complications and a guide for treatment when they occur.
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Affiliation(s)
- Nicholas R Sinclair
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Demetrius M Coombs
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Grzegorz Kwiecien
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - James E Zins
- Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
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Gordon NA, Tower JI, Paskhover B. From the Deep-Plane Rhytidectomy to the Vertical Platysma Advancement. Facial Plast Surg Clin North Am 2020; 28:311-330. [PMID: 32503717 DOI: 10.1016/j.fsc.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This article provides the facial plastic surgeon with anatomic and embryologic evidence supporting use of the deep-plane technique and understanding the evolution of the technique over decades to the vertical platysma advancement for optimal treatment of facial aging. The original description of the deep-plane rhytidectomy described a basic subsuperficial musculoaponeurotic system dissection in the midface. This plane of dissection provides access to deeper anatomic structures. A detailed description of the procedure is provided to allow safe and consistent performance. Insights into anatomic landmarks, technical nuances, and alternative approaches for facial variations are presented.
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Affiliation(s)
- Neil A Gordon
- Section of Otolaryngology Head and Neck Surgery and Facial Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA; Residency Education in Facial Plastic and Reconstructive Surgery; New England Surgical Center, The Retreat at Split Rock, 539 Danbury Road, Wilton, CT 06897, USA
| | - Jacob I Tower
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - Boris Paskhover
- Department of Otolaryngology, Rutgers New Jersey Medical School, Newark, NJ, USA; Section of Facial Plastics and Reconstructive Surgery, Department of Otolaryngology, St. Barnabas Medical Center-RWJ Health, Livingston, NJ, USA
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Jacono AA, Alemi AS, Russell JL. A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques. Aesthet Surg J 2019; 39:927-942. [PMID: 30768122 DOI: 10.1093/asj/sjz045] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/27/2019] [Accepted: 02/09/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sub-superficial musculo-aponeurotic system (SMAS) rhytidectomy techniques are considered to have a higher complication profile, especially for facial nerve injury, compared with less invasive SMAS techniques. This results in surgeons avoiding sub-SMAS dissection. OBJECTIVES The authors sought to aggregate and summarize data on complications among different SMAS facelift techniques. METHODS A broad systematic search was performed. All included studies: (1) described a SMAS facelifting technique categorized as SMAS plication, SMASectomy/imbrication, SMAS flap, high lateral SMAS flap, deep plane, and composite; and (2) reported the number of postoperative complications in participants. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total 183 studies were included. High lateral SMAS (1.85%) and composite rhytidectomy (1.52%) had the highest rates of temporary nerve injury and were the only techniques to show a statistically significant difference compared with SMAS plication (odds ratio [OR] = 2.71 and 2.22, respectively, P < 0.05). Risk of permanent injury did not differ among techniques. An increase in major hematoma was found for the deep plane (1.22%, OR = 1.67, P < 0.05) and SMAS imbrication (1.92%, OR = 2.65, P < 0.01). Skin necrosis was higher with the SMAS flap (1.57%, OR = 2.29, P < 0.01). CONCLUSIONS There are statistically significant differences in complication rates between SMAS facelifting techniques for temporary facial nerve injury, hematoma, seroma, necrosis, and infection. Technique should be selected based on quality of results and not the complication profile. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Andrew A Jacono
- Section Head of Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, NY
- Associate Clinical Professor in the Division of Facial Plastic and Reconstructive Surgery, Albert Einstein College of Medicine, Bronx, NY
| | - A Sean Alemi
- Surgical fellow at a private facial plastic surgery practice in New York, NY
| | - Joseph L Russell
- Facial plastic surgeon in private practice in North Charleston, SC
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Andrén OCJ, Ingverud T, Hult D, Håkansson J, Bogestål Y, Caous JS, Blom K, Zhang Y, Andersson T, Pedersen E, Björn C, Löwenhielm P, Malkoch M. Antibiotic-Free Cationic Dendritic Hydrogels as Surgical-Site-Infection-Inhibiting Coatings. Adv Healthc Mater 2019; 8:e1801619. [PMID: 30735288 DOI: 10.1002/adhm.201801619] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/19/2019] [Indexed: 11/10/2022]
Abstract
A non-toxic hydrolytically fast-degradable antibacterial hydrogel is herein presented to preemptively treat surgical site infections during the first crucial 24 h period without relying on conventional antibiotics. The approach capitalizes on a two-component system that form antibacterial hydrogels within 1 min and consist of i) an amine functional linear-dendritic hybrid based on linear poly(ethylene glycol) and dendritic 2,2-bis(hydroxymethyl)propionic acid, and ii) a di-N-hydroxysuccinimide functional poly(ethylene glycol) cross-linker. Broad spectrum antibacterial effect is achieved by multivalent representation of catatonically charged β-alanine on the dendritic periphery of the linear dendritic component. The hydrogels can be applied readily in an in vivo setting using a two-component syringe delivery system and the mechanical properties can accurately be tuned in the range equivalent to fat tissue and cartilage (G' = 0.5-8 kPa). The antibacterial effect is demonstrated both in vitro toward a range of relevant bacterial strains and in an in vivo mouse model of surgical site infection.
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Affiliation(s)
- Oliver C. J. Andrén
- Division of Coating TechnologyDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
| | - Tobias Ingverud
- Division of Coating TechnologyDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
- Wallenberg Wood Science CenterDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
| | - Daniel Hult
- Division of Coating TechnologyDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
| | - Joakim Håkansson
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Yalda Bogestål
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Josefin S. Caous
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | | | - Yuning Zhang
- Division of Coating TechnologyDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
| | - Therese Andersson
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Emma Pedersen
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Camilla Björn
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Peter Löwenhielm
- RISE Research Institutes of SwedenDivision Biosciences and MaterialsSection for Medical Device Technology Box 857 50115 Borås Sweden
| | - Michael Malkoch
- Division of Coating TechnologyDepartment of Fibre and Polymer TechnologySchool of Chemistry, Biotechnology and HealthKTH Royal Institute of Technology SE‐100 44 Stockholm Sweden
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Lin S, Melki S, Lisgaris MV, Ahadizadeh EN, Zender CA. Post-operative MRSA infections in head and neck surgery. Am J Otolaryngol 2017; 38:417-421. [PMID: 28478091 DOI: 10.1016/j.amjoto.2017.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 03/31/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus (MRSA) is a serious post-operative complication, with head and neck cancer patients at greater risk due to the nature of their disease. Infection with MRSA has been shown to be costly and impart worse outcomes on patients who are affected. This study investigates incidence and risks for MRSA SSIs at a tertiary medical institution. MATERIALS AND METHODS This study reviewed 577 head and neck procedures from 2008 to 2013. Twenty-one variables (i.e. tumor characteristics, patient demographics, operative course, cultures) were analyzed with SPSS to identify trends. A multivariate analysis controlled for confounders (age, BMI, ASA class, length of stay) was completed. RESULTS We identified 113 SSIs of 577 procedures, 24 (21.23%) of which were MRSA. Of all analyzed variables, hospital exposure within the preceding year was a significant risk factor for MRSA SSI development (OR 2.665, 95% CI: 1.06-6.69, z statistic 2.086, p=0.0369). Immunosuppressed patients were more prone to MRSA infections (OR 14.1250, 95%CI: 3.8133-52.3217, p<0.001), and patients with a history of chemotherapy (OR 3.0268, 95% CI: 1.1750-7.7968, p=0.0218). Furthermore, MRSA SSI resulted in extended post-operative hospital stays (20.8±4.72days, p=0.031). CONCLUSIONS Patients who have a history of chemotherapy, immunosuppression, or recent hospital exposure prior to their surgery are at higher risk of developing MRSA-specific SSI and may benefit from prophylactic antibiotic therapy with appropriate coverage. Additionally, patients who develop MRSA SSIs are likely to have an extended postoperative inpatient stay.
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Affiliation(s)
- Sharon Lin
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Sami Melki
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Michelle V Lisgaris
- Department of Medicine - Infectious Diseases, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Emily N Ahadizadeh
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States; Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH, United States
| | - Chad A Zender
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
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Methicillin-Resistant Staphylococcus aureus Infections: A Comprehensive Review and a Plastic Surgeon's Approach to the Occult Sites. Plast Reconstr Surg 2017; 138:515-523. [PMID: 27465172 DOI: 10.1097/prs.0000000000002358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Up to 20 percent of the general population is persistently colonized with Staphylococcus aureus, and 1 to 3 percent of the population is colonized with community-acquired methicillin-resistant S. aureus. Currently, the knowledge of methicillin-resistant Staphylococcus aureus carriage sites other than the nose, and their effect on surgical site infections in cosmetic surgery, is lacking. METHODS A comprehensive literature review using the PubMed database to analyze prevalence, anatomical carrier sites, current screening and decontamination protocols and guidelines, and methicillin-resistant S. aureus in cosmetic surgery was performed. The senior author's (L.R.) methicillin-resistant S. aureus infection experience and prevention protocols were also reviewed. RESULTS Nasal swabs detect only 50.5 percent of methicillin-resistant S. aureus colonization, and broad screening has noted the presence of methicillin-resistant S. aureus in the ear canal and umbilicus. Decolonization protocols within the orthopedic and cardiothoracic surgery literature have reduced rates of methicillin-resistant S. aureus surgical-site infections. There are no decolonization guidelines for plastic surgeons. Since instituting their decolonization protocol, the authors have had no cases of methicillin-resistant S. aureus infection in nearly 1000 cosmetic surgery procedures. CONCLUSIONS There are very limited, if any, Level I or II data regarding methicillin-resistant S. aureus screening and decolonization. As the sequelae of a surgical-site infection can be disastrous, expert opinions recommend that plastic surgeons vigorously address methicillin-resistant S. aureus colonization and infection. The authors have developed and recommend a simple decolonization protocol that includes treatment of the umbilicus, ear canal, and nares to limit surgical-site infection and improve surgical outcomes.
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Comprehensive review of methicillin-resistant Staphylococcus aureus: screening and preventive recommendations for plastic surgeons and other surgical health care providers. Plast Reconstr Surg 2015; 134:1078-1089. [PMID: 25347639 DOI: 10.1097/prs.0000000000000626] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Up to 2.3 million people are colonized with methicillin-resistant Staphylococcus aureus in the United States, causing well-documented morbidity and mortality. Although the association of clinical outcomes with community and hospital carriage rates is increasingly defined, less is reported about asymptomatic colonization prevalence among physicians, and specifically plastic surgeons and the subsequent association with the incidence of patient surgical-site infection. METHODS A review of the literature using the PubMed and Cochrane databases analyzing provider screening, transmission, and prevalence was undertaken. In addition, a search was completed for current screening and decontamination guidelines and outcomes. RESULTS The methicillin-resistant S. aureus carriage prevalence of surgical staff is 4.5 percent. No prospective data exist regarding transmission and interventions for plastic surgeons. No studies were found specifically looking at prevalence or treatment of plastic surgeons. Current recommendations by national organizations focus on patient-oriented point-of-care testing and intervention, largely ignoring the role of the health care provider. Excellent guidelines exist regarding screening, transmission prevention, and treatment both in the workplace and in the community. No current such guidelines exist for plastic surgeons. CONCLUSIONS No Level I or II evidence was found regarding physician screening, treatment, or transmission. Current expert opinion, however, indicates that plastic surgeons and their staff should be vigilant for methicillin-resistant S. aureus transmission, and once a sentinel cluster of skin and soft-tissue infections is identified, systematic screening and decontamination should be considered. If positive, topical decolonization therapy should be offered. In refractory cases, oral antibiotic therapy may be required, but this should not be used as a first-line strategy.
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10
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Infection in face-lift surgery: an evidence-based approach to infection prevention. Plast Reconstr Surg 2015; 135:58e-66e. [PMID: 25539351 DOI: 10.1097/prs.0000000000000824] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Complications in face-lift surgery are rare but can present a difficult experience for the patient and surgeon. It is the objective of this review to evaluate the clinical efficacy of routine perioperative safety measures in preventing surgical-site infection in face-lift surgery. METHODS A review of the literature was performed to assess the correlation of preoperative decolonization, prophylactic antibiotic use, perioperative hypothermia, body mass index, and smoking status with the incidence of surgical-site infection in cosmetic surgery, especially pertaining to face-lift surgery. RESULTS Studies supporting safe practice in cosmetic surgery and "clean" procedures are analyzed and discussed. CONCLUSION This article provides the current evidence on perioperative safety measures and recommendations regarding the prevention of infection in cosmetic surgery, especially in face-lift surgery.
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Abstract
Neck lift surgery performed in isolation or in conjunction with a facelift provides a more youthful cervicomental angle. Complications related to neck lift surgery vary from contour irregularities that may improve with time or conservative measures,to contour irregularities that persist and may benefit from delayed surgical intervention, to expanding hematomas that require immediate surgical intervention. This article reviews complications of neck lift surgery and their etiologies, methods to minimize the incidence of these complications, and management.
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Affiliation(s)
- Rami K Batniji
- Batniji Facial Plastic Surgery, 361 Hospital Road, Suite 329, Newport Beach, CA 92663, USA.
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Kahsay A, Mihret A, Abebe T, Andualem T. Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia. ACTA ACUST UNITED AC 2014; 72:16. [PMID: 24949197 PMCID: PMC4063246 DOI: 10.1186/2049-3258-72-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 02/28/2014] [Indexed: 11/24/2022]
Abstract
Background Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital. Methods A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors. Results Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus. Conclusion The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents.
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Affiliation(s)
- Amlsha Kahsay
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia ; School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Adane Mihret
- School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia ; Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia ; Department of Biochemistry, WHO Immunology Research and Training Center, University of Lausanne, Lausanne, Switzerland
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Gordon NA, Adam SI. The Deep-Plane Approach to Neck Rejuvenation. Facial Plast Surg Clin North Am 2014; 22:269-84. [DOI: 10.1016/j.fsc.2014.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Efficacy of the novel topical antimicrobial agent PXL150 in a mouse model of surgical site infections. Antimicrob Agents Chemother 2014; 58:2982-4. [PMID: 24590479 DOI: 10.1128/aac.00143-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antimicrobial peptides have recently emerged as a promising new group to be evaluated in the therapeutic intervention of infectious diseases. This study evaluated the anti-infectious effect of the short, synthetic, broad-spectrum antimicrobial peptide PXL150 in a mouse model of staphylococcal surgical site infections. We found that administration of PXL150, formulated in an aqueous solution or in a hydroxypropyl cellulose gel, significantly reduced the bacterial counts in the wound compared with placebo treatment, warranting further investigations of the potential of this peptide as a novel local treatment of microbial infections.
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Shaw GY, Montandon SV, Driks MR. Otolaryngologic community-acquired MRSA infections in a suburban private practice. EAR, NOSE & THROAT JOURNAL 2011; 89:E33-40. [PMID: 20981651 DOI: 10.1177/014556131008901007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A retrospective review was conducted of all cases of head and neck community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections seen in the senior author's suburban private practice during a 12-month period. An office and hospital chart review was performed for all patients identified with culture-positive CA-MRSA infections. Several parameters were evaluated, including site of infection, prior therapy, imaging, comorbid disease, culture and sensitivities, surgical and medical management, and long-term results. Of the 10 patients identified, 3 had infections of nasal soft tissues, 3 had infections of the lips, 2 had infections of the paranasal sinus, 1 had an infection of the chin, and 1 had a diffuse, hemifacial infection. All patients were managed successfully with a combination of surgical drainage, wound care, and antibiotics. CA-MRSA is a burgeoning problem in otolaryngology. Appropriate management-including early recognition, appropriate empirical therapy, prompt and thorough surgical drainage with culture and sensitivities, correct antibiotic choice, and meticulous postoperative care-appears to offer excellent results.
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Affiliation(s)
- Gary Y Shaw
- Department of Surgery, Kansas City University of Medicine and Biosciences, Kansas City, USA.
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Liakos T, Kaye K, Rubin AD. Methicillin-resistant Staphylococcus aureus laryngitis. Ann Otol Rhinol Laryngol 2010; 119:590-3. [PMID: 21033025 DOI: 10.1177/000348941011900904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have become more prevalent, in part because of the emergence and spread of community-acquired MRSA. This trend is particularly concerning because of the significant rates of morbidity and mortality associated with MRSA infections, and because MRSA strains are often resistant to many classes of antibiotics. Reports of infections of the head and neck, including wound infections, cellulitis, sinusitis, otitis media, and otitis externa, are well documented. However, to our knowledge, there have been no reports of bacterial laryngitis due to MRSA. We report the first published case of bacterial laryngitis caused by MRSA.
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Affiliation(s)
- Tracey Liakos
- Department of Otolaryngology, St John Macomb-Oakland Hospital, Madison Heights, Michigan, USA
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Abstract
Multidrug-resistant bacteria have emerged as an increasing threat in many areas of medicine. The most prominent multidrug-resistant pathogens are methicillin-resistant S. aureus (MRSA), vancomycin-resistant MRSA (VMRSA), vancomycin-resistant enterococci (VRE), and Enterobacteriaceae with extended-spectrum beta-lactamase (ESBL). In particular, MRSA and VRE cause infections seen in ophthalmology. The lids, lacrimal duct, and ocular surface are frequently involved.
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Affiliation(s)
- T Ness
- Universitäts-Augenklinik Freiburg, Killianstr. 5, 79106 Freiburg.
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Cordova KB, Grenier N, Chang KH, Dufresne R. Preoperative Methicillin-Resistant Staphylococcus aureus Screening in Mohs Surgery Appears to Decrease Postoperative Infections. Dermatol Surg 2010; 36:1537-40. [DOI: 10.1111/j.1524-4725.2010.01678.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:66-73. [PMID: 19225308 DOI: 10.1097/moo.0b013e32832406ce] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Richer SL, Wenig BL. The efficacy of preoperative screening and the treatment of methicillin-resistant Staphylococcus aureus in an otolaryngology surgical practice. Otolaryngol Head Neck Surg 2009; 140:29-32. [PMID: 19130957 DOI: 10.1016/j.otohns.2008.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Revised: 10/13/2008] [Accepted: 10/16/2008] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the efficacy of preoperative Staphylococcus aureus screening on postoperative methicillin-resistant S aureus (MRSA) infection rates in otolaryngology. STUDY DESIGN Chart review. SUBJECTS AND METHODS Postoperative MRSA infection rates in unscreened patients during a 1-year period were compared with infection rates in patients after preoperative S aureus screening was initiated. Colonized patients were treated with mupirocin and chlorhexidine preoperatively. RESULTS Records of 420 patients were reviewed. In the 241 patients without screening, nine patients had S aureus infections, and there were two (0.8%) postoperative MRSA surgical-site infections. Of 179 patients after screening was initiated, 24 patients (13.4%) were colonized with S aureus and underwent preoperative treatment. There were no MRSA infections in the postoperative period. CONCLUSION Early results show the potential benefit of preoperative S aureus screening in MRSA infection rate reduction. Although larger studies are needed, screening and treatment of MRSA colonized patients preoperatively may reduce infectious complications in otolaryngology.
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Khorvash F, Mostafavizadeh K, Mobasherizadeh S, Behjati M, Naeini AE, Rostami S, Abbasi S, Memarzadeh M, Khorvash FA. Antimicrobial susceptibility pattern of microorganisms involved in the pathogenesis of surgical site infection (SSI); A 1 year of surveillance. Pak J Biol Sci 2008; 11:1940-4. [PMID: 18983037 DOI: 10.3923/pjbs.2008.1940.1944] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study is to identify the antibiotic sensitivity pattern of pathogens involved in the process of surgical site infection, in surgical wards. Changes made in the pattern of antibiotic use will result in different microorganism susceptibility patterns, which needs correct determination for precise empiric antibiotic therapy. One thousand patients (62% men and 38% women, 18- 74-years-old, with mean age 43 +/- 8)) who underwent surgical treatment, in Alzahra University Hospital, Isfahan University of Medicine, Isfahan, Iran, were studied from 2005 to 2006. Surgical wound infections, based on the reported criteria, were aspirated for culturing within 1 plus gram staining of prepared smears. Minimum Inhibitory Concentrations (MICs) were determined for samples and all derived data were compared by SPSS 13 and WHO net 5 software. The prevalence of SSI was 13.3% with 150 positive cultures, totally. Of 150 bacteria, isolated from surgical site infections Staphylococcus aureus had most frequency (43%). Resistance of isolated organisms was 41.7% in amikacin, 65 and 78.6% in ceftazidime, 85.7% in ceftriaxone, 61.5% in ciprofloxacin, 78.8% in gentamicine, 6.4% in imipenem, 13% in meropenem and 70.6% in trimethoprim/sulfamethoxazole, respectively. 78.9% of Staphylococcus aureus isolates were MRSA and vancomycine was the most effective antibiotic without any resistance. Among 10 isolates of coagulase negative Staphylococcus, no vancomycine resistance was seen, but in contrast all cases were resistant to oxacillin. The most common gram negative organism was Klebsiella (18 isolates) in which 100 and 80% were sensitive to imipenem and meropenem, respectively. Seventeen cases were E. coli, in which the most sensitivity was to meropenem (80%) and imipenem (77.8%). Thirteen cases of Pseudomonas were detected, in which 16.7% were resistant to imipenem and 8.3% to meropenem. Our results demonstrated that the total antibiotic resistance is increasing among SSIs, with an up sloping pattern, which will contact with a constant empiric antibiotic therapy. So, precise up to date antibiogram tantalize us toward balancing the rate of total antibiotic resistance to SSIs.
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Affiliation(s)
- F Khorvash
- Department of Infectious Diseases and Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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