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Merck B, Henarejos Pérez V, Villalonga Morales A, Barrasa Shaw A. Preventing surgical site infection through patients' education: Results from the MEDIPINAS medical mission. Cir Esp 2022; 100:246-248. [PMID: 35431162 DOI: 10.1016/j.cireng.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/09/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Belén Merck
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.
| | - Valentín Henarejos Pérez
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Castellón de la Plana, Castellón, Spain
| | - Antonio Villalonga Morales
- Departamento de Anestesiología, Centre Hospitalier Mère et Enfant Monkole, Mont-Ngafula Kinshasa, Democratic Republic of the Congo
| | - Antonio Barrasa Shaw
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain
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Gómez Sánchez J, Forneiro Pérez R, Zurita Saavedra M, de Castro Monedero P, González Puga C, Garde Lecumberri C, Mirón Pozo B. Oncologic colorectal surgical site infection: oral or not oral antibiotic preparation, that is the question. Int J Colorectal Dis 2022; 37:373-379. [PMID: 34854980 DOI: 10.1007/s00384-021-04074-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE Surgical wound infection is the most frequent postoperative complication in abdominal surgery, especially at the colorectal level. The aim of this study is analysing the results of mechanical colon preparation combined with oral antibiotic versus mechanical colon preparation without antibiotic therapy in patients with colorectal cancer undergoing elective surgery. METHODS This retrospective cohort study had been developed from November 2017 to February 2020. We have included a total of 281 consecutive patients undergoing elective colon and rectal oncological surgeries by the same surgical group using laparoscopic and open approaches. Transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) approaches were excluded. Exposed patients undergoing colon and rectal cancer surgery received mechanical bowel preparation and oral antibiotics with three doses of neomycin 1 g and erythromycin 500 mg the day before surgery. RESULTS The primary outcome was reduction in surgical wound infection rates before and after starting the oral antibiotic therapy from 17 to 6% (p < 0.05). As a secondary analysis, we evaluated the anastomotic dehiscence rate, corresponding with a decrease from 12 to 3% (p < 0.05). CONCLUSION Mechanical bowel preparation combined with oral antibiotic therapy is still not unanimously carried out in all the medical hospitals. In this report, we show that mechanical bowel preparation in combination with oral antibiotic reduces the risk of surgical wound infection and anastomotic leakage in patients undergoing colon and rectal cancer surgery.
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Affiliation(s)
- Javier Gómez Sánchez
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Rocio Forneiro Pérez
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Marisol Zurita Saavedra
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Paola de Castro Monedero
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Cristina González Puga
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Carlos Garde Lecumberri
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
| | - Benito Mirón Pozo
- Department of Colorectal Surgery, Hospital Universitario Clínico San Cecilio, Avd. de la Investigación s/n, 18016, Granada, Spain
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Herrera Montano I, Presencio Lafuente E, Breñosa Martínez J, Ortega Mansilla A, Torre Díez IDL, Río-Solá MLD. Systematic Review of Telemedicine and eHealth Systems Applied to Vascular Surgery. J Med Syst 2022; 46:104. [PMID: 36471095 PMCID: PMC9734958 DOI: 10.1007/s10916-022-01895-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The objective of this paper is to review and analyze the current state of telemedicine and ehealth in the field of vascular surgery. METHODS This paper collects the relevant information obtained after reviewing the articles related to telemedicine in vascular surgery, published from 2012 to 2022 contained in scientific databases. In addition, the results obtained are statistically studied based on various factors, such as the year of publication or the search engine. In this way, we obtain a complete vision of the current state of telemedicine in the field of vascular surgery. RESULTS After performing this search and applying selection criteria, 29 articles were obtained for subsequent study and discussion, of which 20 were published in the second half of the decade, representing 70% of the results. In the analysis carried out according to the search criteria used, it can be seen that using the word telemedicine we obtained 69% of the articles while with the criteria mHealth and eHealth we only obtained 22% and 9% of the results, respectively. It can be seen that the filter with the most potential content articles was "vascular surgery AND telemedicine". In the analysis performed according to the search engine, it was observed that the Google Scholar database contains 93% of the articles found in the massive search and the relevant articles contained therein represent 52% of the total. CONCLUSION An upward trend has been observed in recent years, with a clear increase in the number of publications and much lower figures in the first years. One aspect to highlight is that 47.8% of the articles analyzed focus only on postoperative treatment, which may be due to the help provided by telemedicine in detecting surgical site infections by sending images and videos, this being one of the most common postoperative complications. The analyzed works show the importance of telemedicine in vascular surgery and identify possible future lines of research. In the analysis carried out on the origin of the selected relevant papers, an important interest of the US in this topic is demonstrated since more than 50% of the research contains authors from this country, it is also observed that there is no research from Spain, so this research would be an initial step to determine the weaknesses of telemedicine in this field of medicine and a good opportunity to open a research gap in this branch.
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Affiliation(s)
- Isabel Herrera Montano
- grid.5239.d0000 0001 2286 5329Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain
| | - Elena Presencio Lafuente
- grid.5239.d0000 0001 2286 5329Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain
| | - Jose Breñosa Martínez
- grid.512306.30000 0004 4681 9396Universidad Europea del Atlántico, C / Isabel Torres, 21, 39011 Santander, Spain
| | - Arturo Ortega Mansilla
- grid.512306.30000 0004 4681 9396Universidad Europea del Atlántico, C / Isabel Torres, 21, 39011 Santander, Spain ,grid.441061.60000 0004 1786 8906Universidad Internacional Iberoamericana, Calle 15 Num. 36, between 10 and 12 IMI III, 24560 - Campeche, Mexico City, Mexico
| | - Isabel de la Torre Díez
- grid.5239.d0000 0001 2286 5329Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Paseo de Belén, 15, 47011 Valladolid, Spain
| | - María Lourdes Del Río-Solá
- grid.411057.60000 0000 9274 367XVascular Surgery Department, Hospital Clínico Universitario de Valladolid, Ramón y Cajal Ave, nº 3, 47003 Valladolid, Spain
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Merck B, Henarejos Pérez V, Villalonga Morales A, Barrasa Shaw A. Preventing surgical site infection through patients' education: Results from the MEDIPINAS medical mission. Cir Esp 2021; 100:S0009-739X(21)00099-3. [PMID: 33879326 DOI: 10.1016/j.ciresp.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Belén Merck
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, España.
| | - Valentín Henarejos Pérez
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Castellón de la Plana, Castellón, España
| | - Antonio Villalonga Morales
- Departamento de Anestesiología, Centre Hospitalier Mère et Enfant Monkole, Mont-Ngafula Kinshasa, República Democrática del Congo
| | - Antonio Barrasa Shaw
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, España
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Intraoperative subcutaneous culture as a predictor of surgical site infection in open gynecological surgery. PLoS One 2021; 16:e0244551. [PMID: 33434238 PMCID: PMC7802959 DOI: 10.1371/journal.pone.0244551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/13/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose To analyze the relationship between intraoperative cultures and the development of surgical site infection (SSI) in women undergoing laparotomy for gynecological surgery. Methods Prospective observational cohort study. Over a six-year period, women who underwent elective laparotomy at our hospital were included. Patients’ demographics, underlying co-morbidities, surgical variables, type and etiology of postoperative surgical site infections were collected. Skin and subcutaneous samples were taken just prior to skin closure and processed for microbiological analysis. Univariate and multivariate analyses (logistic regression model) were conducted to explore the association of the studied variables with SSIs. Results 284 patients were included in our study, of which 20 (7%) developed surgical site infection, including 11 (55%) superficial and nine (45%) organ-space. At univariate analysis, length of surgery, colon resection, transfusion and positive intraoperative culture were associated with surgical site infection occurrence. Skin and subcutaneous cultures were positive in 25 (8.8%) and 20 (7%) patients, respectively. SSI occurred in 35% of women with positive subcutaneous culture and in 20% of those with positive skin cultures. Using multivariate analysis, the only independent factor associated with surgical site infection was a positive subcutaneous culture (OR 10.4; 95% CI 3.5–30.4; P<0.001). Conclusion Intraoperative subcutaneous cultures before skin closure may help early prediction of surgical site infection in open gynecological procedures.
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Jiménez-Martínez E, Cuervo G, Carratalà J, Hornero A, Ciercoles P, Gabarrós A, Cabellos C, Pelegrin I, Dominguez Luzón MA, García-Somoza D, Càmara J, Tebé C, Adamuz J, Pujol M. A Care Bundle Intervention to Prevent Surgical Site Infections after a Craniotomy. Clin Infect Dis 2020; 73:e3921-e3928. [PMID: 32594119 DOI: 10.1093/cid/ciaa884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/22/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although surgical site infections after a craniotomy (SSI-CRAN) are a serious problem involving significant morbidity and costs, information on their prevention is scarce. We aimed to assess whether the implementation of a care bundle was effective in preventing SSI-CRANs. METHODS A historical control study was used to evaluate the care bundle, which included a preoperative shower with 4% chlorhexidine soap, appropriate hair removal, adequate preoperative systemic antibiotic prophylaxis, the administration of 1 g of vancomycin powder into the subgaleal space before closing, and a post-operative dressing of the incisional surgical wound with a sterile absorbent cover. Patients were divided into 2 groups: pre-intervention (January 2013 to December 2015) and intervention (from January 2016 to December 2017). The primary study endpoint was the incidence of SSI-CRANs within a year post-surgery. Propensity score matching was performed and differences between the two study periods were assessed using Cox regression models. RESULTS A total of 595 and 422 patients were included in the pre-intervention and intervention periods, respectively. The incidence of SSI-CRANs was lower in the intervention period (15.3% vs. 3.5%; p < 0.001). Using a propensity score model, 421 pairs of patients were matched. The care bundle intervention was independently associated with a reduced incidence of SSI-CRANs (AOR: 0.23, 95% CI: 0.13-0.40; p < 0.001). CONCLUSION The care bundle intervention was effective in reducing SSI-CRAN rates. The implementation of this multimodal preventive strategy should be considered in centers with high SSI-CRAN incidences.
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Affiliation(s)
- Emilio Jiménez-Martínez
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Guillermo Cuervo
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain
| | - Jordi Carratalà
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain
| | - Ana Hornero
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Pilar Ciercoles
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Andres Gabarrós
- Neurosurgery Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Carmen Cabellos
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain
| | - Ivan Pelegrin
- Infectious Diseases Department, Hospital Parc Taulí, Fundació Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Maria Angeles Dominguez Luzón
- Microbiology Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain
| | - Dolores García-Somoza
- Microbiology Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Jordi Càmara
- Microbiology Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,Nursing Information Systems Department Support, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Biostatistics Unit, IDIBELL, L'Hospitalet de Llobregat, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain.,Research Network for Respiratory Diseases (CIBERES), ISCIII, Madrid, Spain
| | - Cristian Tebé
- Biostatistics Unit, IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jordi Adamuz
- Nursing Information Systems Department Support, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Miquel Pujol
- Infectious Diseases Department, Hospital Universitari de Bellvitge - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.,Spanish Network for Research in Infectious Diseases (REIPI), Instituto Carlos III, Madrid, Spain
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Macias-Valcayo A, Pfang BG, Auñón A, Esteban J. Pharmacotherapy options and drug development in managing periprosthetic joint infections in the elderly. Expert Opin Pharmacother 2019; 20:1109-1121. [PMID: 30983431 DOI: 10.1080/14656566.2019.1602118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Prosthetic joint infections are an increasingly important problem among patients undergoing arthroplasty procedures, and are associated with significant morbidity, reduced quality of life, substantial healthcare costs, and even mortality. Arthroplasties are performed with increasing frequency in elderly patients, who present specific problems. AREAS COVERED Surgical therapy is clearly influenced by the clinical status of the patient, which in some case can contraindicate surgery. Antibiotic selection is also affected by comorbidities and underlying diseases, which in some cases reduce therapeutic options. The authors review this together with the changes in pharmacokinetics and pharmacodynamics in the elderly population and the prospects for future research on prevention and treatment. EXPERT OPINION The management of PJI in the elderly makes multidisciplinary teams even more mandatory than in other patients, because the complexity of these patients. A frequent scenario is that in which surgery is contraindicated with long-term suppressive treatment as the only available option. Treating physicians must consider the presence of multiple comorbidities, interactions with other treatments and secondary effects when choosing antibiotic treatment. An in-depth knowledge of the alterations in pharmacokinetics and pharmacodynamics in elderly patients is key for a proper treatment selection.
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Affiliation(s)
- Alicia Macias-Valcayo
- a Department of Clinical Microbiology , IIS-Fundación Jiménez Díaz , Madrid , Spain.,b Bone and Joint Infection Unit , Fundación Jiménez Díaz University Hospital , Madrid , Spain
| | - Bernadette G Pfang
- b Bone and Joint Infection Unit , Fundación Jiménez Díaz University Hospital , Madrid , Spain.,c Department of Internal Medicine , IIS-Fundación Jiménez Díaz , Madrid , Spain
| | - Alvaro Auñón
- b Bone and Joint Infection Unit , Fundación Jiménez Díaz University Hospital , Madrid , Spain.,d Department of Traumatology and Orthopaedic Surgery , IIS-Fundación Jiménez Díaz , Madrid , Spain
| | - Jaime Esteban
- a Department of Clinical Microbiology , IIS-Fundación Jiménez Díaz , Madrid , Spain.,b Bone and Joint Infection Unit , Fundación Jiménez Díaz University Hospital , Madrid , Spain
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Martínez-Ortega C, Fernández-Prada M. Bundles para prevenir infección de la herida quirúrgica en los servicios de cirugía cardiovascular. ¿debemos añadir la Vancomicina tópica como una medida clave? CIRUGIA CARDIOVASCULAR 2018. [DOI: 10.1016/j.circv.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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