1
|
Andrews R, Layuno-Matos JG, Frankle MA. Common Factors in Shoulder and Hip Arthroplasty Implant Failures: A Historical Review. J Clin Med 2024; 13:2370. [PMID: 38673642 PMCID: PMC11051213 DOI: 10.3390/jcm13082370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/30/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
In this era of subspecialty care in orthopedics, iterations of implant design can occur in a silo which then precludes gaining knowledge from failures of implant design that may have occurred in different subspecialties. This literature review describes the history of failures in hip and shoulder arthroplasties with the purpose of identifying similar factors that led to previous implant failures. A review of the literature was performed by two reviewers assessing articles that described failed hip and shoulder arthroplasty systems over time. We identified and analyzed 53 implant failures-23 in hip arthroplasty and 30 in shoulder arthroplasty. These failures were categorized as material, mechanical, and technical. In hip arthroplasty, 48% were material, 39% mechanical, and 13% technical failures. In shoulder arthroplasty, the distribution was 10% material, 70% mechanical, and 20% technical failures. The distribution of these failures highlights similar and sometimes repeated failure mechanisms between subspecialties. This accentuates the importance of a collaborative approach to improve future arthroplasty designs.
Collapse
Affiliation(s)
- Reed Andrews
- Department of Orthopaedics, School of Medicine, University of South Florida, Tampa, FL 33612, USA;
| | | | - Mark A. Frankle
- Foundation for Orthopaedic Research and Education, Tampa, FL 33607, USA;
- Florida Orthopaedic Institute, Tampa, FL 33637, USA
| |
Collapse
|
2
|
Heinke TL, Joseph A, Carroll D. Safety in Health Care: The Impact of Operating Room Design. Anesthesiol Clin 2023; 41:789-801. [PMID: 37838384 DOI: 10.1016/j.anclin.2023.05.005] [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: 10/16/2023]
Abstract
The science of operating room design has grown over the past 20 years due to the realization that the physical environment influences health care provider performance and patient outcomes. Medical errors occur when the normal workflow in an operating room is disrupted as providers must overcome sub-optimal conditions. All aspects of the physical environment can impact operating room flow. Studying the layout, contents, ergonomics, and environmental parameters of the operating can lead improved work conditions resulting improved patient and provider safety. At the forefront of operating room design science is the use of simulation and the evaluation of new technologies.
Collapse
Affiliation(s)
- Timothy L Heinke
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, 25 Courtenay Drive, Suite 4200, MSC 240, Charleston, SC 29425, USA.
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, 2-141 Lee Hall, Clemson University, Clemson, SC 29631, USA
| | - David Carroll
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, 25 Courtenay Drive, Suite 4200, MSC 240, Charleston, SC 29425, USA
| |
Collapse
|
3
|
Barbarewicz F, Henkel KO, Dudde F. Diagnosis and management of postoperative wound infections in the head and neck region. Oncoscience 2023; 10:56-58. [PMID: 37799961 PMCID: PMC10549770 DOI: 10.18632/oncoscience.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Filip Barbarewicz
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg 22049, Germany
| | - Kai-Olaf Henkel
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg 22049, Germany
| | - Florian Dudde
- Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Hamburg 22049, Germany
| |
Collapse
|
4
|
Kozelskaya AI, Verzunova KN, Akimchenko IO, Frueh J, Petrov VI, Slepchenko GB, Bakina OV, Lerner MI, Brizhan LK, Davydov DV, Kerimov AA, Cherempey EG, Krylov SE, Rutkowski S, Tverdokhlebov SI. Antibacterial Calcium Phosphate Coatings for Biomedical Applications Fabricated via Micro-Arc Oxidation. Biomimetics (Basel) 2023; 8:444. [PMID: 37754195 PMCID: PMC10526763 DOI: 10.3390/biomimetics8050444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023] Open
Abstract
A promising method for improving the functional properties of calcium-phosphate coatings is the incorporation of various antibacterial additives into their structure. The microbial contamination of a superficial wound is inevitable, even if the rules of asepsis and antisepsis are optimally applied. One of the main problems is that bacteria often become resistant to antibiotics over time. However, this does not apply to certain elements, chemical compounds and drugs with antimicrobial properties. In this study, the fabrication and properties of zinc-containing calcium-phosphate coatings that were formed via micro-arc oxidation from three different electrolyte solutions are investigated. The first electrolyte is based on calcium oxide, the second on hydroxyapatite and the third on calcium acetate. By adding zinc oxide to the three electrolyte solutions, antibacterial properties of the coatings are achieved. Although the same amount of zinc oxide has been added to each electrolyte solution, the zinc concentration in the coatings obtained vary greatly. Furthermore, this study investigates the morphology, structure and chemical composition of the coatings. The antibacterial properties of the zinc-containing coatings were tested toward three strains of bacteria-Staphylococcus aureus, methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. Coatings of calcium acetate and zinc oxide contained the highest amount of zinc and displayed the highest zinc release. Moreover, coatings containing hydroxyapatite and zinc oxide show the highest antibacterial activity toward Pseudomonas aeruginosa, and coatings containing calcium acetate and zinc oxide show the highest antibacterial activities toward Staphylococcus aureus and methicillin-resistant Staphylococcus aureus.
Collapse
Affiliation(s)
- Anna I. Kozelskaya
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| | - Ksenia N. Verzunova
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| | - Igor O. Akimchenko
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| | - Johannes Frueh
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| | - Vsevolod I. Petrov
- Tomsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences, 10/4, Akademicheskii Prospekt, 634055 Tomsk, Russia;
| | - Galina B. Slepchenko
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| | - Olga V. Bakina
- Institute of Strength Physics and Materials Science of the Siberian Branch of the Russian Academy of Sciences, 2/4, Akademicheskii Prospekt, 634055 Tomsk, Russia; (O.V.B.); (M.I.L.)
| | - Marat I. Lerner
- Institute of Strength Physics and Materials Science of the Siberian Branch of the Russian Academy of Sciences, 2/4, Akademicheskii Prospekt, 634055 Tomsk, Russia; (O.V.B.); (M.I.L.)
| | - Leonid K. Brizhan
- Federal State Budgetary Institution «Main Military Clinical Hospital Named after Academician N.N. Burdenko» of the Ministry of defense of the Russian Federation», 3 Gospitalnaya Square, 105299 Moscow, Russia; (L.K.B.); (D.V.D.); (A.A.K.)
| | - Denis V. Davydov
- Federal State Budgetary Institution «Main Military Clinical Hospital Named after Academician N.N. Burdenko» of the Ministry of defense of the Russian Federation», 3 Gospitalnaya Square, 105299 Moscow, Russia; (L.K.B.); (D.V.D.); (A.A.K.)
| | - Artur A. Kerimov
- Federal State Budgetary Institution «Main Military Clinical Hospital Named after Academician N.N. Burdenko» of the Ministry of defense of the Russian Federation», 3 Gospitalnaya Square, 105299 Moscow, Russia; (L.K.B.); (D.V.D.); (A.A.K.)
| | | | - Sergey E. Krylov
- BITECA LLC, 9 Zapadnaya Street, Building 10, 143002 Odintsovo, Russia;
| | - Sven Rutkowski
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
- Tomsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences, 10/4, Akademicheskii Prospekt, 634055 Tomsk, Russia;
| | - Sergei I. Tverdokhlebov
- Weinberg Research Center, School of Nuclear Science &Engineering, Tomsk Polytechnic University, 30, Lenin Avenue, 634050 Tomsk, Russia; (K.N.V.); (I.O.A.); (J.F.); (G.B.S.)
| |
Collapse
|
5
|
Jarelnape AA. The Assessment of Nursing Staff Knowledge and Barriers Regarding Aseptic Techniques in Khartoum Teaching Hospital, Sudan. Cureus 2023; 15:e45265. [PMID: 37846261 PMCID: PMC10576657 DOI: 10.7759/cureus.45265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/18/2023] Open
Abstract
Background Aseptic techniques are crucial in preventing healthcare-associated infections, which are an integral part of standard precautions, and encompass a range of practices designed to safeguard patients from healthcare-associated infections. Objective The objective of this study was to evaluate the level of knowledge and identify the barriers faced by nursing staff in implementing aseptic techniques. Methodology This study employed a stratified random sampling technique to ensure the representation of the research sample. A cross-sectional, descriptive research design was used to assess the knowledge and barriers of nursing staff in maintaining aseptic techniques in their medical practice at Khartoum Teaching Hospital, Sudan. The nursing staff members were divided into different units, and a proportionate number of participants were randomly selected from each stratum. A total of 83 nursing staff members were recruited for this study. Data collection was conducted using a structured questionnaire specifically designed for this study. The questionnaire consisted of items that assessed the nursing staff's knowledge and barriers to aseptic technique implementation. Results The study findings revealed that the mean knowledge score of nursing staff was 14.12, with a median score of 15. The knowledge score had a standard deviation of 3.22. Approximately two-thirds of the nurses (66.3%) had an average level of knowledge, while 33.7% had a below-average level of knowledge. The chi-square analysis indicated a significant association between educational level, years of experience, and knowledge scores (P value=0.010) at a significance level of 0.05. Additionally, 65% of the participants reported facing multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, and inadequate support. Conclusion In conclusion, the evaluation revealed that a significant proportion of participants felt that their unit lacked adequate training and resources for aseptic techniques. Many had observed colleagues not adhering to aseptic practices, and the participants faced multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, time constraints, and inadequate support.
Collapse
Affiliation(s)
- Ahmed A Jarelnape
- Department of Nursing, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, SAU
| |
Collapse
|
6
|
Wang Q, Cao M, Tao H, Fei Z, Huang X, Liang P, Liu B, Liu J, Lu X, Ma P, Si S, Wang S, Zhang Y, Zheng Y, Zang L, Chen X, Dong Z, Ge W, Guo W, Hu X, Huang X, Li L, Liang J, Liu B, Liu D, Liu L, Liu S, Liu X, Miao L, Ren H, Shi G, Shi L, Sun S, Tao X, Tong R, Wang C, Wang B, Wang J, Wang J, Wang X, Wang X, Xie J, Xie S, Yang H, Yang J, You C, Zhang H, Zhang Y, Zhao C, Zhao Q, Zhu J, Ji B, Guo R, Hang C, Xi X, Li S, Gong Z, Zhou J, Wang R, Zhao Z. Evidence-based guideline for the prevention and management of perioperative infection. J Evid Based Med 2023; 16:50-67. [PMID: 36852502 DOI: 10.1111/jebm.12514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/09/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND We have updated the guideline for preventing and managing perioperative infection in China, given the global issues with antimicrobial resistance and the need to optimize antimicrobial usage and improve hospital infection control levels. METHODS We conducted a comprehensive evaluation of the evidence for prevention and management of perioperative infection, based on the concepts of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The strength of recommendations was graded and voted using the Delphi method and the nominal group technique. Revisions were made to the guidelines in response to feedback from the experts. RESULTS There were 17 questions prepared, for which 37 recommendations were made. According to the GRADE system, we evaluated the body of evidence for each clinical question. Based on the meta-analysis results, recommendations were graded using the Delphi method to generate useful information. CONCLUSIONS This guideline provides evidence to perioperative antimicrobial prophylaxis that increased the rational use of prophylactic antimicrobial use, with substantial improvement in the risk-benefit trade-off.
Collapse
Affiliation(s)
- Qiaoyu Wang
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Mingnan Cao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Hua Tao
- Department of Pharmacy, Beijing United Family Hospital, Beijing, P. R. China
| | - Zhimin Fei
- Department of Neurosurgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, P. R. China
| | - Xiufeng Huang
- Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, P. R. China
| | - Pixia Liang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Baiyun Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Jianping Liu
- Centre for Evidence-Based Medicine, Beijing University of Chinese Medicine, Beijing, P. R. China
| | - Xiaoyang Lu
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
| | - Penglin Ma
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, P. R. China
| | - Shuyi Si
- Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Yuewei Zhang
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Yingli Zheng
- Department of Pharmacy, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Lei Zang
- Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, P. R. China
| | - Xiao Chen
- Department of Pharmacy, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P. R. China
| | - Zhanjun Dong
- Department of Pharmacy, Hebei General Hospital, Shijiazhuang, P. R. China
| | - Weihong Ge
- Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, P. R. China
| | - Wei Guo
- Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Xin Hu
- Department of Pharmacy, Beijing Hospital, Beijing, P. R. China
| | - Xin Huang
- Department of Pharmacy, The First Affiliated Hospital of Shandong First Medical University/Shandong Province Qianfoshan Hospital, Jinan, P. R. China
| | - Ling Li
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China
| | - Jianshu Liang
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Baoge Liu
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Dong Liu
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, HUST, Wuhan, P. R. China
| | - Linna Liu
- Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, P. R. China
| | - Songqing Liu
- Department of General Surgery, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China
| | - Xianghong Liu
- Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, P. R. China
| | - Liyan Miao
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
| | - Haixia Ren
- Department of Pharmacy, Tianjin First Central Hospital, Tianjin, P. R. China
| | - Guangzhi Shi
- Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Luwen Shi
- Department of Pharmaceutical Administration, School of Pharmaceutical Sciences, Peking University, Beijing, P. R. China
| | - Shumei Sun
- Department of Pediatrics, Nanfang Hospital of Southern Medical University, Guangzhou, P. R. China
| | - Xia Tao
- Department of Pharmacy, Second Affiliated Hospital of Naval Medical University, Shanghai, P. R. China
| | - Rongsheng Tong
- Department of Pharmacy, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, P. R. China
| | - Cheng Wang
- Department of Pharmacy, The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou, P. R. China
| | - Bin Wang
- Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, P. R. China
| | - Jincheng Wang
- Orthopaedic Medical Center, The 2nd Hospital of Jilin University, Changchun, P. R. China
| | - Jingwen Wang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, P. R. China
| | - Xiaoling Wang
- Department of Pharmacy, Beijing Children's Hospital, Capital Medical University, Beijing, P. R. China
| | - Xiaoyan Wang
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Jian Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Shouxia Xie
- Department of Pharmacy, Shenzhen People's Hospital, Shenzhen, P. R. China
| | - Hua Yang
- Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, P. R. China
| | - Jianxin Yang
- Department of Intervention Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Chao You
- Department of Neurosurgery, West China Hospital Sichuan University, Chengdu, P. R. China
| | - Hongyi Zhang
- Department of General Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Yi Zhang
- Department of Pharmacy, Tianjin First Central Hospital, Tianjin, P. R. China
| | - Chengson Zhao
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Jiangsu Suzhou, P. R. China
| | - Qingchun Zhao
- Department of Pharmacy, General Hospital of Northern Theater Command, Shenyang, P. R. China
| | - Jiangguo Zhu
- Department of Pharmacy, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
| | - Bo Ji
- Clinical Pharmacy, General Hospital of Southern Theatre Command of PLA, Guangzhou, P. R. China
| | - Ruichen Guo
- Department of Pharmacy, Qilu Hospital of Shandong University, Jinan, P. R. China
| | - Chunhua Hang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, P. R. China
| | - Xiaowei Xi
- Department of Gynecological Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Sheyu Li
- Department of Endocrinology and Metabolism/China Evidence-based Medicine Center, West China Hospital Sichuan University, Chengdu, P. R. China
| | - Zhicheng Gong
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, P. R. China
| | - Jianxin Zhou
- Department of Intensive Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| | - Rui Wang
- Department of Drug Clinical Trial, PLA General Hospital, Beijing, P. R. China
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, P. R. China
| |
Collapse
|
7
|
Khairullah AR, Sudjarwo SA, Effendi MH, Ramandinianto SC, Gelolodo MA, Widodo A, Riwu KHP, Kurniawati DA. Pet animals as reservoirs for spreading methicillin-resistant Staphylococcus aureus to human health. J Adv Vet Anim Res 2023; 10:1-13. [PMID: 37155545 PMCID: PMC10122942 DOI: 10.5455/javar.2023.j641] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 05/10/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of pathogenic bacteria that is a major problem in the world's health. Due to their frequent interaction with humans, pets are one of the main risk factors for the spread of MRSA. The possibility for zoonotic transmission exists since frequently kept dogs and cats are prone to contract MRSA and act as reservoirs for spreading MRSA. The mouth, nose, and perineum are the primary locations of MRSA colonization, according to the findings of MRSA identification tests conducted on pets. The types of MRSA clones identified in cats and dogs correlated with MRSA clones infecting humans living in the same geographic area. A significant risk factor for the colonization or transmission of MRSA is human-pet contact. An essential step in preventing the spread of MRSA from humans to animals and from animals to humans is to keep hands, clothing, and floor surfaces clean.
Collapse
Affiliation(s)
- Aswin Rafif Khairullah
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sri Agus Sudjarwo
- Department of Veterinary Pharmacology, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Mustofa Helmi Effendi
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Maria Aega Gelolodo
- Department of Animal Infectious Diseases and Veterinary Public Health, Faculty of Medicine and Veterinary Medicine, Universitas Nusa Cendana, Kupang, Indonesia
| | - Agus Widodo
- Doctoral Program in Veterinary Science, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | | |
Collapse
|
8
|
Diamond-like Carbon Coatings in the Biomedical Field: Properties, Applications and Future Development. COATINGS 2022. [DOI: 10.3390/coatings12081088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Repairment and replacement of organs and tissues are part of the history of struggle against human diseases, in addition to the research and development (R&D) of drugs. Acquisition and processing of specific substances and physiological signals are very important to understand the effects of pathology and treatment. These depend on the available biomedical materials. The family of diamond-like carbon coatings (DLCs) has been extensively applied in many industrial fields. DLCs have also been demonstrated to be biocompatible, both in vivo and in vitro. In many cases, the performance of biomedical devices can be effectively enhanced by coating them with DLCs, such as vascular stents, prosthetic heart valves and surgical instruments. However, the feasibility of the application of DLC in biomedicine remains under discussion. This review introduces the current state of research and application of DLCs in biomedical devices, their potential application in biosensors and urgent problems to be solved. It will be useful to build a bridge between DLC R&D workers and biomedical workers in order to develop high-performance DLC films/coatings, promote their practical use and develop their potential applications in the biomedical field.
Collapse
|
9
|
Chen H, Wang P, Ji Q. Analysis of the Application Effect of PDCA Cycle Management Combined With Risk Factor Management Nursing for Reducing Infection Rate in Operating Room. Front Surg 2022; 9:837014. [PMID: 35372464 PMCID: PMC8967976 DOI: 10.3389/fsurg.2022.837014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the application effect of plan-do-check-action (PDCA) cycle management combined with risk factor management nursing in an operating room. Methods A total of 150 surgical patients in our hospital from November 2020 to February 2021 were selected as the conventional group, and 150 surgical patients in our hospital from March 2021 to June 2021 were selected as the research group. The conventional group implemented routine infection management, and the research group implemented PDCA cycle management combined with risk factor management. Detection of pathogenic bacteria, incidence of incision infection, infection control, occurrence of irregular events, and nursing quality in the operating room were observed in the two groups. Results The detection rate of Gram-negative bacillus and Gram-positive cocci, infection rate of incision, and total incidence of irregular events in the research group were lower than those in the conventional group (P < 0.05). The qualified rate of disinfection of object surface, hands of medical staff and air, and nursing quality scores in the research group were higher than those in the conventional group (P < 0.05). Conclusion Plan-do-check-action (PDCA) cycle management combined with risk factor management nursing can reduce the detection rate of pathogenic bacteria and infection rate of incision in the operating room, reduce the incidence of irregular events, improve the qualified rate of disinfection, and greatly improve the quality of nursing, which can be considered to be widely used in clinical practice.
Collapse
|
10
|
Bai Y, Su Y, Zheng Z. The clinical effect of nursing intervention in the operating room on the prevention of orthopedic wound infections. Am J Transl Res 2021; 13:3703-3709. [PMID: 34017554 PMCID: PMC8129312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To study the preventive effect of operating room nursing intervention on surgical incision infections in elderly patients undergoing orthopedic surgery. METHODS Altogether, 128 orthopedic patients were divided into an observation group and a control group according to the nursing method each patient underwent, with 64 patients in each group. RESULTS The grade A incision healing rate in the observation group was significantly higher than the rate in the control group (P<0.01). The eating and getting out of bed times, and the lengths of the hospital stays in the observation group were significantly shorter than the corresponding times in the control group (P<0.01). The incidences of postoperative wound infections in the observation group (0 cases) was significantly lower than the incidences in the control group (14 cases, accounting for 21.88%), and the difference was statistically significant (P<0.001). After the nursing, the prognoses and quality of life scores of the patients in the observation group were better than they were in the control group, and the differences were statistically significant (P<0.01). Our investigation indicated that, after the treatment, the overall patient satisfaction rate in the observation group (98.44%) was significantly higher than the patient satisfaction rate in the control group (84.38%), and the difference was statistically significant (χ2=27.349, P=0.000). CONCLUSION Operating room nursing intervention can effectively prevent postoperative wound infections and promote incision healing, so it is worthy of application.
Collapse
Affiliation(s)
- Yan Bai
- Department of Surgery and Anesthesiology, The Second Affiliated Hospital of Xi'an Medical University Xi'an, Shaanxi Province, China
| | - Yuqiang Su
- Department of Surgery and Anesthesiology, The Second Affiliated Hospital of Xi'an Medical University Xi'an, Shaanxi Province, China
| | - Zhonglei Zheng
- Department of Surgery and Anesthesiology, The Second Affiliated Hospital of Xi'an Medical University Xi'an, Shaanxi Province, China
| |
Collapse
|
11
|
Khan S, Shih T, Shih S, Khachemoune A. Reappraising Elements of the Aseptic Technique in Dermatology: A Review. Dermatol Pract Concept 2021; 11:e2021126. [PMID: 33614211 DOI: 10.5826/dpc.1101a126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 10/31/2022] Open
Abstract
Dermatologic procedures are performed under varying degrees of antisepsis, and no clear guidelines exist regarding the role of the aseptic technique in dermatology. This review aims to clarify the terminology surrounding surgical asepsis and examines the importance of various components of the aseptic technique in cutaneous surgery. Included are studies examining optimal glove type, surgical instruments, skin antisepsis, and cost-reducing protocols. Our review highlights that most dermatology procedures are not performed under completely sterile conditions due to the lack of environmental and foot traffic controls in dermatology offices. In addition, for some outpatient procedures, such as for minor excisions and Mohs surgery before reconstruction, elements of the clean technique can be used without increasing infection rates. However, data on the feasibility of a clean protocol for Mohs reconstruction is conflicting. Future prospective, randomized trials analyzing various components of the aseptic technique in dermatology are greatly needed so that guidelines can be established for practicing dermatologists.
Collapse
Affiliation(s)
- Samiya Khan
- Long School of Medicine, University of Texas Health Science Center at San Antonio, TX, USA
| | - Terri Shih
- David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Shawn Shih
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, Brooklyn, NY, USA.,Department of Dermatology, SUNY Downstate, Brooklyn, NY, USA
| |
Collapse
|
12
|
Holder-Murray J, Yeh A, Rogers MB, Firek B, Mahler B, Medich D, Celebrezze J, Morowitz MJ. Time-dependent displacement of commensal skin microbes by pathogens at the site of colorectal surgery. Clin Infect Dis 2020; 73:e2754-e2762. [PMID: 33097951 DOI: 10.1093/cid/ciaa1615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although the healthy human skin microbiome has been the subject of recent studies, it is not known whether alterations among commensal microbes contribute to surgical site infections (SSIs). The objective of this study was to characterize temporal and spatial variation in the skin microbiota of patients undergoing colorectal surgery and to determine if dysbiosis contributes to SSIs. METHODS Sixty (60) adults scheduled to undergo elective colon or rectal resection were identified by convenience sampling. By analyzing bacterial 16S rRNA gene sequences isolated from clinical samples, we used a culture-independent strategy to monitor perioperative changes in microbial diversity of fecal samples and the skin. RESULTS 990 samples were analyzed from 60 patients. Alpha diversity on the skin decreased after surgery but later recovered at the postoperative clinic visit. In most patients, we observed a transient postoperative loss of skin commensals (Corynebacterium and Propionibacterium) at the surgical site, which were replaced by potential pathogens and intestinal anaerobes (e.g. Enterobacteriaceae). These changes were not observed on skin that was uninvolved in the surgical incision (chest wall). One patient developed a wound infection. Incisional skin swabs from this patient demonstrated a sharp postoperative increase in the abundance of Enterococcus, which was also cultured from wound drainage. CONCLUSION We observed reproducible perioperative changes in the skin microbiome following surgery. The low incidence of SSIs in this cohort precluded analysis of associations between dysbiosis and infection. We postulate that real time monitoring of the skin microbiome could provide actionable findings about the pathogenesis of SSIs.
Collapse
Affiliation(s)
- Jennifer Holder-Murray
- Division of Colon & Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.,Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrew Yeh
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew B Rogers
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian Firek
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brandon Mahler
- Division of Colon & Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - David Medich
- Division of Colon & Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.,Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James Celebrezze
- Division of Colon & Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.,Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael J Morowitz
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Pediatric General and Thoracic Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| |
Collapse
|
13
|
Alverdy JC, Hyman N, Gilbert J. Re-examining causes of surgical site infections following elective surgery in the era of asepsis. THE LANCET. INFECTIOUS DISEASES 2020; 20:e38-e43. [PMID: 32006469 DOI: 10.1016/s1473-3099(19)30756-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 11/29/2019] [Accepted: 12/20/2019] [Indexed: 02/07/2023]
Abstract
The currently accepted assumption that most surgical site infections (SSIs) occurring after elective surgery under standard methods of antisepsis are due to an intraoperative contamination event, remains unproven. We examined the available evidence in which microbial cultures of surgical wounds were taken at the conclusion of an operation and determined that such studies provide more evidence to refute that an SSI is due to intraoperative contamination than support it. We propose that alternative mechanisms of SSI development should be considered, such as when a sterile postoperative wound becomes infected by a pathogen originating from a site remote from the operative wound-eg, from the gums or intestinal tract (ie, the Trojan Horse mechanism). We offer a path forward to reduce SSI rates after elective surgery that includes undertaking genomic-based microbial tracking from the built environment (ie, the operating room and hospital bed), to the patient's own microbiome, and then to the surgical site. Finally, we posit that only by generating this dynamic microbial map can the true pathogenesis of SSIs be understood enough to inform novel preventive strategies against infection following elective surgery in the current era of asepsis.
Collapse
Affiliation(s)
- John C Alverdy
- Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.
| | - Neil Hyman
- Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Jack Gilbert
- Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| |
Collapse
|