Surgical infections
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Surgical infections · Oct 2014
Observational StudyEvaluation of procalcitonin as a marker to predict antibiotic response in adult patients with acute appendicitis: a prospective observational study.
The aim of the study was to investigate the value of serum procalcitonin (PCT) as a predictor of early antibiotic treatment response in patients with acute appendicitis. Procalcitonin is a biochemical marker that increases rapidly in cases of bacterial infection and sepsis; however, the benefit of PCT as a diagnostic tool in acute appendicitis has not been confirmed. ⋯ Procalcitonin has limited additional value, compared with standard laboratory tests as CRP, WBC, and body temperature to predict antibiotic treatment response in adult patients with acute appendicitis.
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Surgical infections · Oct 2014
Review Case ReportsAcute pyogenic inguinal abscess from complex soft-tissue infection or intra-abdominal pathology.
Abscesses involving the inguinal region are uncommon as manifestations of complex soft-tissue infections or intra-abdominal pathology, and the routes by which they cause infection are usually unclear and may be overlooked. ⋯ Computed tomography is helpful in diagnosing inguinal abscess and determining the extent of infection. In patients presenting with inguinal abscess. Early recognition of its origin can facilitate further surgical planning and possibly improve the outcome.
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Surgical infections · Oct 2014
Comparative StudyOutcomes with porcine acellular dermal matrix versus synthetic mesh and suture in complicated open ventral hernia repair.
Mesh reinforcement as part of open ventral hernia repair (OVHR) has become the standard of care. However, there is no consensus on the ideal type of mesh to use. In many clinical situations, surgeons are reluctant to use synthetic mesh. Options in these complicated OVHRs include suture repair or the use of biologic mesh such as porcine acellular dermal matrix (PADM). There has been a paucity of controlled studies reporting long-term outcomes with biologic meshes. We hypothesized that compared with synthetic mesh in OVHR, PADM is associated with fewer surgical site infections (SSI) but more seromas and recurrences. Additionally, compared with suture repair, we hypothesized that PADM is associated with fewer recurrences but more SSIs and seromas. ⋯ The PADM repair of complicated OVHR resulted in fewer recurrences, more seromas, and no difference in SSI compared with suture repair. Although no reduction in SSI was identified with the use of PADM rather than synthetic mesh or suture for OVHR, the meaning of this finding is unclear, as this case-controlled study was underpowered and limited by selection bias. According to our data, 280 patients would have been needed to identify a clinically significant difference in the primary outcome of SSI as well as secondary outcomes of mesh explantation and recurrence (α=0.05; β=0.20). A randomized trial is warranted to compare PADM with synthetic mesh in complicated OVHR.