Surgical infections
-
Surgical infections · Oct 2014
Validity of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) screening for sepsis in surgical mortalities.
Sepsis is among the leading causes of death in the United States. The Agency for Healthcare Research and Quality uses International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) billing code screening for the identification of sepsis. We investigated the incidence of sepsis in mortality at our academic medical center through ICD-9-CM screening of billing codes corresponding to sepsis and compared this approach for accuracy using physician chart review as the gold-standard. ⋯ Sepsis is a common concurrent condition in surgical patients who die unexpectedly. Screening by ICD-9-CM for sepsis is accurate in identifying patients with sepsis but misses the identification of all patients with sepsis. The diagnostic accuracy of ICD-9-CM screening for sepsis is currently not adequate for public reporting or benchmarking, and is useful only as a guide for institutional quality improvement.
-
Surgical infections · Aug 2014
Association of excessive duration of antibiotic therapy for intra-abdominal infection with subsequent extra-abdominal infection and death: a study of 2,552 consecutive infections.
We hypothesized that a longer duration of antibiotic treatment for intra-abdominal infections (IAI) would be associated with an increased risk of extra-abdominal infections (EAI) and high mortality. ⋯ A longer duration of antibiotic therapy for IAI is associated with an increased risk of subsequent EAI and increased mortality.
-
Surgical infections · Aug 2014
Review Case ReportsPyoderma gangrenosum after minor trauma in a pregnant woman, mistaken for necrotizing fasciitis: report of a case and literature review.
Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. ⋯ Pyoderma gangrenosum can mimic infectious necrotizing fasciitis. Differentiating these two conditions is important because mistreatment of pyoderma can lead to disfigurement.
-
Surgical infections · Aug 2014
Randomized Controlled TrialCyanoacrylate skin microsealant for preventing surgical site infection after vascular surgery: a discontinued randomized clinical trial.
Surgical site infections (SSI) after vascular surgery are related to substantial morbidity. Restriction of bacterial access to the site of surgery with a cyanoacrylate sealant is a new concept. We performed a randomized clinical trial to assess the effect of the sealing of skin with a cyanoacrylate preparation at the site of surgery on the incidence of SSI after arterial reconstruction. ⋯ We could not confirm a reduction in the incidence of SSI after inguinal vascular surgery with the use of a cyanoacrylate skin sealant as compared with conventional means for preparing the surgical site.
-
Surgical infections · Aug 2014
Comparative StudyWhere's the difference? Presentation of nosocomial infection in critically ill trauma versus general surgery patients.
Diagnosing infection efficiently is integral to managing critically ill patients. Knowing if and how trauma and general surgery patients differ in their presentation of new infectious complications could be useful. We hypothesized these populations would differ in presentation in the intensive care unit (ICU). ⋯ Differences exist in how new infections manifest in trauma and general surgery patients in the ICU. General surgery patients appeared sicker on their first day of infection, as evidenced by a higher leukocyte count, lower blood pressure, and substantial positive fluid balance. Intensivists may need differing thresholds for triggering infection workups when employed in a mixed unit.