Surgical infections
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Surgical infections · Jun 2014
Longer hospitalization of patients with positive blood cultures receiving total parenteral nutrition.
Total parenteral nutrition (TPN) via central venous catheters has improved nutrient delivery to patients unable to receive nutrition enterally, but its administration can be complicated by bacteremia and fungemia. ⋯ Continuation of TPN after a positive blood culture was associated with statistically significantly longer hospitalization before and after adjustment for co-morbid conditions.
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Surgical infections · Jun 2014
Macrolides are associated with a better survival rate in patients hospitalized with community-acquired but not healthcare-associated pneumonia.
Macrolide-based treatment has been associated with survival benefit in patients hospitalized with community-acquired pneumonia (CAP). However, the influence of macrolide therapy in all patients hospitalized with pneumonia, including healthcare-associated pneumonia (HCAP), is unclear. ⋯ Macrolide-based treatment was associated with better survival in patients hospitalized with pneumonia. The survival advantage appeared predominantly among patients with CAP.
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Surgical infections · Jun 2014
Risk factors for post-operative pulmonary complications after gastrectomy for gastric cancer.
Post-operative pulmonary complications (PPCs) negatively affect patients' quality of life and can be life-threatening. Predictors of PPCs have been evaluated in patients who underwent various operations, but few studies have specifically focused on gastrectomy. ⋯ Extended operating time, total gastrectomy, and predicted VC were independent predictors of PPCs, particularly pneumonia, in patients with gastric cancer who underwent gastrectomy. In patients with restrictive pulmonary dysfunction who are scheduled to undergo total gastrectomy, reduced lymphadenectomy or the avoidance of combined resection should be considered to shorten the operating time.
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Surgical infections · Jun 2014
Not just full of hot air: hyperbaric oxygen therapy increases survival in cases of necrotizing soft tissue infections.
The utility of hyperbaric oxygen therapy (HBOT) in the treatment of necrotizing soft tissue infections (NSTIs) has not been proved. Previous studies have been subject to substantial selection bias because HBOT is not available universally at all medical centers, and there is often considerable delay associated with its initiation. We examined the utility of HBOT for the treatment of NSTI in the modern era by isolating centers that have their own HBOT facilities. ⋯ At HBOT-capable centers, receiving HBOT was associated with a significant survival benefit. Use of HBOT in conjunction with current practices for the treatment of NSTI can be both a cost-effective and life-saving therapy, in particular for the sickest patients.
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Surgical infections · Jun 2014
Open abdomen management of intra-abdominal infections: analysis of a twenty-year experience.
No conclusive results on the efficacy and timing of open abdomen (OA) are available, particularly in the setting of intra-abdominal infections. We analyzed outcomes and risk factors retrospectively in a large series of patients managed with an OA during the past 20 y in an effort to clarify this issue. ⋯ Patients' pre-operative clinical status influences strongly their response to surgical treatment. The management of OA does not affect adversely the survival of patients with intra-abdominal infections, but factors related to the management of OA (duration of OA) seem to affect the possibility of definitive fascial closure.