Surgical infections
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Surgical infections · Oct 2009
ReviewNonoperative management of blunt abdominal trauma: have we gone too far?
The paradigm shift in the management of blunt abdominal trauma has been to become less invasive with both diagnostic tools and management. Avoidance of a laparotomy with its short-term and long-term risks is of obvious benefit to the patient. ⋯ Safe nonoperative management requires adherence to cardinal surgical principles, examination and re-examination of the patient, and fastidious clinical judgment.
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Surgical infections · Oct 2009
Soluble triggering receptor expressed on myeloid cells-1 is an early marker of infection in the surgical intensive care unit.
To determine the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in early differentiation of systemic inflammatory response syndrome (SIRS) from infection in patients in a surgical intensive care unit (ICU). ⋯ In the present study, sTREM-1 was an accurate tool for differentiating SIRS from infection in patients in the surgical ICU.
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Surgical infections · Aug 2009
ReviewHas mortality from sepsis improved and what to expect from new treatment modalities: review of current insights.
The incidence of sepsis is increasing continuously, making mortality rate reduction through improved intensive care unit (ICU) care and new treatment modalities a pressing issue. This study aimed to provide insight into the effects of modern ICU care on mortality trends from severe sepsis and to provide a quantitative review of the relative effectiveness of new treatment modalities in reducing deaths. ⋯ The mortality rate from severe sepsis has decreased significantly with modernization of ICU care. New therapeutic strategies may reduce further the mortality rate. However, focused implementation of these new strategies in accordance with their relative effectiveness is needed before we can expect to see their true effect on mortality rates.
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Surgical infections · Aug 2009
Surgical site infections: does inadequate antibiotic therapy affect patient outcomes?
Complicated skin/skin structure infections involve deeper soft tissues and include surgical site infections (SSIs). Inadequate antibiotic therapy (IAT) has been associated with adverse outcomes in respiratory and blood stream infections, but is seldom evaluated in SSIs. This study assessed the impact of IAT on primary outcomes of length of stay (LOS) and costs in complicated SSIs; identifying risk factors associated with receiving IAT was a secondary objective. ⋯ Inadequate antibiotic therapy is associated with longer LOS and higher costs in complicated SSIs. Risk factors for IAT include prior antibiotic therapy, polymicrobial infection, infection with P. aeruginosa or Enterococcus spp., and abdominal incisions.
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Silver has been used extensively throughout recorded history for a variety of medical purposes. ⋯ Silver was the most important antimicrobial agent available before the introduction of antibiotics.