Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs. Increased concern about antibiotic resistance justifies evaluation of alternative preventive approaches, such a Manuka honey which has displayed antimicrobial properties. Pectin-Honey Hydrogels (PHH), composed by Manuka honey and pectin provide a moist wound environment and microbial growth inhibition. The aim of the study was to evaluate the effectiveness of PHHs in preventing SSI in horses subjected to emergency laparotomy. Horses undergoing laparotomy were evaluated. Horses were randomly divided into two groups: Group 1 received PHH application onto the sutured linea alba before skin closure, while Group 2 received no treatment. Horses with postoperative antimicrobial administration or survival of less than 5 days were excluded. The incidence of SSIs was reported as percentages and compared between groups. Out of 44 horses enrolled in the study, only thirty-six were ultimately included. Exclusions occurred either due to death before 5 days postoperatively (2 horses) or the administration of postoperative antimicrobials (6 horses). The median length of hospitalization was 9 days (range 8-14 days). The overall occurrence of SSI was 19.4 %. One out of eighteen horses (5.5 %) in Group 1 and 6 out of 18 (33.3 %) horses in Group 2 developed SSI. Group 2 had an 8.5-fold increased risk of SSI (p = 0.035, OR = 8.5, 95 % CI. 0.9-80.07). No macroscopically visible adverse reactions were associated with PHH. PHH placed at the abdominal incision during surgery was safe and reduced the prevalence of SSI in horses.

Autistic youth experience elevated rates of co-occurring internalizing symptoms. Interventions to treat internalizing symptoms in autistic youth are almost uniformly costly and time-intensive, blunting dissemination of intervention and highlighting the need for scalable solutions. One promising option is a relatively new class of evidence-based treatments, single-session interventions (SSIs), however, no study has examined SSIs for depression symptoms in autistic youth. Participants included 40 autistic adolescents ranging in age from 11 to 16 (Mage = 14.22, Nmale = 32). Eligible youth who agreed to participate were randomized to either the active intervention (Project Personality), or an active control designed to mimic supportive therapy. Participants and their caregiver completed questionnaires immediately before, after, and three months post intervention. All participants completed the intervention independently and largely reported enjoying it. The intervention was delivered with 100% fidelity. Findings demonstrated improvements in perceived primary control, malleability of personality, and social competence relative to the active control group immediately post-intervention. Further, results revealed improvements in self-reported depression symptoms and parent reported emotional regulation at 3-month follow up. This study was the first to assess a GM-SSI designed to treat depression symptoms in autistic adolescents. Results indicated improvements in perceived control immediately post-intervention and downstream improvements in depression. Nonetheless, we did not find improvements in symptoms of anxiety, suggesting that autistic adolescents may require modifications to the intervention to maximize benefit. Findings demonstrate the utility of GM-SSI for internalizing symptoms for autistic youth and hold considerable promise as a low-intensity and scalable intervention.

UNASSIGNED: Surgical site infection (SSI) is the third most commonly reported nosocomial infection, accounting for 10%-40% of all nosocomial infections and is a major cause of postoperative morbidity. Knowledge of factors related to SSI can help in reducing its incidence and related morbidity, which in many studies is shown to account for 38% of all infections in surgical patients. Lack of extending nosocomial infection surveillance programme and prevention measures in countries like India is viewed as a major challenge for the future.
UNASSIGNED: The aims of this work were (1) to study the SSI rate in patients undergoing both elective and emergency abdominal surgery and SSI with CDC, and NNIS risk index; and (2) to assess SSI along with body mass index (BMI), glycaemic status, smoking and duration of pre-operative hospital stay of patients.
UNASSIGNED: In total, 300 patients who underwent elective and emergency abdominal surgery were enrolled in the study as per inclusion and exclusion criteria. SSI with CDC\'s NNIS risk index were analysed considering BMI, glycaemic status, smoking and duration of pre-operative hospital stay of patients.
UNASSIGNED: In total, 300 cases of abdominal surgeries (elective and emergency) were analysed, out of which 60 cases were diagnosed to have SSI as per the criteria.
UNASSIGNED: This study demonstrated that there is a significant increase in SSI with increasing NNIS score that is, the greater the NNIS score, the greater the risk of SSI. With an increase in age, BMI, glycaemic index and preoperative hospital stay, the risk of SSI increases. Smoking and associated comorbidities also increase the risk of SSI.

OBJECTIVE: NPWT has been tried in many surgical fields, including colorectal, thoracic, vascular, and non-healing wounds, for the prevention of SSI. However, its efficacy in the prevention of SSI-grade IV closed abdominal wounds is yet to be explored.
METHODS: All patients with grade IV abdominal wounds were included in the study. They were randomized into the conventional arm and the VAC arm after confirming the diagnosis intra-operatively. The sheath was closed, and the skin was laid open in the postoperative period. In the VAC arm, the NPWT dressing was applied on postoperative day (POD)-1 and removed on POD-5. In the conventional arm, only regular dressing was done postoperatively. The skin was closed with a delayed primary intention on POD-5 in both arms. The sutures were removed after 7 to 10 days of skin closure.
RESULTS: The rate of SSI (10% in the VAC arm vs. 37.5% in the conventional arm, p-value = 0.004) was significantly lower in the VAC arm, as were the rates of seroma formation (2.4% in the VAC arm vs. 20% in the conventional arm, p = 0.014) and wound dehiscence (7.3% vs. 30%, p = 0.011). The conventional arm had a significant delay in skin closure beyond POD5 due to an increased rate of SSI, which also led to a prolonged hospital stay (5 days in the VAC arm vs. 6.5 days in the conventional arm, p-value = 0.005).
CONCLUSIONS: The VAC dressing can be used routinely in grade IV closed abdominal wounds to reduce the risk of SSI and wound dehiscence.

BACKGROUND: Geriatric hip fracture are a common and disruptive public health problem worldwide. Surgical Site Infection (SSI) can be a devastating complication of this injury. By identifying these factors, the adverse outcomes of elderly hip fractures can be prevented. The objective of this study was to identify factors affecting the incidence of surgical site infection after geriatric hip fracture surgery.
METHODS: In this retrospective study, 440 patients (60 years or older) underwent hip surgery at Imam Khomeini Hospital Complex were selected based on census between April 2017 and March 2020. Demographics information, and additional comorbidities and operation-related variables were extracted and analyzed. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-19 software was used in this study and P values less than 0.05 were considered significant.
RESULTS: The results of univariate analyzes showed that the type of surgery (p=0.005), readmission (p=0.0001) and level of self-care (p=0.001) were significantly associated with Surgical Site Infection (SSI). The results of regression analysis showed that history of readmission and self-care at all levels on SSI.
CONCLUSIONS: The findings showed that the history of readmission and self-care at all levels is effective on SSI in the elderly with hip fractures. Therefore, it can be concluded that by identifying the factors affecting the SSI with hip fractures, fewer acute complications, reduced death and shorter length of hospital stay.

With every surgical procedure there is a risk of postoperative infection (surgical site infection = SSI). This risk of infection can be influenced by various factors, including perioperative antibiotic prophylaxis. In terms of antibiotic stewardship, antibiotics should only be used if there is a proven benefit for the patient. However, this advantage has not yet been conclusively proven, especially for clean and clean-contaminated surgeries. The aim of our study was to document various relevant influencing factors on the infection rate after clean and clean-contaminated surgeries in dogs and cats. In particular, it was documented to what extent a reduced use of antibiotics affects the infection rate in the context of all influencing factors. Over a period of eleven months, 807 clean and clean-contaminated surgeries in dogs and cats were prospectively analyzed with possible influencing factors (gender, ASA classification, underlying endocrinological diseases, duration of anesthesia, duration of surgery, type of surgery, perioperative antibiotic prophylaxis (POA), duration of hospitalization) affecting the infection rate. After surgery all cases were followed up either 30 or 90 days, if implants were used. The effect of the various factors was evaluated using multivariable logistic regression analysis. SSI was detected in 25/664 clean and 10/143 clean-contaminated surgeries. Longer hospitalization, without antimicrobial prophylaxis, and male animals had a significantly higher risk of SSI. In clean surgeries, SSI occurred in 2,3 % of all cases with POA and 5,3 % without POA. The SSI in clean-contaminated was 3,6 % with POA and 9 % without. This difference resulted mainly from the results of osteosynthesis, gastrointestinal and skin surgeries. However, other types of surgeries, such as castrations, neurological interventions, abdominal and thoracic surgeries, and surgeries in the head and neck region, showed comparable infection rates with and without POA.
Bei jedem chirurgischen Eingriff besteht das Risiko für eine postoperative Infektion (surgical site infection= SSI). Dieses Infektionsrisiko kann durch verschiedene Faktoren beeinflusst werden, zu denen auch die perioperative Antibiotikaprophylaxe zählt. Im Sinne der Antibiotic Stewardship sollte jeder Antibiotikaeinsatz nur bei nachgewiesenem Vorteil für den Patienten erfolgen. Insbesondere für saubere und sauber-kontaminierte Eingriffe ist dieser Vorteil bislang jedoch nicht schlüssig nachgewiesen. Ziel unserer Studie war es, verschiedene relevanten Einflussfaktoren auf die Infektionsrate nach sauberen und sauber-kontaminierten Operationen von Hunden und Katzen zu erfassen. Insbesondere wurde erfasst, inwieweit sich ein reduzierter Antibiotikaeinsatz im Kontext aller Einflussfaktoren auf die Infektionsrate auswirkt. Über einen Zeitraum von elf Monaten wurden 807 saubere und sauber-kontaminierte Operationen an Hunden und Katzen, sowie bekannte Einflussfaktoren (Geschlecht, ASA-Klassifikation, Endokrinologische Grunderkrankungen, Anästhesie-Dauer, Operations-Dauer, Operations-Typ, Perioperative Antibiotikaprophylaxe (POA), Dauer der Hospitalisation) prospektiv erfasst. Alle Patienten wurden 30 bzw. 90 Tage (beim Einsatz von Implantaten) nach den Operationen nachkontrolliert. Der Effekt der verschiedenen Faktoren wurde mittels multivariabler logistischer Regressionsanalyse ausgewertet. Eine SSI wurde bei 25/664 sauberen und 10/143 sauber-kontaminierten Operationen detektiert. Eine längere Hospitalisation, der Verzicht auf eine antimikrobielle Prophylaxe und männliches Geschlecht erhöhen das Risiko für eine SSI signifikant. Bei sauberen Operationen trat bei 2,3 % mit POA und bei 5,3 % aller Fälle ohne POA eine SSI auf. Bei den sauber-kontaminierten waren es 3,6 % mit POA und 9 % ohne. Dieser Unterschied ergab sich vor allem aus den Ergebnissen bei Osteosynthesen, gastrointestinalen Eingriffen und Hautchirurgie. Andere Eingriffstypen, wie Kastrationen, neurologische Eingriffe, Abdominale und Thoraxchirurgie, sowie Chirurgie an Kopf und Hals zeigten hingegen vergleichbare Infektionsraten mit und ohne POA.
Toute intervention chirurgicale comporte un risque d’infection postopératoire (infection du site opératoire = ISO). Ce risque d’infection peut être influencé par différents facteurs, dont l’antibioprophylaxie périopératoire. En termes de gestion responsable des antibiotiques, les antibiotiques ne devraient être utilisés que s’il existe un avantage prouvé pour le patient. Cependant, cet avantage n’a pas encore été prouvé de manière concluante, en particulier pour les chirurgies propres et propres-contaminées. L’objectif de notre étude était de documenter divers facteurs d’influence pertinents sur le taux d’infection après des chirurgies propres et propres-contaminées chez les chiens et les chats. Nous avons en particulier cherché à savoir dans quelle mesure une utilisation réduite des antibiotiques affecte le taux d’infection en tenant compte de tous les facteurs d’influence. Sur une période de onze mois, 807 chirurgies propres et contaminées chez des chiens et des chats ont été analysées prospectivement avec les facteurs d’influence possibles (sexe, classification ASA, maladies endocrinologiques sous-jacentes, durée de l’anesthésie, durée de la chirurgie, type de chirurgie, prophylaxie antibiotique périopératoire (POA), durée de l’hospitalisation) affectant le taux d’infection. Après la chirurgie, tous les cas ont été suivis durant soit 30 soit90 jours si des implants avaient été utilisés. L’effet des différents facteurs a été évalué par une analyse de régression logistique multivariable. Des ISO ont été détectées dans 25/664 chirurgies propres et 10/143 chirurgies contaminées propres. Une hospitalisation plus longue sans prophylaxie antimicrobienne ainsi que les animaux mâles présentaient un risque significativement plus élevé d’ISO. Dans les chirurgies propres, les ISO sont survenues dans 2,3 % des cas avec POA et 5,3 % sans POA. Dans les opérations propres-contaminées, les ISO étaient de 3,6 % avec POA et de 9 % sans POA. Cette différence était principalement due aux résultats des ostéosynthèses, des chirurgies gastro-intestinales et cutanées. En revanbche, d’autres types de chirurgies, comme les castrations, les interventions neurologiques, les chirurgies abdominales et thoraciques et les chirurgies de la tête et du cou ont montré des taux d’infection comparables avec et sans POA.
Ogni intervento chirurgico comporta un rischio di infezione postoperatoria (infezione del sito chirurgico = SSI). Questo rischio di infezione può essere influenzato da vari fattori, tra cui la profilassi antibiotica perioperatoria. In termini di stewardship antibiotica, gli antibiotici dovrebbero essere utilizzati solo se esiste un beneficio comprovato per il paziente. Tuttavia, questo vantaggio non è ancora stato definitivamente dimostrato, soprattutto per gli interventi chirurgici puliti e contaminati. Lo scopo del nostro studio era quello di documentare i vari fattori che influenzano il tasso di infezione dopo gli interventi chirurgici puliti e contaminati nei cani e nei gatti. In particolare, è stato documentato in che misura un uso ridotto di antibiotici influisce sul tasso di infezione nel contesto di tutti i fattori di influenza. In un periodo di undici mesi, sono stati analizzati in modo prospettico 807 interventi chirurgici puliti e contaminati in cani e gatti, nonché i fattori di influenza conosciuti (sesso, classificazione ASA, malattie endocrinologiche sottostanti, durata dell’anestesia, durata dell’intervento, tipo di intervento, profilassi antibiotica perioperatoria (POA), durata dell’ospedalizzazione). Dopo l’intervento, tutti i casi sono stati seguiti per 30 o 90 giorni (se erano stati utilizzati impianti). L’effetto dei vari fattori è stato valutato mediante analisi di regressione logistica multivariabile. Le SSI sono state rilevate in 25/664 interventi puliti e in 10/143 interventi contaminati. Un ricovero più lungo senza profilassi antimicrobica e gli animali maschi, presentavano un rischio significativamente più elevato di SSI. Negli interventi puliti, le SSI si sono verificate nel 2,3 % di tutti i casi con POA e nel 5,3 % senza POA. La SSI negli interventi puliti-contaminati è stata del 3,6 % con POA e del 9 % senza POA. Questa differenza è stata determinata principalmente dai risultati degli interventi di osteosintesi, gastrointestinali e cutanei. Tuttavia, altri tipi di interventi, come castrazioni, interventi neurologici, interventi addominali e toracici e interventi nella regione della testa e del collo, hanno mostrato tassi di infezione comparabili con e senza POA.

Reuse of personal protective equipment (PPE), masks more specifically, during the COVID-19 pandemic was common. The primary objective of this study was to compare pre-pandemic surgical site infection (SSI) rates prior to reuse of PPE, to pandemic SSI rates after reuse of PPE in trauma surgical patients.
A retrospective cohort analysis collected from the Michigan Trauma Quality Improvement Program database was performed. The pre-COVID cohort was from March 1, 2019 to December 31, 2019 and post-COVID cohort was March 1, 2020 to December 31,2020. Descriptive statistics were used to assess differences between variables in each cohort.
Nearly half (49.8%) of our cohort (n = 48,987) was in the post-COVID group. There was no significant difference in frequency of operative intervention between groups (p > .05). There was no significant increase (p > .05) between pre- and post-COVID cohorts for superficial, deep, or organ space SSI when reuse of masks was common.
Reuse of PPE did not lead to an increase in SSI in surgical patients. These findings are consistent with previous studies, but the first to be described in the trauma surgical patient population. Studies such as this may help inform further discussion regarding PPE usage as we continue to emerge from the current pandemic with the continuous threat of future pandemics.

This case study is part of a series centered on the Centers for Disease Control and Prevention/National Healthcare Safety Network (NHSN) healthcare-associated infection (HAI) surveillance definitions. This specific case study focuses on the application of common surveillance concepts included in the Patient Safety Component, Chapter 9 - Surgical Site Infection Event (SSI). The intent of the case study series is to foster standardized application of the NHSN HAI surveillance definitions and encourage accurate HAI event determination among Infection Preventionists (IPs).

BACKGROUND: Anxiety is rising across the United States during the COVID-19 pandemic, and social distancing mandates preclude in-person mental health care. Greater perceived control over anxiety has predicted decreased anxiety pathology, including adaptive responses to uncontrollable stressors. Evidence suggests that no-therapist, single-session interventions can strengthen perceived control over emotions like anxiety; similar programs, if designed for the COVID-19 context, could hold substantial public health value.
OBJECTIVE: Our registered report evaluated a no-therapist, single-session, online intervention targeting perceived control over anxiety in the COVID-19 context against a placebo intervention encouraging handwashing. We tested whether the intervention could (1) decrease generalized anxiety and increase perceived control over anxiety and (2) achieve this without decreasing social-distancing intentions.
METHODS: We tested these questions using a between-subjects design in a weighted-probability sample of US adults recruited via a closed online platform (ie, Prolific). All outcomes were indexed via online self-report questionnaires.
RESULTS: Of 522 randomized individuals, 500 (95.8%) completed the baseline survey and intervention. Intent-to-treat analyses using all randomized participants (N=522) found no support for therapeutic or iatrogenic effects; effects on generalized anxiety were d=-0.06 (95% CI -0.27 to 0.15; P=.48), effects on perceived control were d=0.04 (95% CI -0.08 to 0.16; P=.48), and effects on social-distancing intentions were d=-0.02 (95% CI -0.23 to 0.19; P=.83).
CONCLUSIONS: Strengths of this study included a large, nationally representative sample and adherence to open science practices. Implications for scalable interventions, including the challenge of targeting perceived control over anxiety, are discussed.
BACKGROUND: ClinicalTrials.gov NCT04459455; https://clinicaltrials.gov/show/NCT04459455.

In early 2019 in the UK, concern about the risk of COVID-19 transmission to surgeons who operate near to the airway led to wide scale adoption of different masks, including valved types used in industry. It was noted early on that although these masks protect clinicians, they may represent a risk to the patient due to unfiltered air being directed towards them during close contact1 and the National Health Service circulated guidance to that effect2. Subsequently, an increased incidence of surgical site infection (SSI) was noticed, postulated to be due to contamination of the surgical field by microbial particles from valved masks or hoods leading to a National Patient Safety Alert3. A study recommended that a surgical mask be placed over the exhaust valves of these mask types4. We reviewed the literature using the key words surgical masks, power hoods, FFP3 masks and surgical site infection. Most studies showed no reduction in the incidence of SSI with surgical masks5, but some showed an increase6. There were no studies comparing bacterial contamination of the surgical site with different types of masks. A pilot study was designed to evaluate if FFP3 respirators and powerhoods allowed bacterial contamination of the surgical field in comparison with standard surgical masks and no masks. The results appeared to confirm our methodology and suggested that reusable valved FFP3 masks are associated with bacterial dissemination. Subsequent examination of these masks identified a potential mechanism for this bacterial contamination. A larger scale study is needed.