Background Hip fracture patients often experience surgical site infections (SSIs) as a major infectious complication after undergoing total hip arthroplasty (THA), which can lead to extended hospital stays, increased mortality, and higher healthcare costs. This study aimed to determine the incidence of SSI and identify the risk factors associated with it after THA. Objective This study aimed to explore the correlation between blood transfusion along with other factors and the occurrence of SSIs in postoperative patients who underwent THA for transcervical femoral neck fractures. Methods We conducted a retrospective analysis by reviewing the medical records of patients aged 60-80 years who underwent surgery for hip fractures at the Unidad Médica de Alta Especialidad Hospital de Traumatología y Ortopedia No. 21 in Monterrey, Mexico, between January 2020 and January 2021. We analyzed potential risk factors such as age, sex, transfusion necessity, preoperative hemoglobin levels, history of diabetes mellitus, arterial hypertension, and end-stage chronic disease. Data are presented as numbers and percentages, and statistical analyses were performed using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021; IBM Corp., Armonk, New York, United States). Results The study included 87 patients, of whom 55 (63%) were women with an average age of 73 years. SSIs were identified in 12 (13.8%) patients. Among those with infections, nine (75%) had a history of blood transfusion (p=0.05). Diabetes, hypertension, and chronic kidney disease also increased the risk for infection. There was no association with gender, age, American Society of Anesthesiologists (ASA) risk, and preoperative hemoglobin. Conclusions We found a heightened risk of SSI in patients with a history of blood transfusions, emphasizing the need for careful consideration and monitoring during the perioperative period. Additionally, patients with comorbidities such as diabetes, hypertension, and chronic kidney disease were more susceptible to SSI, underscoring the importance of preoperative assessment and targeted preventive measures. Further research and collaboration are needed to refine strategies for mitigating SSI risk factors and optimizing healthcare resource utilization.

UNASSIGNED: Inconsistent evidence exists regarding the association between intraoperative hypothermia and incidence of surgical site infection (SSI). This study aimed to determine the association between intraoperative hypothermia and SSI.
UNASSIGNED: A systematic review was conducted using Embase, PubMed, and Web of Science to identify observational studies evaluating the risk of SSI in patients with intraoperative hypothermia. The primary outcome measure was the diagnosis of SSI within 30 days of surgery. The pooled risk ratio was estimated using a fixed- or random-effect meta-analysis. Sensitivity analyses were performed to examine the impact of the structural design of preoperative warming on the pooled risk of SSI.
UNASSIGNED: Five studies representing 6,002 patients were included in the present meta-analysis. Intraoperative hypothermia was not associated with SSI risk in patients (HR = 1.22, 95% CI: 0.95-2.24, P = 0.119). The pooled hazard ratio showed that intraoperative hypothermia did not result in a higher risk of SSI.
UNASSIGNED: Intraoperative hypothermia was not associated with the risk of SSI. Further studies using objective exposure measurements are required to confirm these results.

BACKGROUND: Surgical site infections (SSIs) are one of the leading causes of operation-related adverse effects. To create an effective hospital infection program, information about a local pattern is essential. The ever-changing pattern of infections and inappropriate use of antibiotics has predisposed to the development of drug-resistant strains and has made the management of SSIs arduous.
OBJECTIVE: The purpose of this study is to estimate prevalence and identify risk factors and commonest organisms associated with SSIs.
METHODS: In this analytical cross-sectional study, the relationship between various risk factors and the development of SSIs was evaluated in patients undergoing elective surgery and staying at least seven days postoperatively in the Department of Surgical Gastroenterology and Liver transplant for a study duration of two months. Diagnosis of SSIs was based on modified CDC criteria. Wound pus was followed by blood collection in suspected secondary septicemia. MacConkey and blood agar were used to culture pus; brain heart infusion broth was used for blood samples. Antimicrobial susceptibility testing was carried out using Mueller-Hinton agar by the Kirby-Bauer method.
RESULTS:  Twelve out of 50 had developed postsurgical wound infections where Gram-negative organisms prevailed over Gram-positive ones. The associated risk factors identified in this study are age, BMI, wound class, American Society of Anesthesiologists (ASA) score, preprocedural WBC count >10,000, and the duration of surgery. Escherichia coli is the causative microbe for the majority of infections (35.7%). Gram-negative bacteria isolated in this study were extended-spectrum β-lactamase (ESBL) producers. Multidrug-resistant organisms were predominant.  Conclusion: The present study identified an SSI rate of 24% in gastrointestinal surgeries. The sensitivity and resistance pattern of the organisms isolated will help in measures to be taken to devise a proper and effective current hospital antibiotic prophylaxis policy.

BACKGROUND: Soft tissue facial injuries (STFI) constitute a huge portion of craniofacial trauma, but the risk of surgical site infection (SSI) and patient-reported outcomes (PROs) following surgical management of STFI are unknown.
METHODS: A PRISMA-compliant search was conducted from January 1990 until March 2023, and meta-analysis was performed using R. Pooled effects of the outcomes were estimated using the DerSimonian and Laird random-effects model or generalised linear mixed model, when feasible.
RESULTS: Among the 8897 screened studies, 38 were included. Twelve studies reported PROMs (n = 985), whereas 28 studies reported SSI rates (n = 10,996) following operative treatment for STFI. The pooled SSI rate (n = 28) was 3.30 % (95 % CI 1.89 %-5.71 %). Surgical and non-surgical closure did not differ significantly in SSI rate. PROs focused on scar outcomes, cosmetic outcomes, quality of life and psychological impact. Subgroup analysis showed lower SSI risk in operative repair for general facial trauma compared to primary repair, and in general facial trauma compared to other aetiologies. The pooled patient scar assessment scale, score at 6-12 months post-intervention (5 studies, n = 217) was 16.16 (95 % CI 15.34-16.97). Limited evidence is available on the effect and superiority of surgical treatment in cosmetic outcomes, quality of life and psychological impact.
CONCLUSIONS: Our findings emphasise the limited and unreliable evidence available on PROs following operative treatment for STFI. Future studies employing robust methodologies are needed to investigate optimal approaches for managing STFI.

BACKGROUND: Recent liquid adhesive skin closure systems with a mesh patch and a 2-octyl cyanoacrylate liquid formula have shown promising results in total joint arthroplasty. Chemical accelerators are typically included to promote the rapid polymerization of 2-octyl cyanoacrylate. The goal of the study is to distinguish designs and wound complication differences between 2 similar systems.
METHODS: An 18-week retrospective study was conducted from July to December 2023, including 207 total hip arthroplasty and 212 total knee arthroplasty cases from 4 attending surgeons at 1 institution that used 1 of 2 dressing designs. Both dressings had a 2-octyl cyanoacrylate liquid adhesive formula that applied topically to a polyester-based mesh overlaying the wound. Mesh A (used in 274 cases) included an accelerator, a quaternary ammonium salt, on the mesh patch, whereas Mesh B (used in 145 cases) included a similar accelerator within the adhesive applicator.
RESULTS: Wound complications (3.2 versus 7.6%; X2 = 3.86; df = 1; P = .049), early periprosthetic joint infections (0 versus 2.8%; X2 = 7.63; df = 1; P = .006), and 90-day reoperations for wound complications (0.4 versus 3.4%; X2 = 6.39; df = 1; P = .011) were significantly lower in patients who received Mesh A versus B, respectively. There was no difference in superficial surgical site infections (0.7 versus 0%; X2 = 1.06; df = 1; P = .302) or allergy rates (3.3 versus 4.1%; X2 = 0.12; df = 1; P = .655) between Mesh A and B.
CONCLUSIONS: We observed significantly different performance in wound complications, early postoperative periprosthetic joint infections, and 90-day reoperation between the 2 designs. Having the accelerator in the applicator rather than on the mesh patch may lead to premature polymerization before bonding appropriately with the mesh to create the desired wound closure and seal.
METHODS: Level III.

OBJECTIVE: This study aims to compare the efficacy of cephalosporin and non-cephalosporin antibiotics in preventing surgical site infections (SSIs) in patients undergoing colorectal surgery, providing a scientific basis for the selection of perioperative antibiotics through systematic review and meta-analysis.
METHODS: Adhering to the PRISMA guidelines, this research employed an extensive literature search strategy across multiple databases to identify relevant studies, including randomized controlled trials (RCTs) and observational studies. Inclusion criteria were studies on adults undergoing colorectal surgery who received preoperative prophylaxis with either cephalosporin or non-cephalosporin antibiotics. Exclusion criteria included preoperative diagnosis of infectious diseases and preoperative use of antimicrobial agents. Meta-analysis was conducted using RevMan 5.3 software to assess the effectiveness of both antibiotic classes in preventing SSIs, including subgroup analyses.
RESULTS: Eight studies met the inclusion criteria, comprising 872 patients. Meta-analysis revealed that the incidence of SSI in the cephalosporin group was lower than in the non-cephalosporin group (14.8% vs 25.1%), with statistical significance (OR = 1.94, 95% CI: 1.38-2.74, PP = =0.0001). However, no significant difference in SSI risk was observed between the groups within 30 days (OR = =1.92, 95% CI: 1.08-3.42). Subgroup analysis indicated that higher-quality studies were associated with larger effect sizes.
CONCLUSIONS: This study suggests that cephalosporin antibiotics may be superior to non-cephalosporins in preventing SSIs following colorectal surgery, especially in the short term. However, their long-term efficacy in SSI prevention may be similar. The selection of perioperative antibiotics should consider factors such as the antimicrobial spectrum, pharmacokinetic properties, and bacterial resistance.

Subcutaneous (SC) saline irrigation was reported as a feasible and cost-effective procedure to prevent cesarean section (CS) surgical site complications. We aim to investigate the efficacy of SC saline irrigation to prevent CS surgical site complications. A systematic review and meta-analysis were conducted synthesizing evidence from randomized controlled trial (RCT) studies obtained from PubMed, Embase Cochrane, Scopus, and Web of Science from inception to March 2024. Pooled outcomes included wound complications (superficial surgical site infections (SSI), hematoma, seroma, and wound separation) and operative time. We used RevMan v.5.4. (The Cochrane Collaboration, Oxford, UK) to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean differences (MD) with a 95% confidence interval (CI). Five RCTs with 4,025 patients were included. Four studies had a low overall risk of bias and only one trial with some concerns about selection bias. There was no difference between SC saline irrigation and no irrigation regarding the incidence of superficial SSI (five RCTs, RR: 0.72 with 95% CI [0.47, 1.10], P = 0.13), seroma (four RCTs, RR: 0.73 with 95% CI [0.32, 1.65], P = 0.45), wound separation (four RCTs, RR: 0.66 with 95% CI [0.36, 1.24], P = 0.2), and operative time (four RCTs, MD: -1.26 with 95% CI [-5.14, 2.62], P = 0.52). However, SC saline irrigation significantly decreased the incidence of hematoma (three RCTs, RR: 0.54 with 95% CI [0.45, 0.65], P = 0.00001). SC saline irrigation of the surgical site after CS was not effective in preventing the incidence of superficial SSI, seroma, or wound separation, while only preventing the incidence of hematoma.

Surgical site infections (SSIs) contribute to increased patient morbidity, prolonged hospital stays, and substantial healthcare costs. Prophylactic antibiotics play a pivotal role in mitigating the risk of SSIs, with their administration being a standard practice before both emergency and elective surgeries. This paper provides a comprehensive review and comparative analysis of the benefits of prophylactic antibiotic administration in emergency surgery versus elective surgery. Through a systematic literature review and analysis of relevant studies identified through PubMed searches, this paper highlights the specific benefits of prophylactic antibiotics between emergency and elective surgeries. The findings underscore the importance of tailored antibiotic regimens and administration protocols to optimize patient care and promote successful surgical outcomes in diverse clinical settings. Further research is warranted to refine guidelines and enhance understanding of the relationship between prophylactic antibiotics and surgical outcomes across different surgical contexts.

Following heart operation, a severe life-threatening complication has been identified by investigators who have recently discovered that local application of platelet-rich plasma (PRP) can lower the rate of wound infection in heart surgery. Nevertheless, due to the low quality of these trials, we have tried to perform high-quality meta-analyses to prove the efficacy of PRP in heart surgery for post-operative wound infections. In this study, five randomised controlled trials (RCTs) were chosen from three databases, and there were 1005 studies to analyse the data. Among 181 cases, PRP was applied to the surgical site, and 205 in the control group. Both the CI and the OR or the average difference (MD) were computed with either a fixed or random-effect model. A meta-analysis of the data was carried out with RevMan 5.3. The results showed that there were no statistically significant differences in the incidence of post-operative surgical site infection (SSI) in control group compared to those treated with PRP gel (OR, 0.97; 95% CI, 0.38, 2.47; p = 0.95); In the heart operation, the local application of PRP gel decreased the rate of drainage after operation (MD, -217.82; 95% CI, -335.38, -100.26; p = 0.0003); The operation time of the PRP gel was not significantly different from that of the control group (MD, 12.65; 95% CI, -2.95, 28.24; p = 0.11). Contrary to earlier research, the application of autoplatelet gel in heart surgery did not seem to decrease operative site infections after the operation, but it did decrease the amount of postoperative drainage. Nevertheless, because of the limited number of RCTs in this meta-analysis, caution should be exercised in their treatment. More high-quality randomised, large-sample trials are required to further confirm the findings.

BACKGROUND: Surgical Site Infection (SSI) remains the most common cause of Healthcare-Associated Infections (HCAIs). In particular, contaminated and dirty abdominal wounds are attended by a high rate of SSI which in turn is associated with a huge burden on patients, caregivers and the entire health care system.
OBJECTIVE: To compare SSI rates following the use of iodine-impregnated adhesive incise drapes (Ioban) with routine conventional drapes in contaminated and dirty abdominal surgical wounds in a Nigerian tertiary hospital.
METHODS: Consecutive, consenting adult patients who underwent laparotomy for cases classified as contaminated and dirty were prospectively enrolled in the study. Patients in the investigation arm had in addition to conventional drapes, iodine-impregnated adhesive incise drapes (Ioban) applied on the skin of the abdomen through which incisions were made, while patients in the control arm only had routine conventional drapes applied. All patients were followed up to 30 days after the operation. Surgical site infection rates were compared between the two groups.
RESULTS: Sixty-two consecutive patients were enrolled into this study, of which 55 completed the 30-day follow-up. The mean ages of patients in the two groups were 37.96 ± 19.59 years and 36.74 ± 16.93 years (p=0.81). Males were 36 (65.5%) and females were 19 (34.5%). Overall, 30 (54.5%) patients had surgical site infection (SSI) in this study. Thirteen (46.4%) patients had SSI in iodine iodine-impregnated adhesive incise drape group while 17 (63%) patients had SSI in the conventional drape group, a difference that was not statistically significant (p=0.22). The most commonly isolated organism from infected wounds was Klebsiella species.
CONCLUSIONS: The use of iodine-impregnated surgical incise drapes was associated with a lower, though non-statistically significant SSI rates compared to the use of conventional drapes. This marginal benefit will require a larger population study to examine its potential cost-effectiveness in our setting.
BACKGROUND: L\'infection du site chirurgical (ISC) reste la cause la plus courante des infections associées aux soins de santé (IASC). En particulier, les plaies abdominales contaminées et sales sont associées à un taux élevé d\'ISC, ce qui entraîne une charge importante pour les patients, les soignants et l\'ensemble du système de santé.
OBJECTIVE: Comparer les taux d\'ISC après l\'utilisation de draps incisifs adhésifs imprégnés d\'iode (Ioban) avec des draps conventionnels habituels dans les plaies chirurgicales abdominales contaminées et sales dans un hôpital tertiaire nigérian.
UNASSIGNED: Des patients adultes consécutifs et consentants qui ont subi une laparotomie pour des cas classés comme contaminés et sales ont été inscrits de manière prospective dans l\'étude. Les patients dans le groupe d\'investigation avaient, en plus des draps conventionnels, des draps incisifs adhésifs imprégnés d\'iode (Ioban) appliqués sur la peau de l\'abdomen à travers laquelle les incisions ont été faites, tandis que les patients dans le groupe témoin n\'avaient que des draps conventionnels habituels appliqués. Tous les patients ont été suivis pendant 30 jours après l\'opération. Les taux d\'infection du site chirurgical ont été comparés entre les deux groupes.
UNASSIGNED: Soixante-deux patients consécutifs ont été inscrits dans cette étude, dont 55 ont terminé le suivi de 30 jours. L\'âge moyen des patients dans les deux groupes était de 37,96 ± 19,59 ans et 36,74 ± 16,93 ans (p=0,81). Les hommes étaient au nombre de 36 (65,5%) et les femmes de 19 (34,5%). Globalement, 30 (54,5%) patients ont présenté une infection du site chirurgical (ISC) dans cette étude. Treize (46,4%) patients ont présenté une ISC dans le groupe avec draps incisifs adhésifs imprégnés d\'iode, tandis que 17 (63%) patients ont présenté une ISC dans le groupe avec draps conventionnels, une différence qui n\'était pas statistiquement significative (p=0,22). L\'organisme le plus fréquemment isolé dans les plaies infectées était l\'espèce Klebsiella.
CONCLUSIONS: L\'utilisation de draps incisifs chirurgicaux imprégnés d\'iode était associée à des taux d\'ISC plus bas, bien que non statistiquement significatifs, par rapport à l\'utilisation de draps conventionnels. Cet avantage marginal nécessitera une étude avec une population plus importante pour examiner son potentiel de rentabilité dans notre contexte.
UNASSIGNED: Plaies contaminées et sales, Drap incisif adhésif, Infection du site chirurgical (ISC).