Surgical Site Infection


Book Description

Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.




Global Gidelines for the Pevention of Surgical Site Infection


Book Description

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.




Infections in Surgery


Book Description

Although most clinicians are aware of the problem of antimicrobial resistance, most also underestimate its significance in their own hospital. The incorrect and inappropriate use of antibiotics and other antimicrobials, as well as poor prevention and poor control of infections, are contributing to the development of such resistance. Appropriate use of antibiotics and compliance with infection prevention and control measures should be integral aspects of good clinical practice and standards of care. However, these activities are often inadequate among clinicians, and there is a considerable gap between the best evidence and actual clinical practice. In hospitals, cultural determinants influence clinical practice, and improving behaviour in terms of infection prevention and antibiotics-prescribing practice remains a challenge. Despite evidence supporting the effectiveness of best practices, many clinicians fail to implement them, and evidence-based processes and practices that are known to optimize both the prevention and the treatment of infections tend to be underused. Addressing precisely this problem, this volume offers an essential toolkit for all surgeons and intensivists interested in improving their clinical practices.




Practical Healthcare Epidemiology


Book Description

A clear, hands-on outline of best practices for infection prevention that directly improve patient outcomes across the healthcare continuum.




Complications in Equine Surgery


Book Description

Complications in Equine Surgery is the first reference to focus exclusively on understanding, preventing, recognizing, managing, and prognosing, technical and post-procedural complications in equine surgery. Edited by two noted experts on the topic, the book presents evidence-based information using a clear approach, organized by body system. Featuring color images, the book contains detailed coverage of the gastrointestinal, respiratory, musculoskeletal, urogenital, and neurological systems. Each chapter contains a short introduction of the procedure with explanations of when and how the procedure is to be performed. All chapters review how to recognize and prevent technical complications and explain how to manage post-operative complications. This important text: Offers the first resource specifically focused on complications encountered in equine surgery Takes a helpful format organized by body system Provides consistently formatted chapters for ease of use Covers clinically relevant information for dealing with technical and post-operative complications Presents more than 350 color images to illustrate the concepts described Written for general practitioners and specialists, Complications in Equine Surgery is an essential resource to decreasing morbidity and mortality and increasing surgical success in horses.




Complications in Small Animal Surgery


Book Description

Complications in Small Animal Surgery provides a complete reference to diagnosing, managing, and treating surgical complications, with information following a standardized format for ease of use. • Presents comprehensive information on diagnosing, managing, and preventing surgical complications using an accessible format • Offers a well-defined, thoroughly illustrated format to maximize practical value, with algorithms, tables, practical tips, and many images throughout • Covers common and uncommon complications in all body systems • Serves as a reference to recent literature relevant to each complication • Includes access to a companion website with videos, figures from the book available for download into PowerPoint, and linked references at www.wiley.com/go/griffon/complications







WHO Guidelines for Safe Surgery 2009


Book Description

Confronted with worldwide evidence of substantial public health harm due to inadequate patient safety, the World Health Assembly (WHA) in 2002 adopted a resolution (WHA55.18) urging countries to strengthen the safety of health care and monitoring systems. The resolution also requested that WHO take a lead in setting global norms and standards and supporting country efforts in preparing patient safety policies and practices. In May 2004, the WHA approved the creation of an international alliance to improve patient safety globally; WHO Patient Safety was launched the following October. For the first time, heads of agencies, policy-makers and patient groups from around the world came together to advance attainment of the goal of "First, do no harm" and to reduce the adverse consequences of unsafe health care. The purpose of WHO Patient Safety is to facilitate patient safety policy and practice. It is concentrating its actions on focused safety campaigns called Global Patient Safety Challenges, coordinating Patients for Patient Safety, developing a standard taxonomy, designing tools for research policy and assessment, identifying solutions for patient safety, and developing reporting and learning initiatives aimed at producing 'best practice' guidelines. Together these efforts could save millions of lives by improving basic health care and halting the diversion of resources from other productive uses. The Global Patient Safety Challenge, brings together the expertise of specialists to improve the safety of care. The area chosen for the first Challenge in 2005-2006, was infection associated with health care. This campaign established simple, clear standards for hand hygiene, an educational campaign and WHO's first Guidelines on Hand Hygiene in Health Care. The problem area selected for the second Global Patient Safety Challenge, in 2007-2008, was the safety of surgical care. Preparation of these Guidelines for Safe Surgery followed the steps recommended by WHO. The groundwork for the project began in autumn 2006 and included an international consultation meeting held in January 2007 attended by experts from around the world. Following this meeting, expert working groups were created to systematically review the available scientific evidence, to write the guidelines document and to facilitate discussion among the working group members in order to formulate the recommendations. A steering group consisting of the Programme Lead, project team members and the chairs of the four working groups, signed off on the content and recommendations in the guidelines document. Nearly 100 international experts contributed to the document (see end). The guidelines were pilot tested in each of the six WHO regions--an essential part of the Challenge--to obtain local information on the resources required to comply with the recommendations and information on the feasibility, validity, reliability and cost-effectiveness of the interventions.




Advances in Patient Safety


Book Description

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.




Pediatric Surgery


Book Description

The second, fully updated edition of this book applies and contextualizes up-to-date information on pediatric surgery for low and middle-income countries (LMICs). The book is organized in general anatomic and thematic sections within pediatric surgery, such as urology, oncology, orthopedics and gastroenterology and includes chapters addressing the unique challenges and approaches for pediatric surgery in low-resource settings. Each chapter has dual authorship LMIC author providing context-specific insights and authors from high-income countries (HICs) contributing experience from well-resourced settings. Written in a reader-friendly format, this book has a uniform structure in each chapter, with introduction, demographics, etiology, pathophysiology, clinical presentations, investigations, management, outcome, prevention, ethics, evidence-based surgery and references. This comprehensive volume fills the gap between up-to-date pediatric surgical scholarship and knowledge developed and applied in HICs, and the practical needs of practitioners in low-resource settings. This is an indispensable guide for postgraduate surgical trainees in Africa and other LMICs as well as general surgeons practicing in Africa and other LMICs, who need to care surgically for children.