Journal Review in Emergency General Surgery: Surgical Site Complications
Behind The Knife: The Surgery Podcast
English - November 14, 2022 10:00 - 25 minutes - ★★★★★ - 1.3K ratingsMedicine Health & Fitness Education Courses education surgery Homepage Download Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
The dreaded Surgical Site Complications! Join Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross from our Emergency General Surgery Team as they discuss surgical site complications and prevention techniques.
Paper 1: Arnold et. al. (2019) Not a Routine Case, Why Expect the Routine Outcome? Quantifying the Infectious Burden of Emergency General Surgery Using the NSQIP. American Surgeon
- NSQIP database 2005-2016 (>800,000 patients) including open/laparoscopic cholecystectomies, ventral hernia repairs, and partial colectomies
- Comparing outcomes in emergent vs elective cases
- Primary outcome: aggregate of SSIs which includes wound disruption, superficial SSI, deep SSI, and organ space SSI
- Results:
-- ↑SSI in the emergency group (5.3% vs 3.6%)
-- When controlling for multiple variables, emergency surgery associated with more SSIs (OR 1.15).
Paper 2: Lakhani et. al. (2022) Prophylactic negative pressure wound dressings reduces wound complications following emergency laparotomies: A systematic review and meta-analysis. Surgery
- NPWD remove excess fluid from subcutaneous space, ↓ collections/contaminants, promote angiogenesis, fibroblast infiltration
- Literature review 2005-2022 (NPWD, laparotomy, SSI)
- 1199 patients included (566 NPWD, 633 standard dressings)
- Results:
-- NPWD ↓ wound infection (OR 0.43) and wound breakdown (OR 0.36)
-- No change in LOS, readmission
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