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Article
ISOLATION AND IDENTIFICATION OF AEROBIC PATHOGENIC BACTERIA FROM BURN WOUND INFECTIONS

Author: Sinai W. Mohammed
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2007 Volume: 10 Issue: 2 Pages: 94-97
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

This study was carried out at Al-Yarmouk teaching hospital in Baghdad, during the period 1/10/2003 to 30/3/2004. A total of 306 specimens were obtained from patients bedding in surgical wards suffering from burn wound infections, the most common single isolated pathogen was Pseudomonas spp (36.7%) as well as Klebsiella spp. (36.7%), and as mixed isolates (64.7%). Pseudomonas spp. & Klebsiella spp. were highly resistant to Cefixime (100%) and sensitive to Norfloxain (67.7%, 56.3%) and Ciprofloxacin (41.7%, 53.8%) in this study.

أجريت هذه الدراسة في مستشفى اليرموك التعليمي في بغداد خلال الفترة 1/10/2003- 30/3/2004. وقد تم فيها الحصول على 306 عينة من الاشخاص الراقدين في ردهات الجراحة. أظهرت الدراسة أن العزلات المرضية المفردة الأكثر شيوعا التي تم الحصول عليها من الجروح و الحروق هي Pseudomonas spp. (36.7%) و كذلك Klebsiella spp. (36.7%) في حين كانت العزلات المرضية المختلطة الأكثر شيوعا هي Klebsiella spp. & Pseudomonas spp (64.7%).وجد أن Pseudomonas spp. و Klebsiella spp. الأكثر مقاومة للمضاد Cefixime (100%) والاكثر حساسية تجاه المضادين Norfloxain (67.7 %, 56.3%) و Ciprofloxacin(41.7% , 53.8%) المستخدم في الدراسة.


Article
REDUCTION OF POSTOPERATIVE WOUND INFECTION AFTER APPENDECTOMY BY PERITONEAL CLOSURE AND WOUND IRRIGATION WITH NORMAL SALINE

Authors: Ahmad Jaleel Abdul-Razzak --- Zeki A Al-Faddagh
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2012 Volume: 18 Issue: 2 Pages: 26-31
Publisher: Basrah University جامعة البصرة

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Abstract

The most common complication following appendectomy is postoperative wound infection andsince it has major effects on patient’s health & recovery and on the health system as itconsumes time and essential resources so from this fact came the importance of the researchesthat are done to find any means to reduce postoperative wound infection and many of themhave been shown to be beneficial in reducing wound infection like the use of prophylacticantibiotics, postoperative antibiotics and laparoscopic appendectomy but in this study we lookfor the effectiveness of 2 simple measures which are peritoneal closure and wound irrigationwith normal saline in reducing the incidence of postoperative wound infection. Aim of the study:to know if peritoneal closure and wound irrigation with normal saline would significantly reducethe incidence of postoperative wound infection after appendectomy.The study had been carried out from January 2010 to January 2012 in Al-Mawanee GeneralHospital and it had been done by the same surgeon and as emergency cases.The study included 297 patients divided into: The control group: include those in whom noperitoneal closure and no wound irrigation were done, patients in this group were 153.Case group: include those in whom peritoneal closure and wound irrigation with normal salinehad been done and it included 144 patients. Comparison between the two groups had beendone according to sex, age, and the state of inflammation of the appendix also factors affectingwound healing and increasing the incidence of wound infection had been taken in consideration.Data were analyzed using P value to determine the significance of the results.Although the incidence of acute appendicitis was slightly higher in males but the incidence ofwound infection was found to be higher in females but it was not statistically different so sex isnot a risk factor for the development of wound infection in both groups. Regarding age, in bothcontrol and case groups, the highest rate of incidence of acute appendicitis was in the agegroup 21-40 years but the highest rate of wound infection was in the age group 60 years andabove, it was 50% in control group and 16% in the case group and so age is a risk factor for thedevelopment of wound infection and there is a clear reduction in the incidence of woundinfection after the use of peritoneal closure and wound irrigation with normal saline and therewere also reduction in the incidence of wound infection in all other age groups after using thesetwo measures. Regarding the state of severity of inflammation of the appendix the highest rateof wound infection was found in the severe appendicitis subgroup in both the control (infectionrate was 31.4%) and case (9.6%) groups but again there was a clear reduction in the incidenceof wound infection.In conclusion: peritoneal closure and wound irrigation with normal saline help in reducing theincidence of postoperative wound infection after appendectomy.


Article
The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection

Authors: Ahmed Hamid Jasim --- Nabeel AL-Dawoody --- Tharwat I. Sulaiman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 181-185
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BSTRACT: BACKGROUND: Surgical site infection is one of the commonest complications after surgical operations and the useof antibiotics in preventing or reducing infection is associated with many problems.OBJECTIVE:To evaluate the use of peri- operative prophylactic antibiotics in preventing or reducing surgicalsite infection in different types of operations PATIENTS AND METHODS:This prospective study was conducted on(560) patients from June 2002 to January 2007 in generalsurgical department in Baghdad teaching hospital.The patients were divided into( 3) groups according to the type of operation; clean operationswhich included 200 patients, clean-contaminated operations which included 160 patients andcontaminated operations which included 200 patients) and they were further subdivided into 2groups, group A of patients were treated with peri operative prophylactic Cefotaxime antibioticwhile the group B patients were treated with therapeutic dose of the same antibiotic for prolongedduration (5 days).Those patients were followed up for 4 weeks after operation and when signs of wound infectionappeared, swab for culture and sensitivity was taken to determine the type of bacteria, and effectiveantibiotics against them.RESULT:Result showed that (3) patients (3%) in clean surgery developed wound infection when usingperioperative regimen as compared to( 2) patients (2%) when using therapeutic regimen. In cleancontaminated wounds infection appeared in (5) patients (5%) in patients using prophylactic orpostoperative regimen while in contaminated wounds, (11) patients (11%) developed woundinfection when using perioperative regimen as compared to( 6) patients (6%) who developedwound infection in patients using postoperative antibiotics.Statistically, there is little difference in effectiveness of the two regimens (A and B) in both group(1) and( 2) operations but in the group( 3) operations, although prophylactic antibiotic regimenreduced the infection rate to 11% but it was not as effective as the therapeutic regimen in reducingwound infection (6%) .CONCLUSION: Postoperative antibiotics should be resisted in clean and clean contaminated operations insteadperioperative antibiotics can be used, and prolonged postoperative antibiotics should be usedonly in contaminated operations


Article
Are prophylactic antibiotics justified in pediatric patients with inguinal hernia repair?

Author: Ali E. Joda
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 2 Pages: 24-29
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: There are different studies highlighting the role of using prophylactic antibiotics in clean surgeries, but still there is conflicting evidence regarding whether prophylactic antibiotics are beneficial or not in preventing post-operative surgical site infection. Aim: This study aims to evaluate the use of peri-operative prophylactic antibiotics in preventing or reducing surgical site infection in the elective open repair of pediatric inguinal hernia. Patients and method: Over a ten-month period a total 150 pediatric patients underwent elective surgical repair for inguinal hernia were enrolled in this randomized prospective study, they were categorized into two equal Groups alternating at the time of operation. The patients in group A (Control) were followed a standard regimen of giving pre-operative parenteral antibiotic (in the ward or at the beginning of anesthesia) & then post-operative oral antibiotics for five days duration, while the patients in group B (Case) underwent the same surgery, but neither preoperative nor post-operative antibiotics were given. A written informed consent from the parents or child guardian was obtained after explanation. The rate of surgical site infection was compared between the two groups. A p value of less than 0.05 was considered to be significant statistically. Results: The total infection rate in both (case and control groups) was 3.33%, the rate of postoperative wound infection in "case group" was 4 % compared to that in "control group" which was 2.67 %. This noticed variance was statistically insignificant (P value by Chi-Square Test = 0.9883, Two –tailed p value using paired samples- t test was = 0.6578). 80% of the infections were mild (grade 1 & 2) & 60% was noticed in the 3rd post-operative day. Conclusion: This study pointed out that peri-operative prophylactic antibiotics are not justified routinely in pediatric inguinal herniotomy as there is no significant increased risk of postoperative wound infection in "group B" compared to "group A" (p value = 0.6578 using paired samples t- test), & this low risk of wound infection does not warrant the economic burden of their usage in such clean surgical operations.


Article
Avoidance of Routine Use of Episiotomy in Primigravida
تجنب الاستخدام الروتيني لبضع الفرج في Primigravida

Authors: Ghada S. Alsakkal --- Trifa Ahmed Hamda
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 1 Pages: 31-36
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The justification of the routine use of the episiotomy arouse at the beginning of 20th century. It was based on personal beliefs without scientific basis and this led to the incorporation of episiotomy in daily practice . High-quality methodological studies gave strong evidence that episiotomy should not be done routinely. The purpose of this study was to find out the rate and degrees of perineal tear in women with versus without episiotomy and to evaluate the severity of pain and complications including wound infection, wound dehiscence and dyspareunia.Methods: This is a prospective interventional study included 200 primigravida with term pregnancy, who attended the labor room at Maternity Teaching Hospital from 1st of January 2008 till 1st of July 2008. Episiotomy was done for a group and avoided in another group, then follow up was done to evaluate complications.Results: Perineal tears were significantly more in patients with episiotomy as episiotomy itself is regarded as second degree perineal tear. There was significant difference in the severity of pain, wound infection and dyspareunia among both groups but there was no significant difference in the Apgar score of the newborn in both group.Conclusions: This study does not supports maternal benefits of routine episiotomy.


Article
Correlation of Postoperative Wound Infection with Intraoperative Culture Results and Duration of Operation

Author: Kussay M. Zwain
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 27-32
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:OBJECTIVES:To show the correlation of postoperative wound infection with intraoperative culture results and duration of operation.METHODS:Prospective studies of 168 randomized patients in which a wound swab was taken at wound closure and send for culture results, another swab taken if the wound become infected 5-7 days postoperative and send for culture to show the correlation of postoperative wound infection with intraoperative culture results in al-NAJAF teaching hospital from Jan.2003 to Jan.2004. Wounds are classified in to clean, contaminated and dirty surgery.RESULTS:In clean surgery the contamination rate was 7.4% and infection rate was 3.7 %, while in contaminated surgery the contamination rate was 27.7% and infection rate was 11%, while in dirty surgery the contamination rate was 35.9% and the infection rate was 25.6%. The results were compared with other studies of the world. Pseudomonas aeruginosa and S. aureus are the most common microorganisms to produce wound infection which are a serious microbe and are mostly hospital acquired and resistant to most of the commonly available antibiotics. As regards to relation of postoperative wound infection and duration of operation our results shows that long operations has a higher infection rate (more than 1 hour was 65.4% from the total cases) while the infection rate in surgical operations less than 1 hour was 34.6%,so infection rate is doubled by operations lasting more than one hour.CONCLUSION:The study showed a higher infection rate in clean surgery due to weak sterilization and poor preoperative preparation of the patients and the role of postoperative antibiotics in reduction of wound infection by about 38%.


Article
Risk Factors for Mesh Related Wound Infection after Ventral Hernia Repair Surgery
عـوامـل الـخـطـورة الـمـؤديـة لالتهابات جـروح عـمـلـيـات رتـق فـتـوق الـبـطـن بـواسـطـة الشبكة

Author: Nabeel J. Sagban نبيل جاسم صكبان
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2015 Volume: 57 Issue: 1 Pages: 18-21
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Mesh infection after hernia repair is a devastating complication. Preoperative prediction of high risk patients may be useful to avoid infections. This study aims at evaluating risk factors for mesh related wound infection in our setting. Patients and methods: This prospective cohort analysis study included 120 patients underwent ventral hernioplasty with polypropylene mesh from October 2009 to February 2013 at Baghdad Teaching Hospital. Clinical data analyzed to determine risk factors of mesh related wound infection.Results: After one year follow up for each of 120; 21 patients (17.5%) developed mesh related wound infection. Predictors of infection were: age ≥ 45 years, BMI≥35 kg/m2, diabetes mellitus, past history of previous surgical repair, presence of more than one sac or defect, defect size larger than 5 cm, type of hernia sac content (small bowel), small bowel anastomoses, and increased duration of surgery.Conclusion: Clinical history and examination preoperatively can predict high risk patients to develop postoperative infection.Key word: ventral hernia , mesh ,wound infection.

خلفية الدراسة:إن منع الإصابة بالمضاعفات الالتهابية هي أحد أهم أهداف الجراحة الناجحة. إن الالتهابات المصاحبة لوجود الشبكة في عمليات إصلاح الفتوق هي من أعقد المشاكل التي تواجه الجراح. لذا معرفة عوامل الخطورة مسبقاً قد يفيد في تفاديها.الهدف من الدراسة: تحليل عوامل الخطورة لإلتهابات الجروح المصاحبة لوجود الشبكة في عمليات إصلاح فتوق البطن الطرق والمرضى: دراسة مستقبلية أجريت في مستشفى بغداد التعليمي من تشرين الأول 2009 ولنهاية شباط 2013 .حيث تم متابعة 120 مريضاً أدخلوا الوحدة الجراحية الثالثة في الطابق الخامس وأجريت لهم عمليات إصلاح فتوق جدار البطن الأمامي بواسطة الشبكة و تم بعد ذلك تحليل عوامل خطورة الالتهابات إحصائياً.النتائج: من تحليل النتائج وجد أن عوامل خطورة الالتهابات الايجابية في هذه الدراسة كانت العمر ≥ 45 سنة، عامل كتلة الجسم ≥ 35 كغمم2، داء السكري، إجراء عملية جراحية سابقة لإصلاح الفتق، وجود أكثر من خلل أو فتق، الفتوق الأكبر حجماً (5سم أو أكثر)، محتويات كيس الفتق(أمعاء دقيقة)، قص الأمعاء الدقيقة وربطها، العمليات الأطول وقتا. مفتاح الكلمات: فتق البطن ، الشبكه ، التهاب الجروح.


Article
COMPARATIVE STUDY BETWEEN INTERRUPTED MATTRESS AND CONTINUOUS SUBCUTICULAR SKIN CLOSURE IN REGARDING POST-APPENDECTOMY WOUND INFECTION

Author: Ahmed Abdul-Hadi Safar
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2016 Volume: 22 Issue: 1 Pages: 17-24
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract Historically, potentially infected surgical wounds, like in acute appendicitis, were recommended to be closed by interrupted skin suturing. However, this method of skin closure can leave a marked scar at the closure site after healing of the wound. On the other hand, there are no enough data about the potential risk increment in wound infection following skin closure by continuous subcuticular approach. This is a prospective study aimed to compare the results of skin closure using interrupted mattress and subcuticular continuous approaches following appendectomy, in terms of postoperative wound infection rates. One hundred and ten (110) patients with acute appendicitis admitted to Al-Sadir Teaching Hospital in the period between January 2013 and February 2014 were chosen for the study. The patients were divided into two groups. In one group, (58) patients, the appendectomy wound was closed by interrupted mattress, and patients in the other group, (52) patients, underwent continuous subcuticular skin closure. All patients were followed up for two days postoperatively in the hospital and seven days as outpatient follow-up for signs and symptoms of wound infection. By assessing the effect of risk factors on the rate of post-appendectomy wound infection, the following results were obtained: Effect of gender on postoperative infection: Males: 8/59 (13.6%), Females 6/51 (11.8%), P value: 0.079. So the association between gender and rate of infection was not significant. Effect of smoking on postoperative infection: Smokers: 4/24 (16.7%), Non-smokers: 10/86 (11.6%), P value: 0.429. So the association between smoking and the rate of infection was not significant. Effect of family history of previous appendectomy on postoperative infection: Positive family history: 7/34 (20.6%), Negative family history: 7/76 (10.1%), P value: 2.738. So the association between family history and the rate of infection was not significant. Effect of history of previous abdominal operations on postoperative infection: Positive history: 1/7 (16.7%), Negative history: 13/103 (12.6%), P value: 0.066. Thus the association between history of previous abdominal operations and the rate of post-appendectomy wound infection was not significant.In interrupted mattress skin closure group, 7/58 (12%) patients developed signs and symptoms of wound infection, whereas in the continuous subcuticular skin closure group, 7/52 (13.4%) patients developed wound infection. In conclusion, there is no significant difference in the risk of wound infection between skin closure by interrupted mattress and continuous subcuticular approaches.


Article
Virulence Genes Profile of Pseudomonas aeruginosa Local Isolates from Burns and Wounds

Author: Noor F. K. AL-Shamaa1, Rasmia A. Abu- Risha2, Mohammad A. AL-Faham3
Journal: Iraqi Journal of Biotechnology المجلة العراقية للتقانات الحياتية ISSN: 18154794 Year: 2016 Volume: 15 Issue: 3 Pages: 31-39
Publisher: Baghdad University جامعة بغداد

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Abstract

In this study a total of 111 swabs were collected from 50 patients suffering from burns and wounds between the age 9 months -69 years from both gender , the specimens were collected from Educational Al-Yarmouk and AL Kadhimiya hospitals in Baghdad during the period between October-December2014, All the samples were identified by biochemical tests , API 20 E and Vitak -2 . From 111 specimens, 31 isolates were Pseudomonas aeruginosa , 33 isolates were Escherichia coli and 10 isolates were Klebsiella spp, . Drug susceptibility tests for the 31 isolates of Pseudomonas aeruginosa were studied by the disk diffusion method against 5 antibiotics and the result showed the percentage of resistance: Carbenicillin 100%, Ticarcillin 61 %, Pipracillin 32 % ,Cefprozil 93% , Colistin 84% . The DNA samples of the 31 isolates of Pseudomonas.aeruginosa were extracted by DNA extraction kit , the concentration for all 31 DNA samples were between 60- 110 ng /ul and the purity were between 1.8-2 .PCR (Polymerase Chain Reactin) was used for screening the virulence factor genes , protein synthesis inhibition genes (exo A , las B , exoU ) of the thirty one isolates of Pseudomonas aeruginosa . The result showed that 27 ( 87%) isolates were positive for exo A and las B genes, 4 ( 13%) were negative, , from 25 burn isolates was 23 (92%) positive isolates and from 6 wound isolates was 4 (66%) positives isolates. . For the exoU gene the result showed that 17 ( 55%) were positive , 14 ( 45% )were negative , From 25 burn isolates the presence of exoU was seen in 15 ( 60 %), while from 6 wound isolates was 2 (33 %).


Article
Microbial Contamination of Operating Theatres and Intensive Care Units at a Surgical Specialty Hospital in Erbil City

Author: Soza Tharwat Baban, Payman Akram Hama Saeed1, Dlovan M. F. Jalal
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 2 Pages: 150-155
Publisher: Babylon University جامعة بابل

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Abstract

Background: Microbial contamination of operating theater (OT) and intensive care unit (ICU) is the most frequent cause of nosocomialinfections in patients. Objectives: this study aims to evaluate the prevalence level and variety of microbial contamination in these high‑riskareas in the surgical specialty hospital in Erbil city. Materials and Methods: Three sampling procedures were employed in this study, whichincludes swabbing, open plate, and both microbiological and biochemical investigation of water supply in these high‑risk areas. Standardmicrobiological techniques were used for microbiological culture and identification of microbial pathogens. Results: 48.3% yielded positivemicrobial growth. The most common isolates were Gram‑positive bacteria (83.1%), of which Staphylococcus aureus accounted for 78.6%of bacterial pathogens isolated, followed by Streptococci (33.3%) and Enterococci (28.6%). Whereas, lower rate of Gram‑negative bacterialcontamination (16.9%) was observed, including Escherichia coli (19%) and each of Pseudomonas aeruginosa and Proteus (4.8%). Aircontamination with Aspergillus (19%) and Molds (14.3%) was observed, respectively. The highest rate of microbial contamination was observedin OT rooms (35.6%) where 50% of environmental hygiene practice was detected using infection control practice audit tool. In addition,21.4% of positive cultures were identified in ICU rooms where only 9% of environmental hygiene was practiced. Conclusions: These findingsemphasize the important role of infection control system to prevent the cross‑transmission of nosocomial pathogens to cause contaminationand infection in the critically ill patients

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