Postoperative wound

Paraffin gauze dressing Perforated film absorbent dressing Polyurethane foam Burns, scaids, grafts Postoperative wounds Burns, ulcers, grafts. Any combination of dry heat, gamma-radiation and ethylene oxide... 

Data reported by the NNIS from 1990 to 1996, adapted from National Academy of the Sciences National Research Council. Postoperative wound infections The influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1984 160 32-135. 

Range of 20-35 kcal/kg per day Maintenance 20-25 kcal/kg per day Repletion/postoperative wound healing/critical illness/sepsis/ 25-30 kcal/kg per day Anabolic//trauma/burns 30-35 kcal/kg per day... 

Skin and skin structure infections Skin and skin structure infections, including those associated with postoperative wounds, ulcers, and burns caused by . coli, P. mirabilis, S. marcescens, Enterobacter sp., P. aeruginosa, K. pneumoniae, and Citrobacter sp. 

For debridement of necrotic tissue and liquefication of slough in acute and chronic lesions such as pressure ulcers, varicose, diabetic, and decubitus ulcers, burns, postoperative wounds, pilonidal cyst wounds, carbuncles, and miscellaneous traumatic or infected wounds. Also stimulates vascular bed activity to improve epithelization. 

A combination of neomycin and nonabsorbable erythromycin base given orally prior to colorectal surgery can markedly reduce the incidence of postoperative wound infection. Orally administered neomycin is sometimes used to suppress the facultative flora of the gut in patients with hepatic encephalopathy. It is unclear how this improves coma, but one theory is that it reduces systemic absorption of the bacterial metabo-htes that allegedly cause hepatic encephalopathy. Although more than 95% of an oral dose of neomycin is excreted unchanged in the stool of normal subjects, the bioavaUabUity of neomycin may be much higher in patients with an abnormal gastrointestinal mucosa. 

Rare reactions include hypersensitivity reactions, lymphopenia, malignancies, and serious infections requiring hospitalization (such as abscess, pneumonia, and postoperative wound infection),... 

Hypersensitivity reaction, malignancies, serious infections (abscess, cellulitis, postoperative wound infection, pneumonia), thrombocytopenia, and worsening of psoriasis occur rarely. 

The Study of the Efficacy of Nosocomial Infection Control (SENIC) identified four independent risk factors for postoperative wound infections operations on the abdomen, operations lasting more than 2 hours, contaminated or dirty wound classification, and at least three medical diagnoses. Patients with at least two SENIC risk factors who undergo clean surgical procedures have an increased risk of developing surgical wound infections and should receive antimicrobial prophylaxis. 

A 56-year-old woman with a postoperative wound infection developed the serotonin syndrome when she was given the antibiotic linezolid intravenously (22). The dose of paroxetine had been tapered and it had been withdrawn 5 days before. 

Currently the most important hospital-acquired pathogen is methicillin-resistant Staph, aureus, which is responsible for a range of serious infections such as pneumonia, postoperative wound infection and skin infections which may in turn be complicated by bloodstream spread. The use of vancomycin and teicoplanin has escalated as a consequence, and in turn has been linked to the emergence of vancomycin-resistant enterococci. 

Postoperative wound infection Posttrauma wound infection Diabetic foot Decubitus ulcer Bone and joint infections... 

We saw in Chapter 30 that it can improve the appearance of stabilized surgical scars on the face. Phenol should not be used to treat recent postoperative wounds that have not yet stabilized, however, as there is a significant risk of necrosis. 

Ascorbic acid, a water-soluble vitamin (1(X) to 250 mg p.o. daily), is indicated in the treatment of frank and subclinical scurvy in extensive bums, delayed fracture or wound healing, postoperative wound healing severe febrile or chronic disease states and in prevention of ascorbic acid deficiency in those with poor nutritional habits or increased requirements. In addition, ascorbic acid has been used for potentiation of meth-enamine in urine acidification and as an adjunctive therapy in the treatment of idiopathic methemoglobinemia. 

Maxillofacial Surgery. The plasma NO-therapy is used to accelerate the healing of postoperative wounds and preventive maintenance of the formation of hypertrophic and keloid scars, treatment of the formed scars, treatment of pyonecrotic processes (abscesses, phlegmon, etc.). With the latter, preliminary coagulation of puralent centers is sometimes utilized (Shekhter et al., 2005). 

A Brandberg, J Holm, Hammarsten, T Schersten. Postoperative wound infections in vascular surgery effect of preoperative whole body disinfection by shower-bath with chlorhexidine soap. In H Maibach, R Aly, eds. Skin Microbiology Relevance to Clinical Infection. New York Springer-Verlag, 1981, pp 98-102. 

Several investigators, including Brandberg and Andersson [33], have shown that showering with a nonantimicrobial soap actually increases the level of the microbial flora. Earlier studies by Cruse and Ford [31] and Dineen [38] had recognized and established the patient s own skin as an importance source of postoperative wound infection. 

OB Jepsen. Postoperative wound sepsis in general surgery. VII. Staphylococcus wound sepsis. Acta Chir Scand 138 343-348, 1972. 

Tanzi EL, Alster TS (2003) Single-pass carbon dioxide versus multiple-pass Er YAG laser skin resurfacing a comparison of postoperative wound healing and side-effect rates. Dermatol Surg 29(l) 80-84... 

Occupational dermatitis was observed in the pharmaceutical industry and in a surgeon who used topical virginiamycin on postoperative wounds (CJ Le Coz, unpublished observations). 

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