Risks Associated with Surgical Procedures

Open and invasive procedures always have a risk of contamination, but the presence of biomaterials in surgeries increases the risk of infection due to their susceptibility to bacterial colonization [11,12], 

Adhesion and colonization of microorganism on the prosthesis (either bone tissue or cardiovascular), mostly occurs during the intervention, which is the main reason why the major infections are of nosocomial origin (hospital acquiring infection). 

When adhesion of bacteria occurs on the surface of the prosthesis an invasive inflammatory process can be developed. If bacteria proliferation continues, a biofilm is formed, and consequently a three-dimensional structure protects bacteria against the patient s own defense system and from systemic antibiotic therapy [13]. Bacteria do not grow exponentially, but rather exist in a slow growing or starvation state. These microorganisms can produce an extracellular matrix that protects them from a hostile environment, enabling them to evade the host immune system and antibiotic treatment. This biofilm facilitates bacterial survival under nutrient-poor, stressful conditions, which occur in the host, and results in structurally-complex, heterogeneous bacterial aggregates associated with a surface [14,15]. 

In the last decade, researchers have focus their efforts in the development of novel techniques which allow local antibacterial therapy. These techniques involve the use of antibiotic impregnated interim prostheses to treat infections. In order to maintain constant drug concentrations in the specific area of treatment, the device is impregnated with various antibiotics. The use of this method is a widespread technique in the treatment of postoperative infections. The advantages and benefits of these methods rely on the immediate treatment of the source of infection [16]. 

The desired characteristics for an antibiotic are to have a wide antibacterial spectrum, to be an effective bactericide at low concentrations, high elution from the matrix for prolonged periods, thermal stabiHty, low allergy risks as well as low influence on the properties of the biomaterial and low serum protein binding [16,19]. Additionally, it is commonly used in the powder form. The antibiotics that implement most of these conditions are the aminoglycosides and glycopeptides. 

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The implantation of medical devices frequently involves complicated surgical procedures. MIS causes minimal damage to body tissues, greatly reduces the risks associated with surgical procedures, reduces trauma to the patient and accelerates their recovery. Medical devices for MIS need... 

Safety and risk considerations are often at the center of mistake proofing. Imagine the risk associated with unveiling new investment software, or with implementing a new surgical procedure. Both the financial and health care industries have a host of mistake-proofing measures in place to avoid costly errors and litigation. 

There is an increased risk of post-operative thromboembolic complications in women taking oral contraceptives Ifposs-bte, use of the drug is discontinued at least 4 weeks before a surgical procedure associated with thromboembolism or during prolonged immobilization. 

High-risk procedures include implantation of prosthetic materials and other procedures in which surgical-site infection is associated with high morbidity. 

The increased risk of thromboembolism associated with atrial fibrillation and with the placement of mechanical heart valves has long been recognized. Similarly, prolonged bed rest, high-risk surgical procedures, and the presence of cancer are clearly associated with an increased incidence of deep venous thrombosis and embolism. Antiphospholipid antibody syndrome is another important acquired risk factor. Drugs may function as synergistic risk factors in concert with inherited risk factors. 

Surgery for hemifecial spasm involves microvascular decompression of the fecial nerve by placement of a sponge under posterior fossa vessels (Jannetta procedure). Surgery for hemifecial spasm is associated with cure rates exceeding 80%, and beyond 2 years there appears to be little risk of relapse. However, surgical intervention can have serious complications such as permanent facial paralysis, deafness, stroke, and even death. 

The major adverse effect associated with the use of viscoelastic substances, such as hyaluronate sodium, is a transient rise in intraocular pressure in the immediate postoperative period, attributed to its viscoelastic nature, resulting in coating and plugging of the trabecular mesh-work. For this reason, it is advisable to dilute hyaluronate sodium at the end of the surgical procedure with a balanced salt solution. Chondroitin sulfate is relatively less likely to precipitate such extreme rises in intraocular pressure because it is cleared rapidly from the trabecular meshwork. However, with any technique or chemical used in surgery there is always the potential for an unexpected adverse effect, and the risks of Viscoat include subepithelial calcium deposition and keratopathy (3). 

Typically, they are used in surgical procedures associated with an infection rate that exceeds 5%. The risks of the prophylactic antimicrobial therapy must be less than the risk and consequences of infection. 

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