Publications by authors named "Wil van der Zwet"

Importance: International guidelines recommend the use of triclosan-containing sutures for the prevention of surgical site infections. However, controversy still remains about triclosan-containing suture use in clinical practice since several new randomized clinical trials (RCTs) have shown contradicting results.

Objective: To update a previous systematic review and meta-analysis of the association of triclosan-containing sutures with surgical site infections and explore the potential added value of new RCTs.

View Article and Find Full Text PDF

Importance: Surgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.

Objective: To compare the outcomes of different types of incisional prophylactic intraoperative incisional wound irrigation for the prevention of SSIs in all types of surgery.

View Article and Find Full Text PDF

In recent decades, minimally invasive surgery has become the favoured surgical technique, with increasing utilisation of robotic surgery to enhance patient outcomes. However, the design complexity of surgical robotic instruments can pose challenges in maintaining adequate cleaning, disinfection and sterilisation-particularly of the device's interior. In our hospital, robotic instruments are reused for a maximum of ten successive patients, following the manufacturer's guidelines.

View Article and Find Full Text PDF

Background: The evidence on prophylactic use of negative pressure wound therapy on primary closed incisional wounds (iNPWT) for the prevention of surgical site infections (SSI) is confusing and ambiguous. Implementation in daily practice is impaired by inconsistent recommendations in current international guidelines and published meta-analyses. More recently, multiple new randomised controlled trials (RCTs) have been published.

View Article and Find Full Text PDF

Background: Surgical site infection (SSI) is the most common postoperative complication and substantially increases health-care costs. Published meta-analyses and international guidelines differ with regard to which preoperative skin antiseptic solution and concentration has the highest efficacy. We aimed to compare the efficacy of different skin preparation solutions and concentrations for the prevention of SSIs, and to provide an overview of current guidelines.

View Article and Find Full Text PDF

Importance: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) are prophylactic antibiotic regimens used in intensive care units (ICUs) and associated with improved patient outcome. Controversy exists regarding the relative effects of both measures on patient outcome and antibiotic resistance.

Objective: To compare the effects of SDD and SOD, applied as unit-wide interventions, on antibiotic resistance and patient outcome.

View Article and Find Full Text PDF

Background & Aims: Oral nutritional supplements (ONS) are often considered for hospitalized patients with acute severe malnutrition, however the compliance to the supplements is known to be variable. The aim of our study was to investigate whether providing a lower volume of ONS at a higher frequency during medication rounds would improve the intake of the supplements.

Methods: In this randomized controlled trial, 234 malnourished inpatients (mean age 71.

View Article and Find Full Text PDF

Background: Colonoscopy is used for the detection of neoplastic polyps, although a significant miss rate has been reported. Limited data suggest that the administration of the antispasmodic hyoscine N-butylbromide during colonoscopy improves polyp detection.

Objective: To investigate whether the use of 20 mg hyoscine N-butylbromide intravenously during colonoscopy improves polyp detection or removal.

View Article and Find Full Text PDF

Background And Study Aims: Recurrences after Doppler-guided haemorrhoidal artery ligation (DG-HAL) tend to occur in patients with concurrent mucosal prolapse. We retrospectively compared the results of DG-HAL and rubber band ligation (RBL) for the treatment of haemorrhoidal disease.

Patients And Methods: From 2005 to 2009, all patients who underwent either a DG-HAL procedure or RBL were selected.

View Article and Find Full Text PDF

Objectives: Delayed hemorrhage is an infrequent, but serious complication of colonoscopic polypectomy. Large size is the only polyp-related factor that has been unequivocally proven to increase the risk of delayed bleeding. It has been suggested that location in the right hemi-colon is also a risk factor.

View Article and Find Full Text PDF

Background: Automation and standardization of sediment analysis of urine samples by flow cytometry might serve as an alternative to labor-intensive laboratory methods, such as microscopic examination and culture. The Sysmex UF-1000i is a urine flow cytometer that uses two separate channels for counting blood cells and bacteria.

Methods: In this study, 358 urine samples were analyzed with the Sysmex UF-1000i in parallel with manual microscopy, Gram stain and bacterial culture, the latter considered the gold standard.

View Article and Find Full Text PDF

Aim: This study was designed to determine the effect of treating hemorrhoids with the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure.

Methods: From June 2005 to March 2008, 244 consecutive hemorrhoidal patients underwent hemorroidal artery ligation performed with the DG-HAL system from AMI. All patients were evaluated postoperatively with a proctologic examination and interview.

View Article and Find Full Text PDF

Objective: To establish the effect of the introduction of an auto-transfusion system on the number of homologous blood transfusions required as part of total hip- and knee-replacement surgery.

Design: Prospective observational study.

Methods: The number of homologous blood transfusions required after total hip or knee replacement was compared between a group of 195 patients before and a group of 176 patients after introduction of an auto-transfusion system.

View Article and Find Full Text PDF

Unlabelled: Background. Ischemia-reperfusion injury and reactive oxygen species (ROS) are considered to play an important role in the pathogenesis of pressure ulcers (PU). Antioxidants may diminish the inflammation and damage of these ROS in pressure ulcer formation.

View Article and Find Full Text PDF

Reliable analysis of single nucleotide polymorphisms (SNPs) in DNA derived from samples containing low numbers of cells or from suboptimal sources can be difficult. A new procedure to characterize multiple SNPs in traces of DNA from plasma and old dried blood samples was developed. Six SNPs in the Mannose Binding Lectin 2 (MBL2) gene were chosen as targets for analysis.

View Article and Find Full Text PDF

A premature infant in a neonatal intensive care unit (NICU) developed a bloodstream infection caused by coagulase-negative staphylococci (CoNS) sensitive to vancomycin. The infection persisted for 3 weeks, despite therapy with vancomycin and replacement of all intravenous catheters. The neonate died due to necrotizing enterocolitis which developed during the ongoing sepsis.

View Article and Find Full Text PDF

We describe an outbreak of vancomycin-resistant Enterococcus faecium (VRE) on the haematology ward of a Dutch university hospital. After the occurrence of three consecutive cases of bacteraemia with VRE, strains were genotyped and found to be identical. During the next 4 months an intensive surveillance programme identified 21 additional patients to be colonized with VRE, while two more patients developed bacteraemia.

View Article and Find Full Text PDF

Objective: Varicella-zoster virus (VZV) can cause severe disease in premature neonates. The fetus receives protective maternal VZV-immunoglobulin G (IgG) mainly in the third trimester of pregnancy. Therefore, premature neonates are considered at risk for VZV infection.

View Article and Find Full Text PDF