Background: To explore the incidence of incision infections and dynamically monitor albumin (ALB) and C-reactive protein (CRP) levels after lumbar fusion.
Methods: A total of 1,773 patients undergoing lumbar fusion in our hospital from March 2011 to March 2021 were selected and divided into the infection group and the non-infection group according to whether incision infections occurred postoperatively. The incidence of postoperative incision infections, the pathogenic characteristics and drug resistance of the pathogenic bacteria in patients in the infection group were analyzed. The general clinical data, serum ALB and CRP levels at different time points were compared between the two groups of patients, and the correlation between ALB and CRP levels was analyzed. ROC curve was used to evaluate the predictive value of serum ALB and CRP levels on the incidence of postoperative incision infections.
Results: Of the 1,773 patients, 41 (2.31%) experienced postoperative incision infections. A total of 57 pathogens were detected, including 36 gram-negative bacteria (63.16%), 18 gram-positive bacteria (31.58%), and 3 fungi (5.26%). Among gram-negative bacteria, Pseudomonas aeruginosa had the highest resistance to ampicillin. Among gram-positive bacteria, Staphylococcus aureus had the highest resistance to penicillin and erythromycin. The age, BMI, the number of diabetes patients, levels of serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and procalcitonin (PCT) IL-8 at 1 d after operation in the infection group were significantly higher than those in the non-infection group (P<0.05). The serum ALB and CRP levels of the two groups differed over time, and the differences were statistically significant in terms of time, inter-group, time and inter-group interaction factors (P<0.05). Correlation analysis showed that ALB was significantly negatively correlated with CRP expression. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) value of combined ALB and CRP detection was 0.856, which was significantly higher than that of single detection with ALB or CRP (P<0.05).
Conclusions: Gram-negative bacterial infection was the main type of incision infection in patients after lumbar fusion. The changes in ALB and CRP levels were related to the incidence of postoperative incision infections.
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http://dx.doi.org/10.21037/apm-21-2512 | DOI Listing |
Clin Orthop Relat Res
December 2024
Division of Plastic and Reconstructive Surgery, Fox Chase Cancer Center, Philadelphia, PA, USA.
Background: Opioid use disorder (OUD) has been implicated as a potential risk factor for adverse outcomes and readmissions in various surgical procedures. Patients admitted with an open fracture of the lower extremity often have multifarious pain needs, require surgical procedures, and have prolonged rehabilitation; previous OUD complicates this process. Our goal was to describe at a national level how OUD is associated with readmission, complications, and healthcare expenditure for patients admitted with open lower extremity fractures.
View Article and Find Full Text PDFEndocrinol Diabetes Metab Case Rep
January 2025
Summary: Palmoplantar keratoderma (PPK), characterised by excessive epidermal thickening of the skin on the palms and/or plantar surfaces of the feet, can be hereditary or acquired. Here, we report a case of a 53-year-old woman with a history of sub-optimally controlled diabetes mellitus presenting with fevers and decreased Glasgow Coma Scale (GCS) to a tertiary hospital. She was diagnosed with diabetic ketoacidosis (DKA), with blood glucose at 40 mmol/L and ketones at 7 mmol/L, in the setting of a methicillin-sensitive Staphylococcus aureus necrotising soft tissue back infection.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
January 2025
Department of Pharmacy Services, Trinity Health Ann Arbor, Ann Arbor, MI, USA.
Objective: To compare the incidence of surgical site infection (SSI) between cefazolin 3 g and 2 g surgical prophylaxis in patients weighing ≥120 kg that undergo elective colorectal surgery.
Methods: A multicenter, retrospective cohort study was performed utilizing a validated database of elective colorectal surgeries in Michigan acute care hospitals. Adults weighing ≥120 kg who received cefazolin and metronidazole for surgical prophylaxis between 7/2012 and 6/2021 were included.
Acta Chir Orthop Traumatol Cech
January 2025
Department of Orthopedics and Traumatology, Ondokuz Mayıs University, Samsun, Turkey.
Purpose Of The Study: Open (incisional) biopsies have long been accepted as the gold standard in diagnosing bone and soft tissue tumors. However, the main disadvantage of this method is that it can lead to increased contamination, hematoma, infection, and pathological fracture. Compared to open biopsies, percutaneous core needle biopsies are less invasive, do not require hospitalization, have low costs and low complication rates, and there is no need for wound healing in cases that require radiotherapy.
View Article and Find Full Text PDFActa Chir Orthop Traumatol Cech
January 2025
Department of Trauma and Orthopaedics, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK.
Purpose Of The Study: Lisfranc is a challenging injury both diagnostically and surgically, with sparse long-term literature evidence of surgical practice. We aim to review our long-term specialist orthopaedic institutional experience of Lisfranc injuries and the surgical management of this complex injury, specifically considering surgical outcomes as per radiological and clinical assessment.
Material And Methods: We present data from a prospectively maintained institutional database, reviewing patients who underwent operative fixation for Lisfranc injury between April 2014 and August 2020.
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