8 results match your criteria: "SC (Dr. Jeray); and the University of South Carolina School of Medicine Greenville[Affiliation]"
Skin Antisepsis before Surgical Fixation of Extremity Fractures.
N Engl J Med
February 2024
From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.).
Article Synopsis
- A study conducted at 25 hospitals compared the effectiveness of two antiseptic solutions (iodine povacrylex and chlorhexidine gluconate) in preventing surgical-site infections during extremity fracture surgeries.
- Results showed that iodine povacrylex led to a lower rate of infections in patients with closed fractures (2.4% vs. 3.3%) but did not show a significant difference for open fractures (6.5% vs. 7.3%).
- Ultimately, the study concluded that iodine povacrylex is a more effective skin antiseptic for closed extremity fractures, resulting in fewer infections compared to chlorhexidine, though both had similar outcomes for reoperations and adverse events.
Importance: Racial disparities in treatment benchmarks have been documented among older patients with hip fractures. However, these studies were limited to patient-level evaluations.
Objective: To assess whether disparities in meeting fracture care time-to-surgery benchmarks exist at the patient level or at the hospital or institutional level using high-quality multicenter prospectively collected data; the study hypothesis was that disparities at the hospital-level reflecting structural health systems issues would be detected.
A pragmatic randomized trial evaluating pre-operative aqueous antiseptic skin solutions in open fractures (Aqueous-PREP): statistical analysis plan.
Trials
September 2022
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Background: Approximately 1 in 10 patients with a surgically treated open fracture will develop a surgical site infection. The Aqueous-PREP trial will investigate the effect of 10% povidone-iodine versus 4% chlorhexidine in aqueous antiseptic solutions in reducing infections after open fracture surgery. The study protocol was published in April 2020.
View Article and Find Full Text PDFDoes negative pressure wound therapy reduce the odds of infection and improve health-related quality of life in patients with open fractures?
Bone Jt Open
March 2022
Department of Surgery, Western University, London, Ontario, Canada.
Aims: To evaluate the impact of negative pressure wound therapy (NPWT) on the odds of having deep infections and health-related quality of life (HRQoL) following open fractures.
Methods: Patients from the Fluid Lavage in Open Fracture Wounds (FLOW) trial with Gustilo-Anderson grade II or III open fractures within the lower limb were included in this secondary analysis. Using mixed effects logistic regression, we assessed the impact of NPWT on deep wound infection requiring surgical intervention within 12 months post-injury.
Risk Factors Associated With Infection in Open Fractures of the Upper and Lower Extremities.
J Am Acad Orthop Surg Glob Res Rev
December 2020
From the Department of Orthopedic Surgery, Boston Medical Center, Boston, MA (Dr. Tornetta III); the University of Missouri School of Medicine, Columbia, MO (Dr. Della Rocca); the University of California San Francisco, San Francisco General Hospital, Orthopaedic Trauma Institute, San Francisco, CA (Dr. Morshed); the The CORE Institute, University of Arizona-Phoenix, Phoenix, AZ (Dr. Jones); the Department of Health Research Methods, Evidence, and Impact (Ms. Heels-Ansdell, Dr. Sprague, and Dr. Bhandari) and the Division of Orthopaedic Surgery, Department of Surgery (Dr. Sprague, Dr. Petrisor, Ms. Del Fabbro, Ms. Bzovsky, and Dr. Bhandari), McMaster University, Hamilton, Ontario, Canada; and the Department of Orthopaedic Surgery, Prisma Health-Upstate, Greenville, SC (Dr. Jeray).
Introduction: Open fractures are associated with a high risk of infection. The prevention of infection is the single most important goal, influencing perioperative care of patients with open fractures. Using data from 2,500 participants with open fracture wounds enrolled in the Fluid Lavage of Open Wounds trial, we conducted a multivariable analysis to determine the factors that are associated with infections 12 months postfracture.
View Article and Find Full Text PDFManaging work flow in high enrolling trials: The development and implementation of a sampling strategy in the PREPARE trial.
Contemp Clin Trials Commun
March 2021
Department of Surgery, McMaster University, 293 Wellington St. N., Suite 110, Hamilton, ON, Canada.
Introduction: Pragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow.
View Article and Find Full Text PDFQuality and Content of Internet-Based Information for Osteoporosis and Fragility Fracture Diagnoses.
J Am Acad Orthop Surg Glob Res Rev
February 2021
From the Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC (Dr. Wally, Dr. Bemenderfer, Dr. McKnight, Dr. Gorbaty, Dr. Seymour, and Dr. Karunakar); the Department of Orthopedic Surgery, Prisma Health-Upstate; Greenville, SC (Dr. Jeray); and the University of South Carolina School of Medicine Greenville, Greenville, SC (Dr. Jeray).
Introduction: We aimed to assess the quality and content of websites addressing orthopaedic conditions affecting older adults, emphasizing osteoporosis and fragility fracture.
Methods: Ten diagnoses were chosen. The transparency of information was assessed via the Health On the Net (HON) score; information content was assessed via diagnosis-specific grading templates.
Effectiveness of Iodophor vs Chlorhexidine Solutions for Surgical Site Infections and Unplanned Reoperations for Patients Who Underwent Fracture Repair: The PREP-IT Master Protocol.
JAMA Netw Open
April 2020
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Importance: The risk of developing a surgical site infection after extremity fracture repair is nearly 5 times greater than in most elective orthopedic surgical procedures. For all surgical procedures, it is standard practice to prepare the operative site with an antiseptic solution; however, there is limited evidence to guide the choice of solution used for orthopedic fracture repair.
Objective: To compare the effectiveness of iodophor vs chlorhexidine solutions to reduce surgical site infections and unplanned fracture-related reoperations for patients who underwent fracture repair.