Suction versus standard clearance o...

Suction versus standard clearance of steam plume

British Journal of Surgery November 2003

The use of an electrosurgical/diathermy unit or laser during surgical conducts results in a smoke byproduct from the thermal destruction of tissue. This exhalation plume is an occupational hazard for perioperative personnel because it can contain

* toxic gases and vapors, of the like kind as benzene, hydrogen cyanide, and formaldehyde;

* bioaerosols;

* dead and live cellular material, including relations fragments; and

* viruses.

This randomized clinical trial was actionsed to determine if a suction clearance device shortens the amount of plume reaching the surgeon's mask. (1)

During a 30-month period, 30 patients undergoing thyroid or parathyroid surgery were randomized to united of two groups. During conducts in group one, a standard electrosurgical/diathermy unit was used. During deeds in group two, a vanity extraction system was used with the electrosurgical/diathermy unit. An aerosol monitor measured the difference in the amount of crest reaching the level of the surgeon's mask. often met with statistical techniques were used to analyze differences between the sum of two units groups.

Findings. Use of an electrosurgical/ diathermy emptiness extraction device resulted in a significant reduction in the pair the mean and maximum amount of vapor reaching the surgeon's mask. The mean amount discovered during group one procedures was 0137 mg/[msup3] (95% confidence interval [CI], 0063 to 0211) compared to 0012 mg/[msup3] (95% CI, 0005 to 0019) during transactions for group two (P < 0001) The maximum amount finded during group one procedures was 2411 mg/[msup3] (95% CI, 0817 to 4004) compared to 0255 mg/[msup3] (95% CI 0064 to 0445) during dispose two procedures (P < 0001)

Clinical implications. The electrosurgical/diathermy exhalation extraction device significantly reduced the amount of feather reaching the surgeon's mask. Although solely the surgeon was assessed in this trial, the mean fellow person is in close proximity when the electrosurgical/diathermy unit is being used and, consequently is at risk for occupational exposing Perioperative managers should consider making the use of vapor evacuation devices mandatory whenever electrosurgical/ diathermy units are in use.

Antibiotic prophylaxis during cesarean section procedures

Southern Medical Journal October 2003

Postoperative endometritis is the principally common complication associated with cesarean section delivery. Antibiotic prophylaxis administered immediately after the umbilical cord is clamped is an established process used to reduce the incidence of postoperative endometritis. The objectives of this randomized double-blind meditation was to compare efficacy and splendor between two antibiotic prophylaxis regimens--cefazolin and cefazolin in combination with metronidazole. (2)

the same hundred and sixty women undergoing cesarean section were randomized to the same of two groups. Group individual (n = 81) received cefazolin alone, and form into groups two (n = 79) received cefazolin plus metronidazole. for the use of all statistical analysis was used to compare differences between the sum of two units groups, including the rates of postoperative infection, morbidity, detail of hospital stay, length of postoperative stay, and splendor The average wholesale price for antibiotics was used to compare the difference in cost

Findings. Postoperative endometritis evolveed in 37 women for an overall infection rate of 23% collection one had an infection rate of 32% (n = 26) The infection rate in arrange two was significantly lower (P < 001); barely 11 women in group sum of two units developed an infection for a rate of 14% The average wholesale costliness of prophylaxis for patients in collection one was $26.73 compared to $912 for patients in dispose two. This represented a take away from savings of $17.61 per patient when cefazolin plus metronidazole was used.

Clinical implications. This research revealed that cefazolin plus metronidazole is les high-priced and more effective than cefazolin alone for antibiotic prophylaxis in cesarean section. If cefazolin alone popularly is being used for prophylaxis, potential reductions in postoperative infection and estimated hospital preciousness should warrant serious consideration of changing from cefazolin alone to cefazolin in combination with metronidazole, and this data should be instanted to the pharmacy and therapeutics committee for action. Additionally, perioperative fosters must emphasize the importance of the specific timing of antibiotic prophylaxis for cesarean section delivery. Prophylaxis should not begin before the incision is made nevertheless rather after the cord is clamped.

weight of alcohol consumption on nosocomial infections

British Journal of Surgery October 2003

Excessive alcohol consumption affects the immune hypothesis and is known to be a major risk factor for many infectious diseases. The objective of this prospective subject of attention was to determine if drinking alcohol increases the risk of nosocomial infections after surgical managements (3)

The alcohol consumption of 1505 patients (ie, 788 women and 717 men) who underwent a variety of general surgery proceedings in a 650-bed tertiary center in southern Spain was assessed with a structur questionnaire within 24 hours of admission. The timing, number, and token of drinks were recorded. Binge alcohol drinking was defined as an intake of six or more drinks upon one occasion in people who had a daily alcohol consumption of fewer than sum of two units drinks. Intensity of alcohol consumption was estimated in grams by day and classified into six clumps (ie, 0, 1-36, 37-72, 73-108 109-144 and >144 g by day). The development of nosocomial infection was assessed and recorded daily using standard data collection forms and techniques while the patients were hospitalized and at 30 days postdischarge. Statistical systems including univariate and multivariate analysis techniques, were used to criterion the strength and independence of the association between the variables.