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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preoperative mechanical bowel preparation, peroperative topical antiseptic measures, and postoperative antibiotic therapy have all been shown to reduce infection after colorectal surgery. We report the results of a randomised trial of preoperative irrigation with a 10% aqueous solution of povidone-iodine (Betadine) versus water in patients undergoing major resection for large bowel carcinoma. All patients had mechanical bowel preparation, preoperative topical povidone-iodine and per and postoperative antibiotics. Of 22 study patients only one (4.6%) developed abdominal wound infection, whereas in 23 controls nine (39.1%) did so (P less than 0.01). In three of the study patients cultures of swabs taken at operation from the transected bowel ends showed no bacterial growth. Arguably the bacterial population would have been markedly reduced in other patients. These results suggest that povidone-iodine irrigation before large bowel resection reduces wound sepsis.
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PMID:Povidone-iodine bowel irrigation before resection of colorectal carcinoma. 403 31

The effects of acute Salmonella typhimurium sepsis on the kinetics of peripheral L-thyroxine (T(4)) distribution and metabolism and on serum total and free T(4) concentrations were studied in rhesus monkeys inoculated i.v. with either heat-killed or viable organisms. The rate of disappearance of labeled T(4) from serum was increased within 8 h after inoculation of monkeys with either heat-killed or viable Salmonella. The effects of the heat-killed organisms were transient and no longer evident by 16 h postinoculation. The monkeys inoculated with the viable Salmonella experienced a 2-3 day febrile, septic illness that was accompanied by an increase in the absolute rate of T(4) disposal. In the infected monkeys, serum total T(4) and endogenously labeled protein-bound iodine concentrations fell significantly during the period of acute sepsis and then rose during convalescence to values that exceeded the preinoculation values, suggesting that thyroidal secretion of hormone had increased in response to a primary depletion of the peripheral hormonal pool. Total cellular and hepatic uptakes of T(4) were enhanced by 4 h after inoculation of monkeys with either heat-killed or viable Salmonella, but the increase in total cellular uptake persisted for 24 h only in the monkeys inoculated with the viable organisms. These alterations in T(4) kinetics could neither be correlated with changes in the binding of T(4) in plasma nor attributed to an increase in vascular permeability. Moreover, they could not be ascribed to an in vitro product of bacterial growth, suggesting that the presence of the organisms themselves was required. An acceleration of T(4) disappearance was also observed during Escherichia coli and Diplococcus pucumoniae bacteremias. Our findings are consistent with a primary increase in the cellular uptake and metabolism of T(4) during bacterial sepsis, possibly related to phagocytic cell function in the host.
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PMID:Accelerated cellular uptake and metabolism of L-thyroxine during acute Salmonella typhimurium sepsis. 462 10

The effects of intrarectal metronidazole and intraincisional povidone iodine on sepsis after emergency appendicectomy were compared in a double-blind randomised controlled trial in 496 patients. Wound sepsis occurred in 12.3% of metronidazole-treated patients compared with 24% in the povidone-iodine group and 23.5% in an untreated control group. The metronidazole-treated patients left hospital approximately 2 days earlier than patients in the other two groups. They returned to work sooner and receiver fewer visits from the district nursing service. A short six-dose course of metronidazole significantly reduces the wound-infection rate in patients over the age of 12 undergoing emergency appendicectomy. If the clinical and economic benefits of metronidazole shown by this study are confirmed, the drug should be considered for routine use in emergency appendicectomy.
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PMID:Clinical and economic consequences of wound sepsis after appendicectomy and their modification by metronidazole or povidone iodine. 611 Sep 65

An experimental wound infection model was used to assess the value of four proprietary antiseptics applied topically in preventing the development of wound sepsis. Irrigation of wounds with either saline or noxytiolin 15 min after contamination with Staphylococcus aureus did not reduce either the incidence or degree of infection. Benzalkonium chloride and, to a lesser degree, povidone-iodine significantly reduced the infection rate, but were inferior to chlorhexidine gluconate which eliminated all overt signs of infection. The rate of healing of the chlorhexidine-treated, contaminated wounds was found to be no different from control non-infected wounds. When irrigation was carried out 45 min before wounds were contaminated, chlorhexidine was the only treatment which reduced the rate of infection (P less than 0.001). It is concluded that the superior activity of chlorhexidine in this model is a good indication that it should be a highly effective agent in the prevention of staphylococcal wound infection, and that this is probably due to a combination of bactericidal and persistent action together with low toxicity.
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PMID:An experimental evaluation of antiseptic wound irrigation. 620 58

Single doses of clindamycin hydrochloride and gentamicin sulfate given preoperatively, combined with intraoperative topical application of povidone-iodine were given to patients with perforated or gangrenous appendicitis. The incidence of wound sepsis was reduced from 36% to 5%; severe infections were reduced from 25% to 0% when compared with a control untreated group of patients. When used alone, povidone-iodine had little effect in these patients. No toxic effects of the antibiotics or antiseptic were recorded nor were any resistant strains of pathogenic organisms grown from cultures.
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PMID:Combined preoperative antibiotic therapy and intraoperative topical povidone-iodine. Reduction of wound sepsis following emergency appendectomy. 637 44

Septicemia is a persistent problem during total parenteral nutrition (TPN). The skin around the catheter insertion site is one possible source of this infection. In previous studies we showed mechanical cleansing of the skin was more important than the ointment applied; however, alternate day dressing changes did not completely eradicate all skin organisms. The present study was designated to examine the effects of daily dressing changes on the skin flora beneath the subclavian dressing. Fifteen patients receiving TPN were studied for a minimum of 11 days each. The dressing was changed daily and the catheter site cultured immediately. The area was then scrubbed with polyvinylpovidine-iodine, an antibiotic ointment was placed on the catheter insertion site, and a new dressing applied. There were no positive skin or blood cultures in this group during a total study period of 242 patient-days. The control group consisted of 23 patients receiving identical subclavian catheter care but on an alternative rather than daily basis. In the control group there was a 3.5% incidence of positive skin cultures in 530 patient-days. Daily dressing changes eliminated all skin organisms beneath the subclavian dressing during TPN and would be useful in patients who are at high risk for septic complications.
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PMID:Daily dressing change effects on skin flora beneath subclavian catheter dressings during total parenteral nutrition. 677 23

The commonest complication of appendicetomy is surgical sepsis, the incidence of which may vary from 4% for normal appendices to 77% for gangrenous or perforated appendices. Although some of these infections are relatively trivial others are serious or even life-threatening. In an effort to reduce the incidence of serious sepsis surgeons have used a variety of topical and systemic prophylactic antibacterial agents such as penicillin, ampicillin, tetracycline, lincomycin, tobramycin, cephalosporins, neomycin, bacitracin, polymyxin and povidone iodine. Although none of these prophylactic procedures has been consistently effective, appropriate systemic antibiotics generally reduce the incidence of intra-abdominal sepsis, while appropriate local treatment reduces the incidence of wound infection. Most reports on the chemoprophylaxis of sepsis after appendicectomy have been concerned solely with clinical aspects of infection and have not considered the nature of the infecting agents. During the last few years there has been an increasing awareness of the importance of non-sporing anaerobes as the major cause of sepsis after surgery of the gastrointestinal tract. Studies carried out at the Luton and Dunstable Hospital and subsequently at other centres have shown that systemic metronidazole, which is a specifically anaerobicidal agent, is highly effective in preventing the development of sepsis due to anaerobes in postappendicetomy patients.
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PMID:The role of nitroimidazole derivates in bacterial infections-metronidazole prophylaxis in appendectomy. 694 53

A randomized stratified clinical trial of topical povidone-iodine in 627 patients undergoing abdominal procedures demonstrated a reduction in postoperative wound sepsis in female patients, in patients receiving subcutaneous low dose heparin and during the first quarter of the trial when the infection rate in control subjects was high. Overall, there was no significant reduction in wound sepsis after administration of povidone-iodine due mainly to a high infection rate in povidone-iodine treated male appendix operations where, by chance, there was an increased incidence of contamination with Bacteroides fragilis. Postoperative stay in those developing wound infection was significantly reduced in the povidone-iodine group. This is considered as indirect evidence for a decrease in severity of wound infection.
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PMID:The effect of topical povidone-iodine on the incidence of infection in surgical wounds. 700 94

The effect of povidone iodine on wound sepsis following gastrointestinal surgery was studied in a trial involving 153 patients of whom 72 had their wounds sprayed with povidone iodine dry powder (Disadine DP) and 81 acted as a control group. The infection rate of 9.9 per cent in the patients treated with povidone iodine was significantly lower than that of 24.4 per cent in the control group (P less than 0.05). Bacterial contamination of the wound at the time of operation was shown to be of importance, being associated with a 52 per cent infection rate in the control group. However, spraying of contaminated wounds with povidone iodine reduced the infection rate to the significantly lower level of 11 per cent (P less than 0.05). We conclude that povidone iodine is a safe and effective means of reducing wound sepsis following gastrointestinal surgery.
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PMID:The effect of topical povidone iodine on wound infection following abdominal surgery. 701 95

From studies in mice, the irrigation of a contaminated surgical wound saline alone proved of little benefit. The addition of cefazolin to the irrigating solution favorably influenced the rate of infection. The most effective way to administer antibiotics topically was by the application of the antibiotic powder to the wound. Topical cefazolin administered in this way was equally as effective as systemic administration in preventing wound sepsis. Irrigation of a contamined wound with a solution of povidone-iodine was no more effective than the use of cefazolin powder but may be associated with significant toxicity.
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PMID:Prevention of wound infection: the comparative effectiveness of topical and systemic cefazolin and povidone-iodine. 708 46


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