Surgical-site infection surveillance in General Surgery: A critical issue

This prospective study assessed the Surgical Site Infection (SSI) rates in General Surgery and the microorganisms isolated. From January 2000 to October 2000, 898 patients were enrolled and electively operated in a General Surgery Clinic in Athens, Greece. Pre-coded questionnaires were used. The diagnosis and surveillance of SSIs was made by the surgeon-investigator who interviewed the patients. Patients were monitored during hospitalization and post-discharge for 30 days. Overall, 402 patients underwent a clean and 496 patients underwent a clean-contaminated operation. A total of 17 SSIs (4.2%) were observed in clean and 64 SSIs (12.9%) in clean-contaminated operations. Microorganisms were isolated in 36 of 65 (55%) of cases that microbiological evaluation was performed. Staphylococcus aureus was the commonest microorganism isolated, followed by Escherichia coli and Pseudomonas aeruginosa. SSI rates were higher than expected and most SSIs, 43 of 81 (53.1%), were diagnosed post-operatively. Post-discharge surveillance of SSIs remains a critical issue. Health care professionals, especially surgeons, should participate in surveillance networks and be aware of the results so to take appropriate action

Attenuation of post-infarction remodeling in rats by sustained myocardial growth hormone administration

Prevention of left ventricular remodeling is an important therapeutic target post-myocardial infarction. Experimentally, treatment with growth hormone (GH) is beneficial, but sustained local administration has not been thoroughly investigated. We studied 58 rats (322 ± 4 g). GH was administered via a biomaterial-scaffold, following in vitro and in vivo evaluation of degradation and drug-release curves. Treatment consisted of intra-myocardial injection of saline or alginate-hydrogel, with or without GH, 10 min after permanent coronary artery ligation. Echocardiographic and histologic remodeling-indices were examined 3 weeks post-ligation, followed by immunohistochemical evaluation of angiogenesis, collagen, macrophages and myofibroblasts. GH-release completed at 3 days and alginate-degradation at ∼7 days. Alginate + GH consistently improved left ventricular end-diastolic and end-systolic diameters, ventricular sphericity, wall tension index and infarct-thickness. Microvascular-density and myofibroblast-count in the infarct and peri-infarct areas were higher after alginate + GH. Macrophage-count and collagen-content did not differ between groups. Early, sustained GH-administration enhances angiogenesis and myofibroblast-activation and ameliorates post-infarction remodeling. © 2015 Taylor and Francis