Risk factors for surgical site infections following clean orthopaedic operations

Background: Surgical site infections can follow clean orthopaedic operations and can cause serious morbidity, mortality and increased resource utilization. Despite this, there are few studies on risk factors for surgical site infections in the Nigerian orthopaedic literature. We conducted a prospective study to determine the host and environmental risk factors for surgical site infections following clean orthopaedic operations.Materials and Methods: Consecutive patients who satisfied the inclusion criteria and were to undergo clean orthopaedic operations performed at the National Orthopaedic Hospital, Igbobi, Lagos from January 2007 to July 2008 were included. Patient’s biodata, duration of preoperative hospitalization and other risk factors were analyzed. The risk factors for surgical site infection were determined with Chi square test.Results: The overall rate of surgical site infection during the 18 months of the study was 9.9% (12 of 121). Independent risk factors for this were: Prolonged duration of preoperative hospital stay greater than 13 days (21% infection rate), increasing age greater than 60 years (31% infection rate), and use of implants and drains (only one un‑drained wound was infected).Conclusion and Recommendations: Patient’s age, duration of preoperative hospitalization, type of surgery (implant or non‑implant), and use of drains were the most significant risk factors affecting surgical site infection. It is recommended that preoperative hospital stay should be as short as possible and extra care/precautions taken when working on the elderly, using implants or requiring drainage.Keywords: Clean orthopaedic operations, risk factors, surgical site infectionNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Plastic surgery in Nigeria-Scope and challenges

Background Plastic surgery as a major subspecialty of surgery has existed in Nigeria for several decades but the populace including medical practitioners are yet to fully appreciate its scope. This leads to very late presentation/referral of cases and management of cases that should have been referred by less qualified practitioners with attendant poor outcomes and complications. Most people still regard plastic surgery as being synonymous with cosmetic/aesthetic surgery but the scope goes far beyond this entity. It is therefore important that the public including medical practitioners who are the main sources of referral to the subspecialty are aware of the range of cases handled by plastic surgery units. The plastic surgeon in Nigeria is also faced with a lot of challenges ranging from the arduous task of one having to manage very many different and complicated cases to being very poorly equipped and appreciated. Objectives To educate the populace especially the medical practitioners on the scope of plastic surgery and the extent of development of the subspecialty in Nigeria and solicit for colleague′s cooperation in order to move plastic surgery forward. To also highlight the difficulties faced by the plastic surgeon in Nigeria and seeking help from appropriate quarters which will help to reduce unnecessary referrals abroad while improving the services rendered to patients locally. Conclusion Plastic surgery in Nigeria has developed significantly both in scope and manpower but it is still faced with a lot of challenges. Knowledge of its scope will help to reduce unnecessary referrals abroad while improving services/skill here in Nigeria

CD4 counts in HIV positive subjects before and during antiretroviral therapy

No Abstract.Journal of Biomedical Investigation Vol. 5 (2) 2007 pp. 66-6

Groin flap for coverage of upper extremity defects in Enugu, Nigeria

No Abstract. Nigerian Journal of Medicine Vol 15 (3) July-September: 295-29

An Accessory Flexor Of The Thumb

The presence of accessory muscles, nerves and other tissues/organs in the upper limb and other parts of the body of some individuals have been previously reported. We report the case of a cadaver with an accesort flexor muscle of the left thumb. This muscle is located on the volar aspect of the left forearm. It originates from the lower fibres of flexor digitorum superficialis (sublimis) and inserts into the tendon of flexor pollicis longus. It is supplied by the median nerve and produced flexion of the thumb and the grasp mechanism of the individual. We have named it \"Flexor Pollicis Accesorius\". Awareness of this is important to Anatomists and surgeons especially plastic/hand surgeons.Key words: Muscle, Thumb, Flexor, Anatomic variationJournal of Experimental and Clinical Anatomy Vol. 4 (1) 2005: 15-1

Morphometric study of nasal parameters in Igbos, South East Nigeria

No Abstract

Pattern of severe electrical injuries in a Nigerian regional burn centre

Background: The causes and incidence of the commonly observed phenomenon of leaving against medical advice (LAMA) in our hospitals have not been studied. This retrospective study was aimed at evaluating its incidence and pattern in order to suggest possible solutions. Methodology: The case files of patients who left against medical advice at the Casualty unit of the University of Calabar Teaching Hospital between July 2002 and December 2003 were retrieved from the Medical Records Department and information regarding age, sex, education/occupation, religion, diagnosis, reason(s) for leaving and duration of stay in casualty were extracted. Results: A total of 3708 patients were seen at the casualty unit within this period. Ninety-seven patients left against medical advice but only ninety case notes were analyzable. Seven folders had incomplete information. Male /Female ratio was 2:1 and the ages ranged between 7 and 70 years (average 31.5 years).The average duration of stay in Hospital was 2.4 days (1—10days). Sixty-five patients (72.2%) were those who had various forms of trauma while 8 (8.8%) had general surgical problems. 19% (17) patients had medical emergencies. Conclusion: The youths are the most vulnerable group and the principal causes in our environment are ignorance and poverty. Because of poor documentation in our centres, it was not possible to know where these patients go and the results of their treatments. There is therefore a need for further studies. Keywords: Incidence; Leaving against medical advice (LAMA); Casualty Nigerian Journal of Clinical Practice Vol. 9 (2) 2006: pp.124-12

Left Fronto - Ethmoidal Sinusitis Complicated By A Contralateral Subdural Abscess - A Case Report

Subdural abscess although very rare is one of the most frequently encountered intracranial complication of sinusitis.A case of contralateral subdural abscess is most unusual. This paper reports the management of a 14 year old male that presented with a left frontoethmoidal sinusitis complicated by a right subdural abscess. The patient recovered fully after a left fronto-ethmoidectomy and right Burr hole drainage of subdural abscess at same anaesthetic session by the ENT and Neurosurgery team respectively. Timely intervention and the benefit of multidisciplinary approach are highlighted and the use of enhanced Computerized Tomography is sine qua non to optimal treatment

The abdomino-hypogastric flap in soft tissue reconstruction of the hand

Background: The hand is the most frequently injured part of the human body. Extensive tissue losses of the hand have remained a big reconstructive challenge to the plastic and reconstructive surgeon. Advances in microsurgery have transformed hand reconstruction, but in the Nigerian environment limited facilities necessitate that the pedicle abdomino-hypogastric flap should remain an option. We aim at discussing the use of abdomino-hypogastric flap for hand reconstruction in our centre, and make suggestions for improvement.Method: The case records of patients with upper extremity defects treated with abdomino-hypogastric flap at the National Orthopaedic Hospital, Enugu over a six year period – January 2000 to December 2005 werereviewed. Information on bio data, presentation, management and outcome were extracted and analysed.Results: Eleven patients’ case files met the inclusion criteria. There were eight males and three females. Their ages ranged from two years to 47 years. The injuries were mainly post traumatic/crush (in five patients)and defects following release of post burns contractures (in four patients). All flaps had satisfactory survival and complications such as shoulder discomfort and a wide scar were few and well tolerated giving an overallsatisfactory outcome.Conclusion: Use of pedicled abdomino-hypogastric flap for reconstruction of upper extremity defects remains a very viable option in our environment and is recommended to those working under similarconditions of very limited resources.Key words: Abdomino-hypogastric, pedicle flap, hand defects reconstruction