41 research outputs found
Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique
- Author
- Publication venue
- BioMed Central
- Publication date
- 01/01/2009
- Field of study
<p>Abstract</p> <p>Background</p> <p>Incisional hernia after abdominal surgery is a well-known complication. Controversy still exists with respect to the choice of hernia repair technique. The objective of this study was to evaluate the long-term recurrence rate as well as surgical complications in a consecutive group of patients undergoing open repair using an onlay mesh technique.</p> <p>Methods</p> <p>Consecutive patients undergoing open incisional hernia repair with onlay-technique between 01/05/1995 and 01/09/2007 at a single institution were included in the study. For follow-up patients were contacted by telephone, and answered a questionnaire containing questions related to the primary operation, the hernia and general risk factors. Patients were examined by a consultant surgeon in the outpatient clinic or in the patient's home if there was suspicion of an incisional hernia recurrence.</p> <p>Results</p> <p>The study included 56 patients with 100% follow-up. The median follow-up was 35 months (range 4–151). Recurrent incisional hernia was found in 8 of 56 patients (15%, 95% CI: 6–24). The overall complication rate was 13% (95% CI, 4–22). All complications were minor and needed no hospital admission.</p> <p>Conclusion</p> <p>This study with a long follow-up showed low recurrence and complication rates in patients undergoing incisional hernia repair with the open onlay technique.</p
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
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- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
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- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W.
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
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- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A.
- Alhady Khaled
- Alhammali Tariq
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- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
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- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Malignant melanoma arising from a perianal fistula and harbouring a BRAF gene mutation: a case report
- Author
- B Abboud
- B Cagir
- BM Helmke
- C Jhappan
- C Peyssonnaux
- C Thibault
- Conrado Martinez-Cadenas
- CW Wong
- D Mayr
- DE Aust
- Enrique Boldó
- Enrique Ochoa
- ES Calhoun
- Esther Flores-Couce
- ET Kimura
- F Schönleben
- G Singer
- GH Welch
- H Davies
- I Iesalnieks
- J Homsi
- JA Curtin
- Javier Munárriz
- JL Rees
- JM Debets
- JR Jass
- JT Droesch
- Juan P Aracil
- K Mees
- L Venclauskas
- LB Yap
- Lucas Peñas
- M Thomas
- M Xing
- MA Weinstock
- Marcos Tajahuerce
- MN Kulaylat
- MS Brady
- Nuria Bosch
- O Olsha
- PH Cooper
- PM Pollock
- Rafael Lozoya
- Ramón Royo
- RH Edwards
- S Yadoo
- T Morita
- T Nagasaka
- T Seya
- TK Larmi
- VT Fripp
- WQ Li
- Y Cohen
- Y Erhan
- Publication venue
- BioMed Central
- Publication date
- 01/01/2011
- Field of study
<p>Abstract</p> <p>Background</p> <p>Melanoma of the anal region is a very uncommon disease, accounting for only 0.2-0.3% of all melanoma cases. Mutations of the <it>BRAF </it>gene are usually absent in melanomas occurring in this region as well as in other sun-protected regions. The development of a tumour in a longstanding perianal fistula is also extremely rare. More frequent is the case of a tumour presenting as a fistula, that is, the fistula being a consequence of the cancerous process, although we have found only two cases of fistula-generating melanomas reported in the literature.</p> <p>Case Presentation</p> <p>Here we report the case of a 38-year-old male who presented with a perianal fistula of four years of evolution. Histopathological examination of the fistulous tract confirmed the presence of malignant melanoma. Due to the small size and the central location of the melanoma inside the fistulous tract, we believe the melanoma reported here developed in the epithelium of the fistula once the latter was already formed. Resected sentinel lymph nodes were negative and the patient, after going through a wide local excision, remains disease-free nine years after diagnosis. DNA obtained from melanoma tissue was analysed by automated direct sequencing and the <it>V600E </it>(<it>T1799A</it>) mutation was detected in exon 15 of the <it>BRAF </it>gene.</p> <p>Conclusion</p> <p>Since fistulae experience persistent inflammation, the fact that this melanoma harbours a <it>BRAF </it>mutation strengthens the view that oxidative stress caused by inflammatory processes plays an important role in the genesis of <it>BRAF </it>gene mutations.</p
Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations.
- Author
- Balderi T
- Bjerregaard L S
- Chan E Y
- Choi P T
- David A McDonald
- de Beer J
- Group. ERAS Compliance
- Gustafsson U O
- Hansen T B
- Henry D A
- Kehlet H
- Kelly E G
- McDonald S
- Mike Gill
- Mike Reed
- Munoz M
- Olle Ljungqvist
- Ong C K
- Opinder Sahota
- Oppedal K
- Parker M J
- Piers Yates
- Robert G Middleton
- Sah A P
- Smith M D
- Sprowson A
- Theusinger O M
- Thomas W Wainwright
- Thomsen T
- Venclauskas L
- Zhu N
- Publication venue
- 'Informa UK Limited'
- Publication date
- 01/01/2020
- Field of study
Background and purpose - There is a large volume of heterogeneous studies across all Enhanced Recovery After Surgery (ERAS®) components within total hip and total knee replacement surgery. This multidisciplinary consensus review summarizes the literature, and proposes recommendations for the perioperative care of patients undergoing total hip replacement and total knee replacement with an ERAS program.Methods - Studies were selected with particular attention being paid to meta-analyses, randomized controlled trials, and large prospective cohort studies that evaluated the efficacy of individual items of the perioperative treatment pathway to expedite the achievement of discharge criteria. A consensus recommendation was reached by the group after critical appraisal of the literature.Results - This consensus statement includes 17 topic areas. Best practice includes optimizing preoperative patient education, anesthetic technique, and transfusion strategy, in combination with an opioid-sparing multimodal analgesic approach and early mobilization. There is insufficient evidence to recommend that one surgical technique (type of approach, use of a minimally invasive technique, prosthesis choice, or use of computer-assisted surgery) over another will independently effect achievement of discharge criteria.Interpretation - Based on the evidence available for each element of perioperative care pathways, the ERAS® Society presents a comprehensive consensus review, for the perioperative care of patients undergoing total hip replacement and total knee replacement surgery within an ERAS® program. This unified protocol should now be further evaluated in order to refine the protocol and verify the strength of these recommendations
Global economic burden of unmet surgical need for appendicitis
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- Aamer A.
- Aaniana K.
- Ababneh A.
- Abaliksta T.
- Abantanga F.
- Abbas M.
- Abbasy J.
- Abbo O.
- Abbouch M.
- Abd-Elmawla M.
- Abd-Elrasoul Y.
- Abdallah E.
- Abdel-Aty A.
- Abdel-Hameed N.
- Abdel-Kader S. M.
- Abdel-Wahab N. Y. E.
- Abdelaal A.
- Abdelaty M.
- Abdelazeam A. R.
- Abdelazim G.
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- Abdelfatah A.
- AbdelFattah I.
- Abdelgelil A.
- Abdelghany S.
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- Abdelhamed R.
- Abdelhamid A.
- Abdelhaq A.
- Abdelkader M.
- Abdelkader O.
- Abdelkareem A.
- Abdelkhalek M.
- Abdelmageed E.
- Abdelmotaleb I.
- Abdelraheim M.
- Abdelraouf A. M.
- Abdelrouf D. M.
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- Abdulaziz H.
- Abdulbagi O.
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- Abdulhakeem E. M.
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- Publication venue
- Oxford University Press
- Publication date
- 01/01/2022
- Field of study
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
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- Aamer A
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- Abd El Hamid N
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- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
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- Abdel-Kader SM
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- Ahlqvist S
- Ahlqvist S
- Ahmed A
- Ahmed A
- Ahmed A
- Ahmed EA
- Ahmed H
- Ahmed H
- Ahmed H
- Ahmed LAM
- Ahmed S
- Ahmed S
- Ahmed SM
- Ahounou EYS
- Aigrain Y
- Aiyaman C
- Ajah J
- Ajai O
- Ajao A
- Ajao AE
- Ajiboye A
- Akatibo E
- Akeel N
- Akhtar M
- Akoto E
- Akpenyi O
- Al Amin S
- Al Attar SM
- Al Awwad S
- Al Barrawi FE
- Al Bastawis F
- Al Meligy A
- Al Rafati AAR
- Al Raouf EA
- Al Saied G
- Al Subaie N
- Al-Aarag AA-R
- Al-Azraqi IAA
- Al-Bahrani A
- Al-Buhaisi A
- Al-Dakka E
- Al-Faifi JJ
- Al-faqawi M
- Al-farram H
- Al-Hameedi HII
- Al-Hasani RKMJ
- Al-khatib A
- Al-Mallah A
- Al-Marakby D
- Al-Mousa M
- Al-Nahrawi S
- Al-Obaedi O
- Al-saqqa S
- Al-Saqqa SW
- Al-Saqqa SW
- Al-shammari A
- Al-Slaibi I
- Al-taher T
- Alaael-Dein S
- Alada M
- Alahmady O
- Alakaloko F
- Alakaloko F
- Alaloul E
- Alamin S
- Alamoudi M
- Alamoudi U
- Albeladi B
- Albiety A
- Alcca Ticona W
- Aldalaq A
- Aldhafeeri S
- Aledrisy M
- Alejos Bermudez YE
- Alexander P
- Alexander P
- Alexander P
- Alexandre C
- Alfarsi MA
- Alghamdi A
- Alghamdi B
- Alghamdi M
- Alghamdi MSA
- Algohary O
- Alhabli I
- Alhady K
- Alhammali T
- Alhassan B
- Alhazmi W
- Alhendy M
- Alherz M
- Ali A
- Ali A
- Ali A
- Ali CDM
- Ali E
- Ali FM
- Ali H
- Ali S
- Ali SAWEW
- Ali SS
- Ali THA
- Ali W
- Alihonou T
- Alimi Q
- Alis H
- Aliyu H
- Aliyu M
- Aliyu S
- Aljboor K
- Aljiffry M
- Aljiffry M
- Aljohani E
- Aljohani E
- Aljohani S
- Alkaaki A
- Alkammash A
- Alkelani M
- Alkhabbaz D
- Alkhouri M
- Allam M
- Allam M
- Allam Y
- Allegri A
- Allegri A
- Allen JLY
- Allott R
- Almallah A
- Almoflihi A
- Almuallem S
- Almy J
- Alnaby MH
- Alnawam E
- Alnuqaydan SA
- Alnusairat A
- Alomar IN
- Alqahtani E
- Alqahtani S
- Alrahawy M
- Alrajraji M
- Alrifaie A
- AlRowais M
- Alsaggaf M
- Alsaggaf MU
- Alsaggaf MU
- Alser OH
- Alshareef R
- Altaf A
- Altaf A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamini A
- Altarayra M
- Althwainy A
- Altibi A
- Altinel Y
- Altinel Y
- Altoe F
- Altwigry AM
- Altwijri A
- Alvarado Jaramillo R
- Alvarez Barreda LM
- Alvi AR
- Alwafai MG
- Aly AK
- Aly MYM
- Alyacoubi S
- Alyahya R
- Alyami R
- Alyami R
- AlYoussef I
- Alzahrani A
- Alzahrani M
- Alzahrani M
- Alzayat T
- Aman NF
- Amandito R
- Amandito R
- Amandito R
- Amandito R
- Ambrona-Zafra D
- Ambrozeviciute V
- Ameen M
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- Amin HAA
- Amin J
- Amin J
- Amjad M
- Ammar M
- Ammar MS
- Amoah M
- Amoako J
- Amoako PT
- Amoako-Boateng M
- Amole I
- Amreia M
- Amreia M
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- Anderson D
- Anderson F
- Anderson R
- Anderson-Knight H
- Andersson L
- Andika FFA
- Andreotti D
- Andres Garcia-Marin J
- Andress C
- Andriola V
- Ang YL
- Angelieri D
- Anis E
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Antar S
- Antezana D
- Anthoulakis C
- Anthoulakis C
- Antoniozzi A
- Anwar AW
- Anwar N
- Anwer W
- Anyanwu L-J
- Anyanwu L-J
- Aonzo P
- Appeadu-Mensah W
- Appiah EK
- Aql S
- Aquilino F
- Arachchi PP
- Arachchige LAJJ
- Arafa O
- Arafa S
- Arango MCM
- Arango MCM
- Aranzabal Durand SY
- Araujo R
- Arcudi C
- Ardley R
- Arenas A
- Arevalo Azmitia JR
- Arias Pacheco RD
- Arman S
- Arman S
- Armando ChunguiBravo J
- Armellini A
- Arnaud A
- Arnaud AP
- Arnaud AP
- Arnaud AP
- Arroyo Basto CA
- Arshad MM
- Arslan E
- Arsyad HM
- Arthur T
- Arulampalam T
- Aruldas N
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- Asar YH
- Asare-Bediako K
- Asele FA
- Ashour A
- Ashour A
- Ashour K
- Ashraf SF
- Ashtari M
- Ashton A
- Asi F
- Asilah SMD
- Assal A
- Assouto PA
- Asturia S
- Asumah H
- Ata A
- Ata AAA
- Ata AY
- Atiyeh A
- Atkins ET
- Atkinson K
- Atobatele K
- Attallah NA
- Attard M
- Attia A
- Attia AM
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- Aung KP
- Austraite A
- Aviles S
- Avoka A
- Awad I
- Awad SA
- Awadallah S
- Awuku-Asabre J
- Ayad S
- Ayandipo O
- Ayandipo OO
- Aydin MC
- Ayyar S
- Aziz DNA
- Aziz MRA
- Aziz NA
- Azizeldine MG
- Azmitia Mendizabal CA
- Azodo IA
- Azzie G
- Azzie G
- Azzis O
- Baba S
- Bachri H
- Badawy M
- Badenjki MA
- Badicel M
- Badr A
- Badr MFM
- Badwi NM
- Badwi NM
- Badwy A
- Bahar S
- Baheeg M
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- Baillie K
- Baird A
- Bakhaidar M
- Baki BE
- Bakr A
- Bakry HM
- Bala M
- Balalis D
- Baldacchino M
- Balducci G
- Balila RMH
- Balkan AZA
- Ballouhey Q
- Balmaceda R
- Balmaceda R
- Balmaceda R
- Balogun F
- Baltrunas R
- Baluch F
- Bamford R
- Bamicha A
- Bamicha A
- Banaitis VJ
- Bandi A
- Bandoh D
- Bani-Sadar A
- Banipal GS
- Baraka H
- Barakat SAE
- Barendegere V
- Barker T
- Barkolias C
- Barmayehvar B
- Barnabas GN
- Barnacle J
- Barneo L
- Barrionuevo Ojeda RR
- Barrios E
- Barrios E
- Barros De Castro Segundo LC
- Barroso de Lima CV
- Barry J
- Basilico S
- Basir ERM
- Bassem M
- Bassit KA
- Basso SMM
- Basson S
- Batt J
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- Beamon M
- Beasley W
- Beaton C
- Bedada AG
- Bediako-Bowan A
- Behar N
- Beisa V
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- Bekhet AH
- Bekhet NM
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- Belkouchi A
- Belli A
- Bello B
- Benammi S
- Benevento A
- Benevento A
- Benger M
- Bennai RM
- Benons N
- Bentounsi Z
- Benyaiche C
- Berti S
- Bertuello I
- Beuran M
- Beuran M
- Beyene R
- Bezerra Morais PA
- Bezzina M
- Bhang A
- Bhangu A
- Bhangu A
- Bhargava A
- Bharj IS
- Bhat S
- Bhatnagar A
- Bhattacharya S
- Bhopal KF
- Bhopal KF
- Bianco F
- Bigaran A
- Billy M
- Bin Adnan A
- Bin Hasnan M
- Bin Ismail MJ
- Bin Mahamood A
- Birindelli A
- Birring A
- Bisset C
- Bjorklund I
- Bjorklund I
- Blacker S
- Blackwell J
- Blanco R
- Blanco-Colino R
- Blencowe N
- Blencowe N
- Bliksoen M
- Blower E
- Bluelle R
- Blundell R
- Boakye-Yiadom K
- Boal M
- Bocchetti T
- Boddy A
- Bode C
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- Bodur S
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- Boijsen M
- Bokhari S
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- Bonavina L
- Bond-Smith G
- Bondin J
- Bondurri A
- Bondurri A
- Boni S
- Bonnard A
- Bonney W
- Borda Luque G
- Borda-Luque G
- Borda-Luque G
- Borg E
- Borg E
- Borg E
- Borin E
- Bortolasi L
- Bortolasi L
- Boshnaq M
- Botes S
- Bottini C
- Botto N
- Bouali O
- Bougard H
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- Bowabsak A
- Bowe R
- Bowley D
- Bowling K
- Bowman C
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- Bradulskis S
- Bradulskis S
- Bratu M
- Bratu MR
- Bratu R-M
- Braungart S
- Bray LD
- Breaud J
- Breistrand M
- Breitenstein S
- Breslin R
- Brincat SD
- Broch A
- Brogden T
- Brown D
- Brown E
- Brown J
- Brown J
- Browning DRL
- Brunoni B
- Bsisu I
- Bucci L
- Bugaev N
- Bugeja R
- Buisson P
- Bukari M
- Bunting D
- Burger S
- Burmistrovas A
- Burns H
- Bustangi N
- Butt MT
- Cabala Chiong JA
- Cabala Chiong JA
- Cacurri A
- Cadogan DD
- Cahill R
- Cakaloglu HC
- Caliman C
- Callan R
- Camacho R
- Cameron B
- Camilleri GM
- Camilleri-Brennan J
- Camilleri-Brennan J
- Camilleri-Brennan JF
- Camilo Correa J
- Campagnaro T
- Canta Calua A
- Capito C
- Capleton P
- Carabott K
- Careta MC
- Carlucci M
- Carmela Lapitan M
- Carmona JM
- Carpio J
- Carrasco N
- Carreira J-A
- Carreiro De Freitas AV
- Cassar K
- Castro Mollo M
- Catani M
- Cautiero R
- Caydiid H
- Cecilia T
- Celik S
- Cengiz TB
- Cengiz Y
- Cengiz Y
- Cengiz Y
- Cengiz Y
- Ceriani C
- Cevik M
- Chabok A
- Chachulski W
- Chai C-A
- Chai FY
- Chambers A
- Chambers A
- Chan E
- Chan L
- Chan T-YK
- Chan XW
- Chan Z
- Chandrakumar C
- Chang K
- Chang KY-C
- Chapman A
- Chapman SJ
- Charles A
- Cheah AEZ
- Chen CY
- Chen KY
- Chen T-L
- Chenn R
- Cheong YJ
- Chetta N
- Cheung YHE
- Chew LS
- Chhabra S
- Chibuye C
- Chidambaram S
- Chiesa D
- Chilton G
- Chin PX
- Chin YR
- Chiu S
- Chiu S
- Chiu SMY
- Choi J
- Choi P
- Chong BFHK
- Chong CL
- Chong CL
- Chong CL
- Chong CS
- Chong H-Y
- Chong HY
- Choudhry A
- Chow CYN
- Chowdhury A
- Chowdhury D
- Chu K
- Chun A
- Chun T
- Chung KJ
- Chung S
- Ciccioli E
- Cirocchi R
- Ciubotaru C
- Claire R
- Clarissa A
- Clark DJ
- Clark T
- Clegg-Lampety J-N
- Clegg-Lamptey J-N
- Clement KD
- Clements JM
- Clerico G
- Clifford C
- Cloro LM
- Coasaca Huaraya R
- Coccolini F
- Coccolini F
- Coccolini F
- Coccolini F
- Cocker DM
- Cocorullo G
- Cohen DM
- Cohen F
- Cole S
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- Coletti M
- Colombani J-F
- Cona C
- Conci S
- Confalonieri G
- Conlon KC
- Connor K
- Connor K
- Contreras Merida SM
- Contreras Urquizu M
- Contreras Vergara AL
- Contreras E
- Coomber R
- Coompson CL
- Corbellini C
- Corbellino M
- Cornick J
- Coronel J
- Corro-Diaz Gonzalez S
- Corro-Diaz S
- Costa C
- Costa-Maia J
- Costa-Maia J
- Costas-Chavarri A
- Costas-Chavarri A
- Courboin E
- Court E
- Cox D
- Cox M
- Coyoy-Gaitan O
- Cragg J
- Craus-Miguel A
- Cross K
- Cruz DH
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- Cucumazzo S
- Cullen F
- Curletti G
- Currow C
- Currow C
- D'aguzan N
- D'Amours S
- D'amours SK
- D'cruz R
- D'Souza MS
- D'Souza R
- Da Silva LA
- Dabboor M
- Dabbour K
- Dabessa D
- Dablouk M
- Dablouk MO
- Dagoe E
- Dahy A
- Dainius E
- Dakubo J
- Dal Canto M
- Dalli J
- Dally C
- Dambrauskas Z
- Dambrauskas Z
- Dan I
- Danelli P
- Daniels I
- Daniyan M
- Danys D
- Dao W
- Daqeeq A
- Dar M
- Dar W
- Dardenne S
- Darweesh M
- Darwish AKZ
- Das A
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- Das S
- Dasari M
- Dashnyam E
- Dassah V
- Datta U
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- Dayie M
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- De Franciscis S
- De Luca E
- De Marco P
- De Sousa AV
- Deal R
- Dean R
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- Debrah S
- Deckelbaum DL
- Decker E
- Dedekind B
- Dedey F
- Deichsel F
- Del Basso C
- del Pilar Paucar A
- Delforge X
- Dell A
- Dempster E
- Denakpo M
- Denewar A
- Depalma N
- Deputy M
- Der Y
- Dervenis C
- Despotidis V
- Desta S
- Deutschmann P
- Devadasar GH
- Dharamshi HA
- Dhillon D
- Di Franco F
- Di Martino N
- Di Saverio S
- Di Saverio S
- Diab A
- Diaconescu B
- Diaconescu I-B
- Dias S
- Diaz Vico T
- Diaz-Jover P
- Diaz-Zorrilla C
- Dick L
- Dickfos M
- Dickson L
- Dijan E
- Dimech T
- Din F
- Dindyal S
- Dindyal S
- Dione Parreno-Sacdalan M
- Dissanayake T
- Djivoh F
- Domini E
- Domini E
- Donnelly P
- Donoghue D
- Dorani RMNR
- Dorisme A
- dos Santos DV
- Dossou F
- Doughan S
- Doughty J
- Dousset B
- Dragatas D
- Drake TM
- Drake TM
- Drake TM
- Driscoll A
- Drungilas M
- Du Plessis D
- du Plooy F
- Du Toit F
- Duane T
- Dubois A
- Duffy L
- Duhoranenayo D
- Duinhouwer L
- Dulskas A
- Dwydar A
- Ebdewi H
- Ebidy M
- Ebidy MM
- Ebrahim OS
- Eduard P
- Edwards J
- Edye M
- Eid MM
- Eisner L
- Ekow M
- El Ashal G
- El Dahab AA
- El Deen KN
- El Gendy A
- El Gendy NH
- El Halawany M
- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El-badawy HA
- El-Dien KS
- El-Dien KS
- El-Din RA
- El-Din SA
- El-Gizawy E
- El-Hamouly AS
- El-Kashef H
- El-Latif NK
- El-Ma'doul AS
- El-Rabaa S
- El-Sagheer N
- El-Sawy A
- El-Sehily A
- El-Shahat NS
- El-Sheemy H
- El-Taher E
- Elabdin HZ
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem AA
- Elazoul M
- Elbanby E
- Elbanby ES
- Elbatahgy A
- Elbe P
- Elbermawy M
- Elbisomy KH
- Eldafrawy M
- Eldamaty L
- Eldeeb AZ
- Eldeen EA
- Eldin MAB
- EldosoukyMohammed A
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
- Elfouly Y
- Elgebaly A
- Elgendy AH
- Elgendy FI
- Elgheriany M
- Elhadad A
- Elhadary NM
- Elhadry S
- Elhalawany E
- Elhamouly S
- Elhelbawy MS
- Elhendawy A
- Elhendawy AOA
- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek EA
- Elkholy A
- Elkholy SS
- Elkolaly SS
- Elkorashy AM
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar MA
- Elnemr AE
- Elrazek AA
- Elsabbagh N
- Elsameea AA
- Elsawahly DME
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed NAR
- Elsayed ZM
- Elsebaaye AO
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay AE
- Elshami M
- Elshanwany S
- Elsharkawy AA
- Elsheikh S
- Elsherbiney S
- Elsherbiny AS
- Elsherif FA
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy DEAA
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escalante Salas MDC
- Espin-Basany E
- Espinoza F
- Essam A
- Essam AA
- Essam M
- Essoun S
- Esteban E
- Estee MM
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
- Evajelista CV
- Evans D
- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahmy MAB
- Fahy C
- Fairfield C
- Fairfield C
- Fairfield C
- Fairfield C
- Fakher R
- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat MM
- Faraz A
- Fares M
- Farhad M
- Farhan-Alanie MMH
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk SAM
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy AM
- Fattah AA
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe CO
- Fergany A
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fermani C
- Fermani CG
- Fernandes C
- Fernandez C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald JE
- Fitzgerald JE
- Florez Farfan ES
- Foco M
- Fok CYJ
- Fontana T
- Foo CC
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler AJ
- Fozard T
- Fozard T
- Frade F
- Fraga GP
- Francisco Roxas M
- Franco H
- Francois P
- Francois-Coridon H
- Francone E
- Freitas AV
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan MM
- Gaafar S
- Gaarder T
- Gad A
- Gad MO
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaignard E
- Gaignard E
- Gaizauskas V
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez CP
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan YY
- Gani MA
- Garaycochea O
- Garcia Bernardo C
- Garcia Florez LJ
- Garcia Septiem J
- Garcia Torres CP
- Garcia-Florez L
- Garland A
- Gash K
- Gash K
- Gash K
- Gastaldi P
- Gasteratos K
- Gaujoux S
- Gavagna L
- Gbessi DG
- Gemeah M
- Gemenetzis G
- Gemenetzis G
- George R
- Germanos S
- Germanos S
- Gerosa A
- Gerosa A
- Geuoshy A
- Ghaben A
- Ghandora N
- Ghanem A
- Ghanem E
- Ghanem S
- Ghanem S
- Ghannam M
- Gharib A
- Gharib A
- Ghazy AA
- Gheith A
- Ghetia M
- Ghetia M
- Ghonaim MA
- Ghoneem M
- Ghoneim O
- Giacci L
- Giardino FR
- Giavarini L
- Giglio MC
- Gilbert R
- Gilbert RW
- Giles J
- Gillespie M
- Gimzewska M
- Giraldo RSR
- Giuliani S
- Giuliani S
- Giuriato TF
- Gkiokas G
- Glasbey J
- Glasbey J
- Glasbey JC
- GlobalSurg Collaborative
- Glover TE
- Glover-Addy H
- Glynn M
- Gobin N
- Gobin N
- Goh CC
- Goh CC
- Goh W
- Gohar ME-SAM
- Gokani S
- Goldin E
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- Wold TB
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- Yeung MHA
- Yifieyeh A
- Yildirim R
- Yip C
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- Yoganathan P
- Yolcu S
- Yong CO
- Yong GL
- Younis A
- Youssef D
- Youssef H
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- Zaa'treh R
- Zachariades D-C
- Zadoroznas A
- Zahran D
- Zakaria E
- Zakaria M
- Zakaria Y
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- Zamarin K
- Zammit S
- Zampitis N
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- Zapata Ponze De Leon M
- Zapata Ponze De Leon M
- Zapata F
- Zarb C
- Zardab A
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- Zerihun AB
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- Zilinskiene R
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- Ziubryte G
- Zohair A
- Zorrilla CD
- Zuber M
- Zuber M
- Zuk G
- Zulkifli A
- Zumbuhl L
- Publication venue
- Publication date
- 15/10/2018
- Field of study
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
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- Wilson Michael
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- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
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- Worku Mengistu
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- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
- Author
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- &apos
- Aahlin Ek
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
- Abbas A
- Abbas M
- Abbasy J
- Abbo O
- Abbo O
- Abbott T
- Abbouch M
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader Sm
- Abdel-Wahab Nye
- Abdelaal A
- Abdelaty M
- Abdelazeam Ar
- Abdelazim G
- Abdelaziz Ma
- Abdelbadeai K
- Abdelfatah A
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelhady S
- Abdelhamed R
- Abdelhamid A
- Abdelhaq A
- Abdelkader M
- Abdelkader M
- Abdelkader O
- Abdelkareem A
- Abdelkhalek M
- Abdelmageed E
- Abdelmotaleb I
- Abdelraheim M
- Abdelraouf Am
- Abdelrouf Dm
- Abdelshafy M
- Abdelshakour M
- Abdrabou Ak
- Abdul-Latif S
- Abdulaziz H
- Abdulaziz M
- Abdulbagi O
- Abdulgawad M
- Abdulhakeem Em
- Abdullah Ma
- Abdullah N
- Abdullah Nan
- Abdullah Nan
- Abdullahi L
- Abdurrazzaaq A
- Abebe Ns
- Abebe Ns
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- Abington E
- Abiola O
- Aboarab A
- Aboelella M
- Aboelmagd O
- Aboelsoud Mr
- Aboraya M
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- Abouelnasr A
- Aboul-Naga Ms
- Abouzahra A
- Abouzaid A
- Abozaid M
- Abozeid K
- Abozyed Maf
- Abu-Toyour M
- Abubakr M
- Abudeeb H
- Abuowda Y
- Abuqwaider E
- Abusalem L
- Abuseif M
- Abushamleh S
- Acharya P
- Ackom E
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- Adelshone A
- Ademuyiwa A
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- Adenekan B
- Adeniran J
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- Adeniyi A
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- Adesanya O
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- Adesina A
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- Adesuyi A
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- Adham W
- Adhitama N
- Adil M
- Adisa Ao
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- Adnan Ab
- Adu-Aryee N
- Afana S
- Afandy A
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- Agalianos C
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- Agarwal A
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- Agbedinu K
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- Ahlonsou G
- Ahlqvist S
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- Ahmed A
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- Ahmed H
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- Al Saied G
- Al Subaie N
- Al-Aarag Aa
- Al-Azraqi Iaa
- Al-Bahrani A
- Al-Buhaisi A
- Al-Dakka E
- Al-Faifi Jj
- Al-Faqawi M
- Al-Farram H
- Al-Hameedi Hii
- Al-Hasani Rkmj
- Al-Khatib A
- Al-Mallah A
- Al-Marakby D
- Al-Mousa M
- Al-Nahrawi S
- Al-Obaedi O
- Al-Saqqa S
- Al-Saqqa Sw
- Al-Shammari A
- Al-Slaibi I
- Al-Taher T
- Alaael-Dein S
- Alada M
- Alahmady O
- Alakaloko F
- Alakaloko F
- Alaloul E
- Alamin S
- Alamoudi M
- Alamoudi U
- Albeladi B
- Albiety A
- Aldalaq A
- Aldhafeeri S
- Aledrisy M
- Alexander P
- Alexander P
- Alexandre C
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- Alghamdi A
- Alghamdi B
- Alghamdi M
- Alghamdi Msa
- Algohary O
- Alhabli I
- Alhady K
- Alhammali T
- Alhassan B
- Alhazmi W
- Alhendy M
- Alherz M
- Ali A
- Ali A
- Ali A
- Ali Cdm
- Ali E
- Ali Fm
- Ali H
- Ali S
- Ali Sawew
- Ali Ss
- Ali Tha
- Ali W
- Alihonou T
- Alimi Q
- Alimi Q
- Alis H
- Aliyu H
- Aliyu M
- Aliyu S
- Aljboor K
- Aljiffry M
- Aljiffry M
- Aljohani E
- Aljohani E
- Aljohani S
- Alkaaki A
- Alkammash A
- Alkelani M
- Alkhabbaz D
- Alkhouri M
- Allam M
- Allam M
- Allam Y
- Allegri A
- Allegri A
- Allen Jly
- Allen-Ingabire Jc
- Allott R
- Almallah A
- Almanon Cl
- Almoflihi A
- Almuallem S
- Almy J
- Alnaby Mh
- Alnawam E
- Alnuqaydan Sa
- Alnusairat A
- Alomar In
- Alqahtani E
- Alqahtani S
- Alrahawy M
- Alrajraji M
- Alrifaie A
- AlRowais M
- Alsaggaf M
- Alsaggaf Mu
- Alsaggaf Mu
- Alser Oh
- Alshareef R
- Altaf A
- Altaf A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamini A
- Altarayra M
- Althwainy A
- Altibi A
- Altinel Y
- Altinel Y
- Altoe F
- Altwigry Am
- Altwijri A
- Alvarez Iiz
- Alvi Ar
- Alwafai Mg
- Aly Ak
- Aly Mym
- Alyacoubi S
- Alyahya R
- Alyami R
- Alyami R
- AlYoussef I
- Alzahrani M
- Alzahrani M
- Alzahrani Mna
- Alzayat T
- Aman Nf
- Amandito R
- Amandito R
- Amandito R
- Amandito R
- Ambrona-Zafra D
- Ambrozeviciute V
- Ameen M
- Amer Ma
- Amin Haa
- Amin J
- Amin J
- Amjad M
- Ammar M
- Ammar Ms
- Amoah M
- Amoako J
- Amoako Pt
- Amoako-Boateng M
- Amole I
- Amreia M
- Amreia M
- Anandkumar D
- Anderson D
- Anderson F
- Anderson R
- Anderson-Knight H
- Andersson L
- Andika Ffa
- Andreotti D
- Andress C
- Andriola V
- Ang Yl
- Angelieri D
- Anis E
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Ansaloni L
- Antar S
- Antezana D
- Anthoulakis C
- Anthoulakis C
- Antoniozzi A
- Anwar Aw
- Anwar N
- Anwer W
- Anyanwu Lj
- Anyanwu Lj
- Aonzo P
- Appeadu-Mensah W
- Appiah Ek
- Aql S
- Aquilino F
- Arachchi Pp
- Arachchige Lajj
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- Arango Mcm
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- Arango Mcm
- Araujo Jslr
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- Arnaud Ap
- Arshad Mm
- Arslan E
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- Arulampalam T
- Aruldas N
- Asaat Ul Razi S
- Asal M
- Asar Yh
- Asare-Bediako K
- Asele Fa
- Ashour A
- Ashour A
- Ashour K
- Ashraf Sf
- Ashtari M
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- Asi F
- Asilah Smd
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- Ata Aaa
- Ata Ay
- Atiyeh A
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- Atobatele K
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- Attard M
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- Attia Am
- Augestad Km
- Aung Kp
- Austraite A
- Aviles S
- Avoka A
- Awad I
- Awad Sa
- Awadallah S
- Awuku-Asabre J
- Ayad S
- Ayandipo O
- Ayandipo Oo
- Aydin Mc
- Ayyar S
- Aziz Dna
- Aziz Mra
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- Azodo Ia
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- Azzie G
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- Badr Mfm
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- Badwi Nm
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- Baillie K
- Baillie K
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- Bakhaidar M
- Baki Be
- Bakr A
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- Baky Fahmy MA
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- Balila Rmh
- Balkan Aza
- Ballouhey Q
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- Balmaceda R
- Balmaceda R
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- Bamford R
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- Bamicha A
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- Bandoh D
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- Barendegere V
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- Barmayehvar B
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- Barreda Lma
- Barrientos Lam
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- Barrios E
- Barrios E
- Barry J
- Basilicò
- Basir Erm
- Bassem M
- Bassit Ka
- Basso Sm
- Basson S
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- Batt J
- Bautista Acm
- Bautista Acm
- Bayram S
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- Beaton C
- Bedada Ag
- Bediako-Bowan A
- Behar N
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- Beisa V
- Bekhet Ah
- Bekhet Nm
- Beleñ
- Belkouchi A
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- Bello B
- Benammi S
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- Benevento A
- Benger M
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- Benyaiche C
- Bermú
- Bernardo Cg
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- Bertuello I
- Beuran M
- Beuran M
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- Bezzina M
- Bhangu A
- Bhangu A
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- Bhangu A
- Bhargava A
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- Bhat S
- Bhatnagar A
- Bhattacharya S
- Bhopal Kf
- Bhopal Kf
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- Billy M
- Birindelli A
- Birring A
- Bisset C
- Bjö
- Bjö
- Blacker S
- Blackwell J
- Blanco R
- Blanco-Colino R
- Blencowe N
- Blencowe N
- Bliksø
- Blower E
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- Boakye-Yiadom K
- Boal M
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- Boddy A
- Bode C
- Bode C
- Bodur S
- Boereboom C
- Boggon A
- Boijsen M
- Bokhari S
- Bonavia K
- Bonavina L
- Bonavina L
- Bond-Smith G
- Bondin J
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- Bondurri A
- Boni S
- Bonnard A
- Bonney W
- Borda-Luque G
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- Borg E
- Borg E
- Borin E
- Bortolasi L
- Bortolasi L
- Boshnaq M
- Botero Jam
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- Botto N
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- Bougard H
- Boukhal K
- Bowabsak A
- Bowe R
- Bowley D
- Bowling K
- Bowman C
- Boyce T
- Bré
- Bradulskis S
- Bradulskis S
- Bratu M
- Bratu Mr
- Bratu Rm
- Braungart S
- Bravo Jac
- Bray Ld
- Breistrand M
- Breitenstein S
- Breslin R
- Brincat Sd
- Broch A
- Brogden T
- Brown D
- Brown E
- Brown J
- Brown J
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- Brunoni B
- Bsisu I
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- Bugaev N
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- Buisson P
- Bukari M
- Bunting D
- Burger S
- Burmistrovas A
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- Bustangi N
- Butt Mt
- Cabrera Ccrr
- Cacurri A
- Cadogan Dd
- Cahill R
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- Camacho R
- Cameron B
- Camilleri Gm
- Camilleri-Brennan J
- Camilleri-Brennan J
- Camilleri-Brennan Jf
- Campagnaro T
- Canto Md
- Capito C
- Capleton P
- Carabott K
- Cardozo Jt
- Cardozo Ram
- Careta Mc
- Carlucci M
- Carmona Jm
- Carneros Vj
- Carpio J
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- Carreira Ja
- Cassar K
- Castillo Vdp
- Castro Mr
- Catani M
- Cautiero R
- Caydiid H
- Cecilia T
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- Cengiz Y
- Cengiz Y
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- Chachulski W
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- Chai Fy
- Chambers A
- Chambers A
- Chan E
- Chan L
- Chan Tk
- Chan Xw
- Chan Z
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- Chang Ky
- Chapman A
- Chapman Sj
- Charles A
- Cheah Aez
- Chen Cy
- Chen Jhc
- Chen Ky
- Chen Tl
- Chenn R
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- Chetta N
- Cheung Yhe
- Chew Ls
- Chhabra S
- Chibuye C
- Chidambaram S
- Chiesa D
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- Chin Yr
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- Chiong Jac
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- Chiu S
- Chiu Smy
- Choi J
- Choi P
- Chong Bfhk
- Chong Cl
- Chong Cl
- Chong Cl
- Chong Cs
- Chong Hy
- Chong Hy
- Choudhry A
- Chow Cyn
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- Chowdhury D
- Chu K
- Chun A
- Chun T
- Chung Kj
- Chung S
- Ciccioli E
- Cirocchi R
- Ciubotaru C
- Claire R
- Clarissa A
- Clark Dj
- Clark T
- Clegg-Lampety Jn
- Clegg-Lamptey Jn
- Clement Kd
- Clements Jm
- Clerico G
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- Coccolini F
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- Cohen F
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- Coletti M
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- Confalonieri G
- Conlon Kc
- Connor K
- Connor K
- Contreras E
- Contreras-Vergara Al
- Coomber R
- Coompson Cl
- Corbellini C
- Corbellino M
- Cornick J
- Coronel J
- Correa Jc
- Corro-Diaz S
- Costa C
- Costa-Maia J
- Costa-Maia J
- Costas-Chavarri A
- Costas-Chavarri A
- Courboin E
- Court E
- Cox D
- Cox M
- Coyoy-Gaitan O
- Cragg J
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- Cross K
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- Cruz H
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- Currow C
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- Dé
- D&apos
- D&apos
- D&apos
- D&apos
- D&apos
- D&apos
- Da Silva LA
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- Dablouk Mo
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- Dahy A
- Dainius E
- Dakubo J
- Dalli J
- Dally C
- Dambrauskas Z
- Dambrauskas Z
- Dan I
- Danelli P
- Daniels I
- Daniyan M
- Danys D
- Dao W
- Daqeeq A
- Dar M
- Dar W
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- Darweesh M
- Darwish Ak
- Das A
- Das K
- Das S
- Dasari M
- Dashnyam E
- Dassah V
- Datta U
- Davenport R
- Davies J
- Davies R
- Davor A
- Dawnay G
- Dawood K
- Dawoud H
- Dayie M
- De Boni D
- De Bono P
- De Bono P
- De Castro Segundo LCB
- De Franciscis S
- De Freitas AVC
- De La Medina AR
- de Leó
- De Leon MZP
- De Leon MZP
- de Lima CVB
- De Luca E
- De Marco P
- De Sousa AV
- Deal R
- Dean R
- Deane C
- Debrah S
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- Dedekind B
- Dedey F
- Deichsel F
- Del Basso C
- Del Pilar Paucar A
- Delforge X
- Delgado Jm
- Delgado Msftl
- Dell A
- Dempster E
- Denewar A
- Depalma N
- Deputy M
- Der Y
- Dervenis C
- Despotidis V
- Desta S
- Deutschmann P
- Devadasar Gh
- Dharamshi Ha
- Dhillon D
- Di Franco F
- Di Martino N
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- Di Saverio S
- Diab A
- Diaconescu B
- Diaconescu Ib
- Dias S
- Diaz-Jover P
- Diaz-Zorrilla C
- Dick L
- Dickfos M
- Dickson L
- Dijan E
- Dimech T
- Din F
- Dindyal S
- Dindyal S
- Dissanayake T
- Djivoh F
- Domini E
- Domini E
- Donnelly P
- Donoghue D
- Dorani Rmnr
- Dorismé
- Dos Santos DV
- Dossou F
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- Doughty J
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- Drake Tm
- Drake Tm
- Driscoll A
- Drungilas M
- Du Plessis D
- du Plooy F
- Du Toit F
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- Dubois A
- Dueñ
- Duffy L
- Duhoranenayo D
- Duinhouwer L
- Dulskas A
- Durand Sya
- Dwydar A
- Ebdewi H
- Ebidy M
- Ebidy Mm
- Ebrahim Os
- Eduard P
- Edwards J
- Edye M
- Eid Mm
- Eisner L
- Ekow M
- El Ashal G
- El Dahab AA
- El Deen KN
- El Galeel AA
- El Gendy NH
- El Gendy A
- El Halawany M
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- El Hamid NA
- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Salam YA
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El Slam MA
- El-Badawy Ha
- El-Dien Ks
- El-Dien Ks
- El-Din Ra
- El-Din Sa
- El-Gizawy E
- El-Hamouly As
- El-Kashef H
- El-Latif Nka
- El-Ma&apos
- El-Rabaa S
- El-Sagheer N
- El-Salam Fa
- El-Sawy A
- El-Sehily A
- El-Shahat Ns
- El-Sheemy H
- El-Taher E
- Elabdin Hz
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem Aa
- Elazoul M
- Elbanby E
- Elbanby Es
- Elbatahgy A
- Elbe P
- Elbermawy M
- Elbisomy Kh
- Eldafrawy M
- Eldamaty L
- Eldeeb Az
- Eldeen Ea
- Eldin Mab
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
- Elfouly Y
- Elgebaly A
- Elgendy Ah
- Elgendy Fi
- Elgheriany M
- Elhadad A
- Elhadary Nm
- Elhadry S
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- Elhamouly S
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- Elhendawy A
- Elhendawy Aoa
- Elhoseny G
- Elhusseiny Aae
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek Ea
- Elkholy A
- Elkholy Ss
- Elkolaly Ss
- Elkorashy Am
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar Ma
- Elnemr Ae
- Elrasoul Ya
- Elrazek Aa
- Elsabbagh N
- Elsameea Aa
- Elsawahly Dme
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed Nar
- Elsayed Zm
- Elsebaaye Ao
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay Ae
- Elshami M
- Elshanwany S
- Elsharkawy Aa
- Elsheikh S
- Elsherbiney S
- Elsherbiny As
- Elsherif Fa
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy Deaa
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escobar Eg.
- Espin-Basany E
- Espinoza F
- Espinoza Kt
- Espinoza Kt
- Essam A
- Essam Aa
- Essam M
- Essoun S
- Esteban E
- Estee Mm
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
- Evajelista Cv
- Evans D
- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahy C
- Fairfield C
- Fairfield C
- Fairfield C
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- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat Mm
- Faraz A
- Fares M
- Farfan Esf
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- Farhan-Alanie Mmh
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk Sam
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy Am
- Fattah Aa
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
- Fergusson Sj
- Fergusson Sj
- Fermani C
- Fermani Cg
- Ferná
- Fernandes C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferreira Sak
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald Je
- Florez Ljg
- Foco M
- Fok Cyj
- Fontana T
- Foo Cc
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler Aj
- Fozard T
- Fozard T
- Frade F
- Fraga Gp
- Franco H
- Francois P
- Francois-Coridon H
- Francone E
- Freitas Av
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
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- Gü
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- Gaafar S
- Gaarder T
- Gad A
- Gad Mo
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaiž
- Gaignard E
- Gaignard E
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez Cp
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan Yy
- Gani Ma
- Garaycochea O
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- Gemeah M
- Gemenetzis G
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- Germanos S
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- Gerosa A
- Gerosa A
- Geuoshy A
- Ghaben A
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- Ghetia M
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- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Methicillin-Resistant Staphylococcus aureus
- Author
- Publication venue
- 'Mary Ann Liebert Inc'
- Publication date
- Field of study
Meta-analysis on Materials and Techniques for Laparotomy Closure: The MATCH Review
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/06/2018
- Field of study
BACKGROUND: The aim of this systematic review and meta-analysis was to evaluate closure materials and suture techniques for emergency and elective laparotomies. The primary outcome was incisional hernia after 12 months, and the secondary outcomes were burst abdomen and surgical site infection. METHODS: A systematic literature search was conducted until September 2017. The quality of the RCTs was evaluated by at least 3 assessors using critical appraisal checklists. Meta-analyses were performed. RESULTS: A total of 23 RCTs were included in the meta-analysis. There was no evidence from RCTs using the same suture technique in both study arms that any suture material (fast-absorbable/slowly absorbable/non-absorbable) is superior in reducing incisional hernias. There is no evidence that continuous suturing is superior in reducing incisional hernias compared to interrupted suturing. When using a slowly absorbable suture for continuous suturing in elective midline closure, the small bites technique results in significantly less incisional hernias than a large bites technique (OR 0.41; 95% CI 0.19, 0.86). CONCLUSIONS: There is no high-quality evidence available concerning the best suture material or technique to reduce incisional hernia rate when closing a laparotomy. When using a slowly absorbable suture and a continuous suturing technique with small tissue bites, the incisional hernia rate is significantly reduced compared with a large bites technique.status: publishe