Surgical site infections also account for nearly 4 million excess hospital days annually, and nearly $2 billion in increased health care costs. To reduce the burden of these infections, CP-868596 concentration a partnership of national organizations, including the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention, created the Surgical Care Improvement Project and developed six infection prevention measures. Of these, three core measures contain recommendations
regarding selection of prophylactic antibiotic, timing of administration, and duration of therapy. For most patients undergoing clean-contaminated surgeries (e.g., cardiothoracic, gastrointestinal, orthopedic, vascular, gynecologic), a cephalosporin is the recommended prophylactic antibiotic. Hospital compliance with infection prevention measures is publically reported. Because primary care physicians participate in the pre- and postoperative care of patients, they should be familiar with the Surgical Care
Improvement Project recommendations. (Am Fam Physician. 2011;83(5):585-590. Copyright (c) 2011 American Academy of Family Physicians.)”
“Objectives: The aim of this study is to compare efficacy, Proteases inhibitor early postoperative morbidity and patient comfort of two laser wavelengths and fibre types in treatment of great saphenous vein (GSV) incompetence resulting in varicosities of the lower limb.
Design: Prospective randomised clinical trial.
Materials and Methods: Sixty patients (106 limbs) were randomised into two groups. They were treated with bare-tip fibres and a 980 nm laser in group 1 and radial fibres and 1470 nm laser in group 2 in order to ablate the GSV. Local pain, ecchymosis, induration and paraesthesia in treated regions, distance from skin, vein diameter, treated vein length, tumescent anaesthesia volume, delivered energy and patient satisfaction were recorded. Follow-up visits
were planned on the 2nd postoperative day, 7th day, 1st, 2nd, 3rd and 6th months.
Results: Mean GSV diameters at saphenofemoral junction and knee levels were 12.1 S.D. 4.3 mm and 8.2 S.D. 2.4 mm, and 11.8 S.D. 4.1 mm and 7.9 Selleck ON-01910 S.D. 2.6 mm respectively in groups 1 and 2. There were 14 patients with induration, 13 with ecchymosis and nine minimal paraesthesia in group 1 and no or minimal local pain, minimum ecchymosis or induration in group 2. Duration of pain and need for analgesia was also lower in group 2 (p < 0.05). There was significant difference on postoperative day 2, day 7 and 1st month control in favour of group 2 in venous clinical severity scores (VCSS).
Conclusion: Treatment of the GSV by endovenous laser ablation using a 1470 nm laser and a radial fibre resulted in less postoperative pain and better VCSS scores in the first month than treatment with a 980 nm laser and a bare-tip fibre. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.