Thesis (M.D.S.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 86-107).

Thesis (M.D.S.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 86-107). Also available in print.

Source: Masters Abstracts International, Volume: 46-03, page: 1492. Adviser: Robert E. Roberts. Includes bibliographical references.

Surgical site infection not only brings morbidity and mortality to patients, but it also bring substantial financial burden to the hospital and the healthcare system. To minimize the clinical consequences of surgical site infection, it is crucial that all appropriate measures for reduction of surgical site infection should be implemented. Since patient’s skin is a potential source of pathogens, normal skin flora is a common cause of surgical site infections. Preoperative skin disinfection of the surgical site with an antiseptic agent is an effective method to remove the soil and transient organisms from the skin. Currently, there are different skin antiseptics available and the most commonly used agents are povidone iodine and chlorhexidine gluconate. Although povidone iodine has a long-standing recommendation and it is widely used in various surgical procedures, it has several limitations. On the other hand, there is an increasing interest of the use of chlorhexidine in indwelling catheter placement and care, surgical hand scrubbing, as well as wound dressing. In view of this, there is a potential of replacing povidone iodine by chlorhexidine as preoperative skin antiseptic agent. As there is no existing guideline supportingthis innovative movement, this dissertation aimed to review the currently available evidence on preoperative skin preparation and to develop an evidence-based guideline of using chlorhexidine in preoperative skin preparation for reducing surgical site infection in patients undergoing general surgery. Five randomized controlled studies were identified from MEDLINE, CINAHL and PUBMED and evaluated by a critical appraisal tool, the Scottish Intercollegiate Guidelines Network. All studies reported that preoperative skin preparation with chlorhexidine is more effective than the use of povidone iodine in reducing surgical site infection. An evidence-based guideline is developed according to the guideline development process from the Scottish Intercollegiate Guideline Network. Patient characteristics, local clinical setting, organizational infrastructure and staff competency is congruent with the proposed innovation. The new protocol not only can minimize the risk of postoperative surgical site infection but also save costs. The cost-benefit analysis showed that the new protocol can help to save $675,552 to $1,097,772 (HK dollars) in six-month period after implementation. To facilitate a more comprehensive plan in actual implementation of the proposed guideline, stakeholders at administrative, managerial, and operational levels would be invited to take part in the 12-week pilot test. Surgical site infection, staff satisfaction and compliance, as well as cost and benefit ratio of the guideline would be measured in the evaluation plan. The refined guidelines would then be implemented for one year. The effectiveness of the guideline would be determined by reduction in postoperative surgical site infection, increase in staff knowledge and satisfaction, and the overall expenditure. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (Ph. D.)--University of Technology, Sydney, 2004. / Bibliographic references: leaves 174-199.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2006. / Härtill 5 uppsatser.

INTRODUCTION: For persons with diabetes, surgery is fraught with complications; of primary concern is postoperative infection. A postoperative infection rate of up to 13% has been noted in patients with diabetes undergoing elective surgical procedures compared with less than 3% in nondiabetic populations. OBJECTIVE: The objective of this study was to provide preliminary evaluation of the efficacy of a novel bioresorbable microfilm matrix (20 µm thick) containing very low amounts of silver (0.16 mg/in²) in preventing surgical site infections when placed at the level of subcutaneous tissue and dermis prior to primary closure in the patient with diabetes undergoing elective surgery. MATERIALS AND METHODS: Twenty-two patients with diabetes undergoing nonemergent or elective foot or ankle surgery and who met at least 1 of the following 6 criteria were included in the study: neuropathy, infection, open wound, history of recurrent infection, nonhealing wound, or peripheral vascular disease. Patients underwent amputation, removal of exostosis, midfoot bone removal, Achilles tendon repair, bunionectomy, or an elevating osteotomy with primary closure of the wound. After hemostasis was obtained and subcutaneous closure achieved, if applicable, the bioresorbable microfilm matrix was applied just deep to the incision at the level of subcutaneous tissue and dermis, and the incision primarily closed. A nonadherent cover dressing was applied over the suture line, and routine follow-up was scheduled for 3 to 5 days later. RESULTS: No patient exhibited signs of infection at initial follow-up, and all adherent patients achieved complete healing during the 3-month follow-up period. Eighteen patients healed at a rate typical for the respective procedure. In 2 patients, time to healing was delayed secondary to weight-bearing dehiscence. Two patients were not included in the results secondary to multiple infractions of nonadherence with the postoperative protocol. CONCLUSIONS: The application of microfilm matrix in surgical incisions at the level of subcutaneous tissue and dermis prior to primary closure is safe for and has the potential to prevent postoperative surgical site infections in at-risk patients with diabetes..

Submitted in partial compliance with the requirements of the Master’s Degree in Technology: Homoeopathy, Department of Homeopathy, Durban University of Technology, Durban, South Africa, 2016. / Introduction This research study investigated the efficacy of a homoeopathic protocol in the post-surgical wound management of medical male circumcision (MMC) in the KwaZulu-Natal region. The study had 30 male participants from 10 of the 11 district municipalities of the KwaZulu-Natal province. The study consultations took place at the Durban University of Technology Health Sciences Clinic. Aim of the study The aim of the study was to determine the efficacy of a topical application of a homoeopathic protocol using; Calendula officinalis (mother tincture (M.T.)), Hypericum perforatum (M.T.) and Delphinum staphysagria 30CH (orally) as an adjunct to the standard care of the post-surgical effects of circumcision and to assess the wounds post-surgically in terms of time taken to heal and associated signs and symptoms. Methodology The data for this study was collected from 30 male participants who had undergone MMC from various hospitals within KwaZulu-Natal. The participants were aged between 18 to 30 years. All participants underwent a medical examination and were given a pain rating scale and a pain and sleep diary. They were instructed to keep a daily record using the data collection tools mentioned above for the study period of six weeks. Descriptive statistics were employed in the form of tables and graphs. The data analysis methods used in the study are: independent samples t-test and the non-parametric Spearman’s Correlation test. Results Group statistics in relation to ‘time to heal’ showed a statistically significant reduction in the time taken for the group on the homoeopathic protocol. Analysis of ‘time to heal’ by group shows that on average, Group 1 (active group: homoeopathic protocol + standard care) (M = 31.4, SD = 7.49) healed in a significantly shorter time than Group 2 (control group: standard care) (M = 38.6667, SD = 1.99), t (28) = -2.617, p=.014. There was no other statistical significance noted except for the results of the Spearman’s rho, where table 4.8 shows there is a significant positive correlation between average quality sleep until healing and the proportion of days across healing NOT feeling refreshed (rho = .676, p<.0005). / M

published_or_final_version / Dentistry / Master / Master of Dental Surgery