Caracterización de las infecciones posoperatorias en un servicio de cirugía general / Characterization of Postoperative Infections in a General Surgery Service

Introducción: Las infecciones del sitio quirúrgico u operatorio constituyen un grave problema sanitario por lo que su prevención y tratamiento representan un reto para las instituciones hospitalarias. Objetivo: Describir las características de las infecciones posoperatorias según las principales causas relacionadas con su aparición. Métodos: Se realizó un estudio descriptivo y observacional con 207 pacientes ingresados y operados de cirugías mayores que presentaron infecciones posoperatorias en el Servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, durante 2018-2020. Resultados: La tasa global de infecciones posquirúrgicas fue de 4,18 pr ciento. Las infecciones incisionales superficiales, seguidas de las profundas fueron las más frecuentes. El número de pacientes infectados se triplicó en los operados con urgencia respecto a los electivos, con predominio de los apendicectomizados. El tiempo quirúrgico y la estadía hospitalaria promedio se elevaron en los pacientes infectados. Fallecieron 12 integrantes de la casuística, atribuible a la infección generalizada y el choque séptico. Conclusiones: La aparición de las infecciones posquirúrgicas se relacionan con factores dependientes del enfermo; de la propia cirugía como es la calificación del cirujano actuante, así como la presencia de factores de riesgos preoperatorios y durante la intervención. La infección incisional superficial es la más frecuente, en tanto que la mayoría de los pacientes que fallecen corresponden a aquellos con infección de órganos y espacios(AU)

Introduction: Surgical (or operative) site infections are a serious health problem, a reason why their prevention and treatment represent a challenge for hospital institutions. Objective: To describe the characteristics of postoperative infections according to the main causes related to their occurrence. Methods: A descriptive and observational study was carried out with 207 patients admitted and operated on in major surgeries who presented postoperative infections in the general surgery service of Saturnino Lora Provincial Teaching Hospital of Santiago de Cuba, during 2018-2020. Results: The overall rate of postoperative infections was 4.18 percent. Superficial incisional infections, followed by deep incisional infections, were the most frequent. The number of infected patients was tripled in those operated on urgently compared to electively, with a predominance of appendectomized patients. Surgical time and average hospital stay were higher in infected patients. 12 members of the casuistics have passed, attributable to generalized infection and septic shock. Conclusions: The occurrence of postoperative infections is related to factors depending on the patient; on the surgery itself, such as the qualification of the surgeon; as well as on the presence of preoperative and intraoperative risk factors. Superficial incisional infection is the most frequent, while most of the patients who die correspond to those with infection of organs and spaces(AU)

Distribution of bacteria infected by metagenomic sequencing technology in maxillofacial space / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare and analyze the consistency and difference between metageno-mic next-generation sequencing (mNGS) and conventional bacterial culture in the detection of pathogenic microorganisms in maxillofacial space infection, as well as to provide a new detection method for the early clinical identification of pathogenic bacteria in maxillofacial space infection.@*METHODS@#The clinical data of 16 patients with oral and maxillofacial space infections in the First Affiliated Hospital of Zhengzhou University from March 2020 to June 2020 were collected. mNGS and conventional bacterial culture methods were used to detect pus. We then analyzed and compared the test results of the two methods, including the test cycle, positive detection rate, anaerobic bacteria, facultative anaerobes and aerobic bacteria detection rates, distribution of pathogenic bacteria, relative species abundance, and resistance genes.@*RESULTS@#The average inspection period of mNGS was (18.81±3.73) h, and the average inspection period of bacterial culture was (83.25±11.64) h, the former was shorter than the latter (@*CONCLUSIONS@#Compared with conventional bacterial culture, mNGS has the characteristics of short test time, high sensitivity, and high accuracy. Thus, it is a new detection method for the early identification of pathogenic bacteria in maxillofacial space infection and is beneficial to the early clinical diagnosis and treatment of the disease.

Retrospective analysis of 59 patients with descending necrotizing mediastinitis from oral and maxillofacial space infection / 口腔疾病防治

Objective@# A retrospective analysis aimed to identify the clinical features of patients with descending necrotizing mediastinitis (DNM) to improve the effects of treatment and prognosis.@*Methods@#The clinical data of 59 patients with DNM who were treated in the Department of Oncology of Oral and Maxillofacial Surgery of the Affiliated Stomatology Hospital of Xinjiang Medical University and transferred to the intensive care unit (ICU) were retrospectively analyzed from March 2010 to March 2020. Statistical analysis was performed to identify the risk factors that were associated with mortality.@*Results @# A total of 59 patients were identified: 21 cases of DNM typeⅠ (35.6%), 19 cases of DNM typeⅡA (32.2%), and 19 cases of DNM type ⅡB (32.2%). All patients with DNM received emergency surgery. Patients with typeⅠ and ⅡA underwent anterior mediastinal xiphoid incision and drainage combined with thoracic drainage. The thoracic mediastinum was completely debrided, and postoperative drainage was performed in type ⅡB patients. Pus samples from all 59 DNM patients were cultured for bacteria, and 19 of them were positive. Systemic antiinflammatory therapy was administered. Five patients died (8.5%), and 54 patients survived (91.5%). Compared with the survival group, the mortality group had a higher proportion of patients aged ≥ 65 years, with diabetes, with an interval from admission to ICU ≥ 6 days, with an APACHE Ⅱ score ≥ 20 days, with a duration of ICU treatment ≥ 10 days, and with septic shock, with statistically significant differences (P < 0.05). @*Conclusions@#Timely transfer to the intensive care unit for treatment combined with early active surgery and timely treatment of systemic diseases and systemic antimicrobial therapy is the key to reducing DNM mortality.

Clinical analysis of 5 cases of odontogenic maxillofacial-neck-mediastinal infection treated with negative pressure sealing drainage / 口腔疾病防治

Objective @#To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces.@*Methods@# Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied.@*Results@#Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital.@*Conclusion@#For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.

Bilateral canine space infection secondary to odontogenic origin: a rare case report

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a ra-diolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To per-form treatment of odontogenic infections, the Oral & Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

​Clinical Profile and Outcome of Ludwig’s Angina in Tertiary Care Hospital in Tamil Nadu

Background: Ludwig’s angina is a lethal infectious cellulitis of the submandibular space, which always makes a difficult situationfor treating surgeons.Objectives: The objective of this study was to study about the presentation, management, and clinical outcome of Ludwig’sangina.Materials and Methods: A study made in the Department of ENT - Head and Neck Surgery, Tirunelveli Medical College,Tirunelveli, for a period of 1 year from July 2016 to July 2017, a total of 41 patients - 33 males and 8 females were includedin the study.Results: Majority of the patients were having a dental infection before the episode - 85%. Pseudomonas aeruginosa is the mostcommon among the isolated pathogens. Six patients presented with stridor and needed tracheostomy. With early incision anddrainage, proper antibiotics and supportive measures, 37 patients survived without any morbidities. Despite all of our greatestefforts, four patients expired. Although comorbidities such as diabetes and chronic kidney disease are seen in few, majoritywere not having any other systemic illness.Conclusion: Prompt diagnosis and surgical drainage with broad-spectrum antibiotics and if needed tracheostomy often givemuch better results in the treatment of Ludwig’s angina. An early intervention of dental infection in early stages may be helpfulin avoiding progression into Ludwig’s angina.

Antibiotic sensitivity and resistance of bacteria from odontogenic maxillofacial abscesses

OBJECTIVES: This study investigated the types and antibiotic sensitivity of bacteria in odontogenic abscesses.MATERIALS AND METHODS: Pus specimens from 1,772 patients were collected from affected areas during incision and drainage, and bacterial cultures and antibiotic sensitivity tests were performed. The number of antibiotic-resistant bacteria was analyzed relative to the total number of bacteria that were tested for antibiotic susceptibility.RESULTS: Bacterial cultures from 1,772 patients showed a total of 2,489 bacterial species, 2,101 gram-positive and 388 gram-negative. For penicillin G susceptibility tests, 2 out of 31 Staphylococcus aureus strains tested showed sensitivity and 29 showed resistance. For ampicillin susceptibility tests, all 11 S. aureus strains tested showed resistance. In ampicillin susceptibility tests, 46 out of 50 Klebsiella pneumoniae subsp. pneumoniae strains tested showed resistance.CONCLUSION: When treating odontogenic maxillofacial abscesses, it is appropriate to use antibiotics other than penicillin G and ampicillin as the first-line treatment.

Clinical value of vacuum sealing drainage in the treatment of oral and maxillofacial space infection / 华西口腔医学杂志

OBJECTIVE@#This study aims to observe the efficacy of vacuum sealing drainage (VSD) by continuous negative pressure drainage and saline irrigation in the treatment of oral and maxillofacial space infection.@*METHODS@#Retrospective analysis was conducted on 116 cases of maxillofacial space infection, and clinical data were collected to compare the therapeutic effects of routine incision with drainage treatment (traditional treatment group, 58 cases) and VSD treatment (VSD group, 58 cases).@*RESULTS@#The length of hospital stay, white blood cell count, scar length, frequency of dressing change, and pain degree of patients in the VSD group were all lower than those in the traditional treatment group. Moreover, the improvement degree of mouth opening in the VSD groups was better than that in the traditional treatment group (P<0.05).@*CONCLUSIONS@#VSD is a more effective method for the treatment of oral and maxillofacial space infection.

Temporal, buccal and masticator space infections in an immunocompromised patient: report on a rare case

@#AIDS” is a term used to describe the various clinical syndromes, specific opportunistic infections or malignancies that occur with HIV infection. Oral manifestations are common in people with HIV infection. .Oral lesions may be due to decline in immune function. Hence patients with AIDS are subjected to recurrent, Life threatening opportunistic infection. Here is a case report of a 70 year old female who presented with right buccal, masticator and submandibular space infection. A routine blood test reveals seropositivity positive for HIV infection. She was treated with antibiotics and underwent an incision and drainage following hospitalization

The clinical and bacteriological analysis of the diabetic with oral and maxillofacial space infections / 口腔疾病防治

Objective@#To analyze the clinical characteristics of oral and maxillofacial space infection between the diabetic and non-diabetic patients and to explore the common pathogenic bacteria and antibiotic sensitivity of diabetic patients, to guide the clinical medication. @*Methods @# A retrospective study was conducted on 61 patients who received treatment in Qingdao municipal hospital affiliated to Qingdao university, between December 2014 and December 2016 with Oral and maxillofacial space infection. The 61 patients were divided into diabetic group and non-diabetic group. The research contented the patients'age, sex, source of infection, pathogenic bacteria, antibacterial drugs sensitivity, fasting blood glucose levels, white blood cell total and neutrophils percentage, and days of hospitalization. T test and chi-square test in SASS.19.0 software was used. @*Results @#In the 2 groups of patients, the most common etiological factor was odontogenic infection; the most easiest affected space was submandibular space. The most common pathogenic bacteria were streptococcus. Vancomycin was the most sensitive drug, then levofloxacin and cefotaxime. In addition, the diabetes patients'age, fasting blood glucose levels and hospitalization days were significantly higher than non-diabetic patients'.@*Conclusion @#For the diabetic patients with maxillofacial space infection, levofloxacin and cefotaxime was first used for the conservative treatments when the results of the bacterial culture and drug susceptibility test are not obtained. Meanwhile, according to the oral and maxillofacial anatomy, combination of anti-anaerobic agents such as Tinidazole is also suggested. But the final situation of medication is based on the result of the drug susceptibility test.

Pharmaceutical Care for One Case of Intervertebral Space Infection with Multiple Drug Resistant Pseudomonas Aeruginosa / 中国药师

Objective:To share a drug treatment experience for multiple drug resistant Pseudomonas aeruginosa.Methods:A retrospective analysis of the pharmaceutical care participated by clinical pharmacist for one case of intervertebral space infection with multiple drug resistant Pseudomonas aeruginosa was carried out.Results:Pharmacists participated in the whole treatment process,made the combined antimicrobial regimen (fosfomycin + ceftazidime + ciprofloxacin),and adjusted the time sequence.As a result,satisfactory curative effect was obtained.Conclusion:The infection with multiple drug resistant Pseudomonas aeruginosa may be treated with the three-drug therapy.Clinical pharmacists can play a positive role in the treatment of complicated infections.

Survey of distribution and drug resistance of pathogenic bacteria in patients with oral and maxillofacial infections / 国际检验医学杂志

Objective To investigate the distribution and drug resistance of pathogens in patients with oral and maxillofacial in-fection.Methods A total of 73 patients with oral and maxillofacial infection in our hospital from January 2012 to December 2016 were selected.The sputum samples were isolated and cultured,and gram positive bacteria susceptibility test was performed by GN201 method.Gram negative bacteria susceptibility test was performed by GP method.Results A total of 71 strains of pathogen-ic bacteria were isolated from 73 cases of diabetic patients with oral and maxillofacial infections..Among them,there were 48 strains of gram negative bacteria,accounting for about 67.61%,21 strains of gram positive bacteria,accounting for 29.58%,and 2 strains of fungi accounting for 2.82%.Among gram negative bacteria Klebsiella pneumoniae was the most,in 19 strains,followed by 17 strains of Pseudomonas aeruginosa,9 strains of Escherichia coli,3 strains of others;among gram positive bacteria,Staphylococcus aureus were the most,in 10 strains,followed by 8 strains of Staphylococcus epidermidis,3 strains of Enterococcus;gram negative bacteria were mainly resistant to ceftazidime,levofloxacin.The resistance rate of Klebsiella pneumoniae to ceftazidime was 94.74%, and the resistance rate to levofloxacin was 68.42%;the resistance rate of Pseudomonas aeruginosa to ceftazidime was 100.00%,and the resistance rate to levofloxacin was 88.24%.The gram positive bacteria were mainly resistant to penicillin G and vancomycin;the resistance rate of Staphylococcus aureus to penicillin G was 90.00%,and the resistance rate to vancomycin was 100.00%;the re-sistance rate of Staphylococcus epidermidis to penicillin G was 87.50%,and the resistance rate to vancomycin was 75.00%.Conclu-sion Oral and maxillofacial infection in diabetic patients are mainly Gram-negative bacteria.The resistance rates of major Gram-negative bacteria were relatively high to ceftazidime and levofloxacin.The resistance rates of major gram positive bacteria to penicil-lin G and vancomycin were relatively high.

Application of vacuum sealing drainage in the treatment of severe maxillofacial and neck space infection / 实用口腔医学杂志

Objective:To investigate the efficacy of vacuum sealing drainage (VSD) in the treatment of severe maxillofacial and neck space infection.Methods:9 patients (6 males,3 females) with severe maxillofacial and neck space infection were treated with VSD.After incision of abscess,the incision was covered by VSD material and 40-60 KPa continuous negative pressure drainage was given.Results:Swelling and pain of the patients reduced rapidly.The period of VSD treatment was 4 to 10 days (mean 5.8 days).9 patients were all cured without mediastinitis.Conclusion:VSD ehhance the dranage efficiency and prevent infection spreading.

The clinical effect and cost analysis of patients of oral and maxillofacial space infection treated with improved closed negative pressure drainage / 中国实用护理杂志

Objective To explore the clinical effect of patients of oral and maxillofacial space infection treated with improved closed negative pressure drainage combined with hyperbaric oxygen, and the possibility of using this method to decrease the hospital expenses. Methods 156 patients with oral and maxillofacial space infection were divided into control group, closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group by random number table. 52 patients in each group. The granulation tissue growth time, the healing of wound, clinical effect of the 8thday, hospitalization days, wound healing time, antibiotic cost, average cost in hospital were recorded after treatment. Results The average wound healing time of patients in improved closed negative pressure drainage combined with hyperbaric oxygen group was(6.06 ± 0.23)days, while the granulation tissue growth time was(16.13 ± 2.89)days, both of them were much shorter than the control group[(15.46 ± 4.68)days and(28.60 ± 3.50)days respectively],as well as the closed negative pressure drainage group [(7.43 ± 0.75) days and (22.67 ± 4.34) days respectively], and the differences were statistically significant which the F values equaled to 6.213 and 8.451, P values all less than 0.05. The total healing rate of patients in closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were both 100.00%(52/52), the difference was statistically significant compared with control group (χ2=6.89, P<0.05). The average hospitalization days of the patients in the closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were (8.20 ± 1.49) days and (7.45 ± 0.42)days, the antibiotic cost were(5 068.34 ± 1 074.68)RMB and (5 001.00 ± 456.00) RMB, the average total cost were (9 457.43 ± 647.23)RMB and (9 249.00 ± 367.00)RMB, all these indexes were much lower that which in control group[(18.40 ± 5.89)days,(21 000.43 ± 2 036.48) RMB and (31 000.66 ± 2 711.36) RMB], and the differences were statistically significant, F values equaled to 15.221, 29.434 and 81.220 each, P values were all less than 0.01. Conclusions Improved closed negative pressure drainage combined with hyperbaric oxygen method could improve the clinical effect of patients with oral and maxillofacial space infection, speed up the granulation tissue, shorten the in-hospital time as well as reduce the medical cost.

Comparison of the clinical features and treatment outcomes of oral and maxillofacial space infection between diabetic and non-diabetic patients / 实用口腔医学杂志

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.

Analysis of 16 cases of maxillofacial space infection caused death / 实用口腔医学杂志

16 death cases of oral and maxillofacial space infection were analyzed.10 of the 16 patients were over 60 years old,the other 6 were aged 49-57 years,most of them had systemic underlying disease,and 11 of them were with diabetes mellitus.Odontogenic infection is the leading cause of maxillofacial infections(n =13).Lethal factor in oral and maxillofacial space infection is various,and comprehensive treatment should be given.

Severe odontogenic infection: past or reality? a case series report / Infecções odontogênicas severas: passado ou realidade? relatos de casos clínicos

Odontogenic infection is still a reality of the oral cavity, consequence of lack of access to preventive odontology, of bad treatment when the case is at the beginning or of ignorance about the complication associated to this infection. In this context, moderate and severe infection is a common occurrence in Clinical Dentistry, where septic tooth infection in patients with or without systemic alterations may lead to surgical procedures which are expensive for the public and private health system. The goal of this article is to present a series of clinical cases of odontogenic infection (moderate and/or severe) treated in Oral & Maxillofacial Surgery hospitals, presenting and discussing the many immediate and mediate forms of treatment, and also the possibility of preventive care.

As infecções odontogênicas ainda são uma realidade no universo dos processos infecciosos da cavidade bucal, sendo consequentes às dificuldades de acesso à Odontologia preventiva ou pela má condução clínica quando o caso ainda está em fase inicial e, ainda, por desconhecimento das complicações associadas a estas infecções. Neste contexto, situações de infecções moderadas a severas ocorrem diariamente nos serviços de Odontologia Hospitalar, onde a manutenção de dentes sépticos por longos períodos podem levar, em pacientes com ou sem alterações sistêmicas, a tratamentos cirúrgico-medicamentosos de elevado custo para o sistema público e privado. Dessa forma, este artigo tem por objetivo apresentar uma série de casos clínicos de infecções odontogênicas (moderadas e/ou graves) tratados em serviços hospitalares de Cirurgia e Traumatologia Buco-Maxilo-Faciais, apresentando e discutindo as diversas formas de tratamento imediata e mediata, como também, as possibilidades de cuidados prévios ao seu acometimento.

An infection in disguise.

Nocardia is gram positive partially acid fast bacilli and widely present in soil, fresh water, marine water, organic matter habitats and so saprophytic in existence Nocardiasis is a rare bacterial infection and thus bacteria can be localized or systemic suppurative disease in humans. They may be rarely present on the skin and in the upper respiratory tract. Here we present a rare case of buccal space infection where in the culture reported nocardial infection. In our case the nocardiosis seems to be opportunistic and could have been inoculated following fall in the mud in this alcoholic state. Patient was treated with Amoxicillin-clavulanic acid and Amikacin and he responded well.

Particular Features of Surgical Site Infection in Posterior Lumbar Interbody Fusion

BACKGROUND: Previous reports have observed differences only in infection rates between posterolateral fusion and posterior lumbar interbody fusion (PLIF). There have been no reports that describe the particular features of surgical site infection (SSI) in PLIF. In this study, we endeavor to identify the distinguishing characteristics and risk factors of SSI in PLIF. METHODS: Our study undertook a review of a case series of an institute. Patients who had undergone PLIF consecutively in the author's hospital were reviewed. Two proactive procedures were introduced during the study period. One was irrigation of the autolocal bone, and the other was the intradiscal space irrigation with a nozzle. Infection rate and risk factors were analyzed. For subgroup analysis, the elapsed time to a diagnosis (ETD), clinical manifestations, hematologic findings, and causative bacteria were examined in patients with SSI. RESULTS: In a total of 1,831 cases, there were 30 cases of SSI (1.6%). Long operation time was an independent risk factor (p = 0.008), and local bone irrigation was an independent protective factor (p = 0.001). Two cases of referred SSI were included in the subgroup analysis. There were 6/32 (19%) superficial incisional infections (SII), 6/32 (19%) deep incisional infections (DII), and 20/32 (62%) organ/space infections (O/SI). The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI. ETD was 8.5 +/- 2.3 days in SII, 8.7 +/- 2.3 days in DII and 164.5 +/- 131.1 days in O/SI (p = 0.013). CONCLUSIONS: The rate of SSI in PLIF was 1.6%, with the most common type being O/SI. The causative bacteria of O/SI was of lower virulence than in the incisional infection, and thus diagnosis was delayed due to its latent and insidious feature. Contamination of auto-local bone was presumed attributable to the progression of SSI. Irrigation of auto-local bone helped in the reduction of SSI.

Treatment of life threatening head and neck space infection:A retrospective analysis of 32 cases / 实用口腔医学杂志

Objective:To review the treatment of life threatening head and neck space infection.Methods:Retrospective was con-ducted to analyse the patient characterization,signs and symptoms at the time of presentation,presence of concomitant systemic co-morbidities,treatment,prognosis and bacteriology.Results:32 patients from 2007.01 to 2013.01(mean age was 57.71 years)were included.The cases were increased year by year.1 1 (34.37%)patients had breathing difficulty requiring tracheostomy and 19 (59.3%)had concomitant systemic comorbidities.23 cases recovered completely,8 with severe mediastinal infection were trans-ferred to the department of thoracic surgery or the department of respiratory medicine.1 patient died.Pus submission rate was 96.87%,the bacteria detection rate was 37.50%.Pus culture showed mixed infection dominated by streptococci.Staphylococcus au-reus,pseudomonas aeruginosa,enterococcus faecalis,prevotella and neisseria were detected.Conclusion:Annually incidence of life threatening head and neck space infection is increasing.Treatment of the infection should include:①Ensuring the airway patency;②Surgical incision and drainage as early as possible;③ Hypoglycemic control,maintenance of hemodynamic,nutritional support,and multi-disciplinary approach are the key points in the management of such infections;④ Systemic antibiotics.