RESUMO
Objectives: To investigate the risk factors for surgical site infection together with the identification of the etiological pathogens and their antimicrobial susceptibility at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. Methods: A prospective case series study conducted at King Khalid University Hospital to all patients admitted to the surgical wards during the period between January 1st and September 30th 2007. The demographic data, diagnostic criteria, associated risk factors and laboratory data including gram stain, culture results and antimicrobial susceptibility of swabs from the surgical sites were collected. Results: Out of the one hundred and thirty one patients recruited in the study, nine patients showed evidence of sepsis yielding an infection rate of 6.8%. Emergency operations and associated diabetes showed significantly higher rates of infection compared to their counterparts. The most commonly isolated bacteria were: E. coli, Pseudomonas aurigenosa and Staphylococcus aureus.Conclusion: The rate of surgical site infection was 6.8% which was comparable to that reported literature. E. coli was the most commonly isolated bacteria. Neither MRSA nor Acinetobacter species were common isolates. The rate of infection in diabetics and those who underwent emergency operations was significantly higher than others. Other comorbidities did not directly affect the rate of surgical site infection in our series
RESUMO
Thyroidectomy is a commonly performed procedure for thyroid problems. Inadvertent removal of the parathyroid glands is one of its recognized complications, which occurs more frequently in certain high-risk patients. The aim of this study was to identify the incidence, risk factors, and clinical relevance of incidental parathyroidectomy during thyroid surgery. A retrospective review of thyroid operations performed at a tertiary referral hospital between January 2004 and December 2008. Pathology reports were reviewed to identify the specimens that included parathyroid tissue and underlying thyroid pathology. Postoperative calcium levels were reviewed in these patients. During the study period, 287 thyroidectomies were performed and 47 [16.4%] patients had incidentally removed parathyroid glands. Risk factors for inadvertent parathyroid resection included total thyroidectomy [P=.0001], Hashimoto thyroiditis [P=.004], and extrathyroidal spread [P=.0003]. Postoperative hypocalcemia occurred in 18 [38.3%] of the patients in whom the parathyroid gland was removed inadvertently and in 48 [20%] of the rest of the patients [P=.0123]. The incidence of incidental removal of parathyroid tissue during thyroidectomy is 16.4%. Total thyroidectomy, extrathyroidal extension of the tumor, and thyroiditis were found to be the risk factors. Hypocalcemia was significantly higher among patients who had inadvertent parathyroidectomy