Intrawound low-dose vancomycin is superior to high-dose in controlling the risk of wound dehiscence in spine surgeries.

Wound complications in spine surgeries are common and serious. This study aimed to determine the risk of wound dehiscence with a low-dose of intrawound vancomycin compared to that with a high-dose and no-vancomycin and its effectiveness in the prevention of surgical site infection. Patients were categorized into 3 groups. The first group did not receive any intrawound vancomycin. In the second, patients received a high-dose of vancomycin (1 g). The third group included patients who received a low-dose of intrawound vancomycin (250 mg). Patient demographics, clinical data, and surgical data were also collected. Multivariate linear regression analysis was used to examine factors associated with dehiscence or infection. Of the 391 patients included in our study, 56 (14.3%) received a high-dose of intrawound vancomycin, 126 (32.2%) received a low-dose, and 209 (53.5%) did not receive any treatment. The overall incidence of wound dehiscence was 6.14% (24 out of 391 patients). Wound dehiscence was significantly higher (P = .039) in the high-dose vancomycin group than in the low-dose vancomycin group. The overall incidence of postoperative infection was 2.05% (8 patients) and no statistically significant differences were observed between the low-dose and high-dose vancomycin groups. Patients with higher body mass index were more likely to experience wound dehiscence and postoperative infection, irrespective of the dose of vancomycin used. The use of low-dose intrawound vancomycin (250 mg) resulted in less wound dehiscence compared with high-dose vancomycin. Further trials are required to evaluate the effectiveness of the low-dose in preventing postoperative infections.

Assessment of Patient Experiences in an Academic Hospital in Saudi Arabia.

Introduction Patient continuous assessment is an important component of patient-centered healthcare systems and requires the identification of the services and resources of these systems to ensure patient satisfaction. This study aimed to determine the factors that affect patient satisfaction, identify patients' unmet health care and informational needs, and suggest measures to fill these gaps in healthcare systems. Methods A cross-sectional study included 235 patients who were admitted to the medical ward of an educational tertiary healthcare center in Jeddah, Saudi Arabia, between June-September 2016. A self-administered questionnaire based on the Arabic version of the "échelle de qualité des soins en hospitalisation" or the quality of care in hospitalization scale (ESQ-H) consisting of two subscales that measured their satisfaction with the services received was offered to the study participants. We analyzed the data to identify factors associated with patient dissatisfaction using IBM SPSS® Statistics Version 21.0. Results The patients included 145 males (61.7%) and 90 females (38.3%). The Cronbach's alpha coefficient was 0.933 for the questionnaire. In the subscale associated with the quality of the medical information patients received, three independent variables were associated with higher patient satisfaction: planned patients' hospital stay (p<0.001), patients' health improvement (p<0.001), and patients' overall life satisfaction (p<0.001). In the subscale associated with patients' relationship with medical staff and the daily routine of the medical ward, four independent variables were significant: male gender (p=0.007), patients, if the hospital stay was planned (p=0.009), improvement of patients' health (p<0.001), and patients' overall life satisfaction (p=0.006). Conclusion Patients' satisfaction level was "very good" with the medical information subscale and "excellent" with the relationship subscale. We found that although patients were satisfied with some aspects of their health care, other aspects required more attention; hence, the resolution of patients' unmet health care and informational needs should be prioritized by stakeholders to improve patient satisfaction. Furthermore, the patients should be informed about what they can expect during their upcoming hospital stay, their overall life satisfaction should be considered, and patients with issues related to their life satisfaction should be appointed a social worker.

Parental perceptions of dental health and need for treatment in children with epilepsy: a multicenter cross-sectional study.

BACKGROUND: Epilepsy is a common neurological disorder in childhood. However, there have been limited studies on its impact on the oral health of affected children. Our study aimed to assess the oral health of children with epilepsy in the city of Jeddah, Saudi Arabia, as perceived by their mothers. METHODS: We conducted a cross-sectional study in three hospitals. We included children 2-18 years old with physician-confirmed epilepsy diagnosis. We assessed parental perception of dental status and need for dental care using a standardized questionnaire that was completed by the mothers. To adjust for potential confounding variables, we used univariate and multivariate logistic regression. RESULTS: We included 96 children with epilepsy in our study. Their mean age was 6.4±3.4 years. In 55.2% (n=53), dental status was rated as bad, and in 84.4% (n=81) a need for dental care was expressed. Cerebral palsy (OR 5.06, 95% CI 1.28-19.99; P=0.021), motor disability (OR 6.41, 95% CI 1.12-36.73; P=0.037), referral from a pediatric neurology clinic to a dentist (OR 10.755, 95% CI 3.290-35.151; P<0.001), and irregular brushing of teeth (OR 5.397, 95% CI 1.536-18.961; P=0.009) were significantly associated with increased risk of perceived bad dental status. Perception of the child as being overweight (OR 0.117, 95% CI 0.034-0.400; P=0.001) was significantly associated with decreased risk of perceived bad dental status. Motor disability (OR 5.73, 95% CI 1.64-20.04; P=0.006) was significantly associated with increased parental expression of need for dental care. CONCLUSION: In most children with epilepsy, perceived dental status was bad and there was a high expressed need for dental care. Interventions to improve the dental health of children with epilepsy should focus on those with cerebral palsy and motor disability.