ABSTRACT
Antibiotic prophylaxis in surgery is one of the most effective measures for preventing surgical site infection, although its use is frequently inadequate and may even increase the risk of infection, toxicities and bacterial resistance. As a result of advances in surgical techniques and the emergence of multidrug-resistant organisms, the current guidelines for prophylaxis need to be revised. La Sociedad Española de Enfermedades Infecciosas (Spanish Society of Infectious Diseases and Clinical Microbiology) (SEIMC) together with the Asociación Española de Cirujanos (Spanish Association of Surgeons) (AEC) have revised and updated the recommendations for antibiotic prophylaxis to adapt them to any type of surgical intervention and to current epidemiology. This document gathers together the recommendations on antimicrobial prophylaxis in the various procedures, with doses, duration, prophylaxis in special patient groups, and in epidemiological settings of multidrug resistance to facilitate standardized management and the safe, effective and rational use of antibiotics in elective surgery
La profilaxis antibiótica en cirugía es una de las medidas más eficaces para la prevención de la infección de localización quirúrgica, aunque su uso es con frecuencia inadecuado, pudiendo incrementar el riesgo de infección, toxicidades y resistencias bacterianas. Debido al avance en las técnicas quirúrgicas y la emergencia de microorganismos multirresistentes, las actuales pautas de profilaxis precisan ser revisadas. La Sociedad Española de Enfermedades Infecciosas (SEIMC), conjuntamente con la Asociación Española de Cirujanos (AEC), ha revisado y actualizado las recomendaciones de profilaxis antimicrobiana para adaptarlas a cada tipo de intervención quirúrgica y a la epidemiología actual. En este documento se recogen las recomendaciones de los antimicrobianos utilizados en profilaxis en los diferentes procedimientos, las dosis, la duración, la profilaxis en huéspedes especiales, y en situación epidemiológica de multirresistencia, de tal forma que permitan un manejo estandarizado, un uso racional, seguro y efectivo de los mismos en la cirugía electiva
Subject(s)
Humans , Consensus Development Conferences as Topic , Societies, Medical/organization & administration , Antibiotic Prophylaxis/standards , Surgical Procedures, Operative/standards , Societies, Medical/standards , Antibiotic Prophylaxis/methods , Infection Control/organization & administrationABSTRACT
La profilaxis antibiótica en cirugía es una de las medidas más eficaces para la prevención de la infección de localización quirúrgica, aunque su uso es con frecuencia inadecuado, pudiendo incrementar el riesgo de infección, toxicidades y resistencias bacterianas. Debido al avance en las técnicas quirúrgicas y la emergencia de microorganismos multirresistentes las actuales pautas de profilaxis precisan ser revisadas. La Sociedad Española de Enfermedades Infecciosas (SEIMC), conjuntamente con la Asociación Española de Cirujanos (AEC) ha revisado y actualizado las recomendaciones de profilaxis antimicrobiana para adaptarlas a cada tipo de intervención quirúrgica y a la epidemiología actual. En este documento se recogen las recomendaciones de los antimicrobianos utilizados en profilaxis en los diferentes procedimientos, las dosis, la duración, la profilaxis en huéspedes especiales, y en situación epidemiológica de multirresistencia, de tal forma que permitan un manejo estandarizado, un uso racional, seguro y efectivo de los mismos en la cirugía electiva
Antibiotic prophylaxis in surgery is one of the most effective measures for preventing surgical site infection, although its use is frequently inadequate and may even increase the risk of infection, toxicities and antimicrobial resistance. As a result of advances in surgical techniques and the emergence of multidrug-resistant organisms, the current guidelines for prophylaxis need to be revised. The Sociedad Española de Enfermedades Infecciosas (Spanish Society of Infectious Diseases and Clinical Microbiology) (SEIMC) together with the Asociación Española de Cirujanos (Spanish Association of Surgeons) (AEC) have revised and updated the recommendations for antibiotic prophylaxis in surgery to adapt them to any type of surgical intervention and to current epidemiology. This document gathers together the recommendations on antimicrobial prophylaxis in the various procedures, with doses, duration, prophylaxis in special patient groups, and in epidemiological settings of multidrug resistance to facilitate standardized management and the safe, effective and rational use of antibiotics in elective surgery
Subject(s)
Humans , Consensus Development Conferences as Topic , Consensus , Societies, Medical/standards , Antibiotic Prophylaxis/standards , Surgical Procedures, Operative/standards , Surgical Wound Infection/prevention & control , ProjectsABSTRACT
Antibiotic prophylaxis in surgery is one of the most effective measures for preventing surgical site infection, although its use is frequently inadequate and may even increase the risk of infection, toxicities and bacterial resistance. As a result of advances in surgical techniques and the emergence of multidrug-resistant organisms, the current guidelines for prophylaxis need to be revised. La Sociedad Española de Enfermedades Infecciosas (Spanish Society of Infectious Diseases and Clinical Microbiology) (SEIMC) together with the Asociación Española de Cirujanos (Spanish Association of Surgeons) (AEC) have revised and updated the recommendations for antibiotic prophylaxis to adapt them to any type of surgical intervention and to current epidemiology. This document gathers together the recommendations on antimicrobial prophylaxis in the various procedures, with doses, duration, prophylaxis in special patient groups, and in epidemiological settings of multidrug resistance to facilitate standardized management and the safe, effective and rational use of antibiotics in elective surgery.
Subject(s)
Communicable Diseases , Surgeons , Antibiotic Prophylaxis , Consensus , Humans , Surgical Wound Infection/prevention & controlABSTRACT
Antibiotic prophylaxis in surgery is one of the most effective measures for preventing surgical site infection, although its use is frequently inadequate and may even increase the risk of infection, toxicities and antimicrobial resistance. As a result of advances in surgical techniques and the emergence of multidrug-resistant organisms, the current guidelines for prophylaxis need to be revised. The Sociedad Española de Enfermedades Infecciosas (Spanish Society of Infectious Diseases and Clinical Microbiology) (SEIMC) together with the Asociación Española de Cirujanos (Spanish Association of Surgeons) (AEC) have revised and updated the recommendations for antibiotic prophylaxis in surgery to adapt them to any type of surgical intervention and to current epidemiology. This document gathers together the recommendations on antimicrobial prophylaxis in the various procedures, with doses, duration, prophylaxis in special patient groups, and in epidemiological settings of multidrug resistance to facilitate standardized management and the safe, effective and rational use of antibiotics in elective surgery.
ABSTRACT
Liver abscesses usually arise from amoebian or bacterial origin, being rarely secondary to foreign bodies (1-3). We report the case of a 72-years-old female complaining from abdominal pain located in epoigastrium and right hypochondrium during the last 48 hours. Laboratory data revealed leukocytosis with neutrophilia and pain located in the mentioned locations at physical examination. Ultrasonography showed a liver abscess involving segments 2 and 3. CT scan revealed that the abscess was secondary to a fishbone perforating the duodenum and inlaid in the liver (Figure 1). The fishbone was surgically extracted from the hepatic lobe with hemostasia and a duodenal suture with epiploplastia was performed. Antibiotic was added to the treatment. The patient presented an uneventful postoperative course. The intake of foreign bodies is a frequent event, representing bones and fishbones the most frequent foreing bodies in the adults. Sometimes, the diagnosis may be difficult because the symptoms are not specific. Imaging test are very usefol for the diagnosis, as in the case we present.
Subject(s)
Duodenum/injuries , Fishes , Intestinal Perforation/complications , Liver Abscess/etiology , Aged , Animals , Anti-Bacterial Agents/therapeutic use , Bone and Bones , Duodenum/diagnostic imaging , Female , Foreign Bodies/surgery , Foreign-Body Migration , Humans , Intestinal Perforation/diagnostic imaging , Liver/diagnostic imaging , Liver/surgery , Liver Abscess/diagnostic imaging , Liver Abscess/surgery , Tomography, X-Ray Computed , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Liver Abscess/metabolism , Liver Abscess/pathology , Intestinal Perforation/diagnosis , Intestinal Perforation/metabolism , Leukocytosis/blood , Leukocytosis/metabolism , Liver Abscess/diagnosis , Liver Abscess/genetics , Intestinal Perforation/rehabilitation , Intestinal Perforation/surgery , Leukocytosis/complications , Leukocytosis/prevention & controlABSTRACT
INTRODUCTION: Body Mass Index (BMI) is one of the most used parameters in bariatric surgery. However, it does not discriminate the weight associated with adiposity. CUN-BAE formula is an equation that calculates Body Fat Percentage or adiposity, based on easily available values (age, sex and BMI). With this new classification many of the subjects that was considered normal weight or overweight (BMI ≤ï 30 kg/m2) really have a higher adiposity and they have comorbidities associated with obesity. The objective of this study is to evaluate the adiposity by formula CUN-BAE as a predictive marker of cardiovascular risk in morbidly obese patients before and after sleeve gastrectomy. MATERIAL AND METHODS: We performed a retrospective observational study of women that were intervened with sleeve gastrectomy, between 2007 and 2012 at the Universitary General Hospital of Elche. The adiposity was calculated by formula CUN-BAE preoperatively and 12 months after surgery. These values were correlated with different metabolic and cardiovascular risk parameters. RESULTS: 50 women were studied. Preoperatively, the mean BMI was 50.4 ± 7 kg/m2 and adiposity 54.8 ± 3%. One year after surgery, the mean BMI was 27.7 ± 3 and adiposity 39.4 ± 4%. The adiposity was significantly correlated with 3 biochemical factors associated with increased cardiovascular risk (cortisol, vitamin D and ratio TG/HDL). CONCLUSION: Adiposity, according to the formula CUNBAE, and biochemical analysis of predictive factors of obesity together represent useful tools for assessing the risk of cardiovascular disease after sleeve gastrectomy.
Introducción: Introducción: El Índice de Masa Corporal (IMC) es uno de los parámetros más utilizados en cirugía bariátrica. Sin embargo, no discrimina el peso asociado a adiposidad. La fórmula CUN-BAE es una ecuación que permite calcular el Porcentaje de Grasa Corporal (PGC) o adiposidad, basándose en valores fáciles de disponer (edad, sexo e IMC). Con esta nueva clasificación muchos de los sujetos considerados con normopeso o sobrepeso (IMC ≤ï 30 kg/m2) en realidad tienen un PGC alto y presentan comorbilidades asociadas a la obesidad. El objetivo de este estudio es evaluar PGC cuantificado mediante fórmula CUN-BAE como marcador predictivo de riesgo cardiovascular en pacientes obesos mórbidos, antes y después de ser sometidos a Gastrectomía Vertical (GV). Material y métodos: Realizamos un estudio observacional retrospectivo de mujeres intervenidas de GV entre 2007 y 2012 en el Hospital General Universitario de Elche, calculando el PGC mediante la fórmula CUN-BAE de forma preoperatoria y 12 meses tras la intervención. Se correlacionaron estos valores con diferentes parámetros metabólicos y de riesgo cardiovascular. Resultados: Se estudiaron 50 mujeres. Preoperatoriamente, el IMC medio de 50,4 ± 7,4 kg/m2 y PGC del 54,8 ± 3%. Al año de la intervención, el IMC medio era de 27,7 ± 2,6 y el PGC 39,4 ± 3,7%. La PGC se correlacionó significativamente con 3 factores bioquímicos asociados con mayor riesgo cardiovascular (cortisol, vitamina D y cociente TG/HDL). Conclusión: la adiposidad, según la fórmula CUN-BAE, y el análisis de factores bioquímicos predictivos de obesidad, de forma conjunta suponen herramientas útiles para valorar el riesgo de enfermedad cardiovascular, después de GV.
Subject(s)
Adiposity , Body Mass Index , Cardiovascular Diseases/metabolism , Gastrectomy , Obesity, Morbid/metabolism , Obesity, Morbid/surgery , Adult , Cardiovascular Diseases/complications , Female , Gastrectomy/methods , Humans , Mathematical Concepts , Obesity, Morbid/complications , Predictive Value of Tests , Preoperative Period , Retrospective Studies , Risk FactorsABSTRACT
Introducción: El Índice de Masa Corporal (IMC) es uno de los parámetros más utilizados en cirugía bariátrica. Sin embargo, no discrimina el peso asociado a adiposidad. La fórmula CUN-BAE es una ecuación que permite calcular el Porcentaje de Grasa Corporal (PGC) o adiposidad, basándose en valores fáciles de disponer (edad, sexo e IMC). Con esta nueva clasificación muchos de los sujetos considerados con normopeso o sobrepeso (IMC ≤ 30 kg/m2 ) en realidad tienen un PGC alto y presentan comorbilidades asociadas a la obesidad. El objetivo de este estudio es evaluar PGC cuantificado mediante fórmula CUN-BAE como marcador predictivo de riesgo cardiovascular en pacientes obesos mórbidos, antes y después de ser sometidos a Gastrectomía Vertical (GV). Material y métodos: Realizamos un estudio observacional retrospectivo de mujeres intervenidas de GV entre 2007 y 2012 en el Hospital General Universitario de Elche, calculando el PGC mediante la fórmula CUN-BAE de forma preoperatoria y 12 meses tras la intervención. Se correlacionaron estos valores con diferentes parámetros metabólicos y de riesgo cardiovascular. Resultados: Se estudiaron 50 mujeres. Preoperatoriamente, el IMC medio de 50,4 ± 7,4 kg/m2 y PGC del 54,8 ± 3%. Al año de la intervención, el IMC medio era de 27,7 ± 2,6 y el PGC 39,4 ± 3,7%. La PGC se correlacionó significativamente con 3 factores bioquímicos asociados con mayor riesgo cardiovascular (cortisol, vitamina D y cociente TG/HDL). Conclusión: la adiposidad, según la fórmula CUN-BAE, y el análisis de factores bioquímicos predictivos de obesidad, de forma conjunta suponen herramientas útiles para valorar el riesgo de enfermedad cardiovascular, después de GV (AU)
Introduction: Body Mass Index (BMI) is one of the most used parameters in bariatric surgery. However, it does not discriminate the weight associated with adiposity. CUN- BAE formula is an equation that calculates Body Fat Percentage or adiposity, based on easily available values (age, sex and BMI). With this new classification many of the subjects that was considered normal weight or overweight (BMI ≤ 30 kg/m2 ) really have a higher adiposity and they have comorbidities associated with obesity. The objective of this study is to evaluate the adiposity by formula CUN-BAE as a predictive marker of cardiovascular risk in morbidly obese patients before and after sleeve gastrectomy. Material and methods: We performed a retrospective observational study of women that were intervened with sleeve gastrectomy, between 2007 and 2012 at the Universitary General Hospital of Elche. The adiposity was calculated by formula CUN-BAE preoperatively and 12 months after surgery. These values were correlated with different metabolic and cardiovascular risk parameters. Results: 50 women were studied. Preoperatively, the mean BMI was 50.4 ± 7 kg/m2 and adiposity 54.8 ± 3%. One year after surgery, the mean BMI was 27.7 ± 3 and adiposity 39.4 ± 4%. The adiposity was significantly correlated with 3 biochemical factors associated with increased cardiovascular risk (cortisol, vitamin D and ratio TG/HDL). Conclusion: Adiposity, according to the formula CUNBAE, and biochemical analysis of predictive factors of obesity together represent useful tools for assessing the risk of cardiovascular disease after sleeve gastrectomy (AU)
