Evaluation of the role of povidone­iodine in the prevention of surgical site infections.

Background: The occurrence of surgical site infections (SSIs) is associated with increased risk of mortality, development of other infections, and the need for reintervention, posing a significant health burden. The aim of this review was to examine the current data and guidelines around the use of antiseptic povidone­iodine (PVP-I) for the prevention of SSIs at each stage of surgical intervention. Methods: A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertise. Results: Scientific evidence demonstrates that PVP-I can be used at every stage of surgical intervention: preoperative, intraoperative, and postoperative. PVP-I is one of the most widely used antiseptics on healthy skin and mucous membranes for preoperative surgical site preparation and is associated with a low SSI rate. For intraoperative irrigation, aqueous PVP-I is the recommended agent and has been demonstrated to decrease SSIs in a range of surgical settings, and for postoperative wound healing, there is a growing body of evidence to support the use of PVP-I. Conclusions: There is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation. The use of a single agent (PVP-I) at each stage of surgical intervention could potentially provide advantages, including economic benefits, over agents that can only be used at discrete stages of the surgical procedure. Key message: Evidence supports the use of PVP-I at all stages of surgical intervention, from preoperative measures (including skin preparation, preoperative washing, and nasal decolonization) to intraoperative irrigation, through to postoperative wound management. However, there is a need for more stringent study designs in clinical trials to enable meaningful comparisons between antiseptic agents, particularly for preoperative skin preparation.

Periorbital Necrotizing Fasciitis Induced by Streptococcus pyogenes: A Case Report and Clarification.

Periorbital necrotizing fasciitis (PONF) is a rare condition of the face. PONF can lead to blindness, functional and esthetic sequelae, multiple-organ failure, and death. The aim of this report is to raise the awareness of this severe condition in maxillofacial surgeons. This report describes the case of a 30-year-old woman who presented with a bilateral palpebral edema and pain 3 days after a jugal wound was sutured. Necrosis of the skin of the left palpebral unit was extending rapidly. The patient had signs of sepsis. Surgical debridement was performed promptly and intravenous broad-spectrum empiric antibiotics were administered. The patient recovered slowly with no complication other than a residual skin defect of the 2 eyelids that was later corrected by full-thickness skin grafting. Special attention should be paid to signs of preseptal cellulitis because it can, in some cases, rapidly develop into PONF. Early diagnosis and treatment are the keys to a favorable outcome.

Huge teratoma of the face.

BACKGROUND: A case of facial teratoma is reported which was composed of the three germinal layers of the embryo. Teratomas form tissues foreign to the body part in which they arise. These are most common in the sacrococcygeal region and in the gonads, but can also be present in extragonadal sites. They remain rare in the head and neck area. Facial teratoma is a very rare tumour, generally benign. Less than 5% of those appearing in the head and neck of children are estimated to be malignant. PATIENT: We describe the case of a female neonate with a very large facial mass, deforming the orbit, the zygomatic arch and the jaws, without any intracranial extension. The tumour was removed at the age of 4 months because of rapid growth. An extended laterofacial approach was used, with superficial parotidectomy and complete facial nerve dissection. The postoperative course was unevenful. The diagnosis was mature teratoma. CONCLUSION: Clinical outcome of teratomas depends on their histological grade, localization and quality of surgical treatment.