Cases reported "Surgical Wound Infection"

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1/8. Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction.

    A pedicled anterolateral thigh fasciocutaneous flap that was used to cover a complicated perineogenital defect after bilateral gracilis myocutaneous flap for perineal reconstruction is presented. The indications and advantages of this approach are outlined. This technique offers to the plastic surgeon and gynecologic oncologist a new option in the armamentarium for reconstruction of the perineum, and it offers the patient reduced donor-site morbidity.
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ranking = 1
keywords = gynecologic
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2/8. Anaerobic infections in surgery: clinical review.

    Anaerobic bacteria are being recognized with increasing frequency as important micro-organisms in surgical infections. clostridium, Bacteriodes, fusobacterium, and peptostreptococcus are the clinically prominent pathological anaerobes. All are commensals and, consequently, most anaerobic infections are endogenous in origin. In the colon, anaerobes are 1,000 times more prevalent than aerobes. This has important implications regarding the management of gastrointestinal tract operations and the treatment of infections originating from the bowel. Typical anaerobic infections include gas gangrene, brain abscess, oral infections, putrid lung abscesses, intra-abdominal abscesses, and wound infections following gynecologic and bowel surgery, perirectal abscesses, postabortal infections, and septic thrombophlebitis. Infections with anaerobic organisms must be suspected when there is feculent odor and/or gas production following gynecologic or bowel surgery, when there are organisms on gram staining but no growth on aerobic cultures, or when septicemia is associated with repeatedly negative blood cultures. debridement and drainage constitute the main stay of treatment. All anaerobes are sensitive to chloramphenicol and clindamycin and all but bacteroides fragils are sensitive to penicillin. Identification of anaerobes requires proper specimen sampling, immediate culturing on prereduced media, and careful gram staining of clinical material. The frequency of anaerobic organisms in surgical infections generally is not recognized by many surgeons; their importance needs to be stressed in the future.
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ranking = 2
keywords = gynecologic
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3/8. Postoperative wound infection with pasteurella multocida from a pet cat.

    We summarize an unusual postoperative wound infection that was caused by pasteurella multocida from a house cat licking the incision in an obese gynecologic oncology patient. A 48-year-old morbidly obese woman had a wound abscess 6 weeks after hysterectomy and panniculectomy for a International Federation of gynecology and obstetrics stage IA grade 1 endometrial cancer. P multocida was cultured from the abscess and the patient was treated with drainage and intravenous antibiotics. Further history revealed that her house cat had licked the wound. P multocida wound infection is a potential complication for people with dog or cat contact postoperatively. penicillin g is the antibiotic of choice for treatment.
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ranking = 1
keywords = gynecologic
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4/8. Human acellular dermal matrix for closure of a contaminated gynecologic wound.

    BACKGROUND: Polypropylene mesh for abdominal wall reconstruction increases the risk of postoperative complications in previously irradiated patients or patients with contaminated operative fields. A novel alternative, acellular dermal matrix, easily incorporates into native tissue when used for fascial reconstruction, forming a strong repair with minimal adhesions and lower infection rates. CASE: We describe a patient previously treated with radiation for cervical cancer who presented with a contaminated operative field due to enteral spillage and pelvic infection. Acellular dermal matrix was used as part of a stepwise secondary closure of a large fascial defect in the anterior abdominal wall that was the result of repeated surgical procedures. CONCLUSION: Use of acellular dermal matrix rather than traditional polypropylene mesh should be considered for patients with contaminated or irradiated operative fields.
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ranking = 4
keywords = gynecologic
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5/8. Ovarian abscess following cesarean section. A case report and review of literature.

    Ovarian abscess is presented although such a finding is an unusual gynecologic complication. It is difficult to distinguish from a tubo-ovarian abscess. Its presence may be suspected in a patients after surgery, carrying IUD, having intraperitoneal infection and pregnancy. If an abscess is present, a tubo-ovarian abscess is much more common, except in pregnancy. For the last 110 years only 120 cases of ovarian abscesses have been reported in the literature.
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ranking = 1
keywords = gynecologic
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6/8. Infectious morbidity in gynecologic cancer.

    A retrospective investigation of infectious morbidity in gynecologic oncology patients documented that 54 (11%) of 494 patients and 68 (6%) of 1204 patient admissions were complicated by a serious infection. The highest rate of infectious morbidity by admission was 21%, occurring in patients admitted for cancer of the vulva. The highest surgical infectious morbidity, 22%, occurred in patients admitted for cervical cancer. Important factors in determining infection risk include multiple host factors, radical surgical procedures, factors inherent in the tumor itself, and additional irradiation and chemotherapy. These serious polymicrobial infections dictate intelligent selection of antimicrobials and appropriate monitoring to anticipate complications inherent in antimicrobial therapy. beta-Lactamase induction, superinfection, nephrotoxicity, and necrotizing enterocolitis are documented problems in these patients.
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ranking = 5
keywords = gynecologic
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7/8. Necrotizing surgical infection and necrotizing fasciitis in obstetric and gynecologic patients.

    Necrotizing fasciitis (NF) is a rapidly progressive disease characterized by extensive necrosis of the skin, fascia, and subcutaneous tissue, with sparing of the underlying muscle. diabetes mellitus, Bartholin's gland abscess, and recent surgical procedures (including episiotomy) are factors often found in obstetric and gynecologic patients. mortality in this group of patients is higher than in the general surgical population. death is usually due to overwhelming sepsis, renal and respiratory failure, and multiple organ failure. The infections are usually polymicrobial, with alpha-hemolytic streptococci, gram-negative coliforms, and anaerobic bacteria. Lower survival has been reported in large series when the groin is involved or when the general nutritional state is poor. From October 1988 to August 1990, we treated five patients with necrotizing fasciitis. Certain important characteristics of such patients have not been discussed in the obstetric and gynecologic literature. nutritional status, with special emphasis on total protein, albumin, and the effects of alcoholism, has a significant impact on mortality. nutritional support of these patients may improve survival. To limit the impact of secondary infections, surgical approaches should be modified by the anatomic location of the initial lesions. More frequent debriding in the operating room and early fecal diversion are recommended.
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ranking = 6
keywords = gynecologic
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8/8. Streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.

    Necrotizing fasciitis is a rare infection of the deep and subcutaneous tissue layers most commonly caused by group A beta-hemolytic Streptococcus. The disease begins as a typical cellulitis. necrosis of the deeper tissues progresses rapidly, accompanied by a dusky, gray-blue skin discoloration with erythematous margins. Even with appropriate treatment, mortality rates remain as high as 36%. Most cases of necrotizing fasciitis have been reported in the general surgical literature, associated with trauma or as a postoperative wound infection after abdominal and gynecologic procedures. Of the 50 cases involving the eyelids reported in the literature, only three were reported to have occurred as a "postoperative" complication. This report is of the first known case of streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.
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ranking = 1
keywords = gynecologic
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