Browsing by Subject "Infections"

Now showing 1 - 4 of 4
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    177. Prophylactic Absorbable Antibiotic Beads For High Risk Implant-based Reconstruction: A Single Institution Pilot Study
    (Wolters Kluwer, 2023-05-19) Ahmed, Shahnur; Lee, Jason T. C.; Roth, Dylan D.; Liu, Steven; Fisher, Carla S.; Fan, Betty; Imeokparia, Folasade; Ludwig, Kandice; Lester, Mary E.; Hassanein, Aladdin H.; Surgery, School of Medicine
    PURPOSE: Infections are problematic in implant-based reconstruction after mastectomies. Infection rates have been reported to be as high as 31%. Strategies to reduce the risk of infection include various antibiotic irrigation solutions, “no-touch” techniques, optimizing sterility, and empiric antibiotic use for skin flora coverage. Absorbable antibiotic beads have been well described for other indications, including orthopedic and pressure sore reconstruction. The purpose of this study is to evaluate the use of prophylactic biodegradable antibiotic beads during pre-pectoral and sub-pectoral implant-based breast reconstruction following mastectomy. METHODS: A single-center retrospective review of patients who underwent implant-based breast reconstruction post-mastectomy between 2019 to 2022. Patients were divided into two groups: Group I were deemed “high risk” by the senior author and received biodegradable antibiotic beads (1 gram vancomycin, 240 mg gentamicin) during tissue expander or implant reconstruction (pre-pectoral or subpectoral) while Group II (control) had no antibiotic beads. Demographic data, diabetes, body mass index (BMI), implant plane (pre-pectoral or sub-pectoral), smoking and use of mesh were recorded. Outcome variables included postoperative cellulitis or infection requiring oral or intravenous antibiotics and tissue expander loss at 90 days. RESULTS: In our study period, 19 patients (36 total implants/expanders) received biodegradable antibiotic beads during implant-based breast reconstruction (Group I). There were 174 patients (290 total expanders) who did not receive antibiotic beads (Group II). Patients in Group I had a history of previous expander/implant infection in 73.6%. Pre-pectoral placement of implants occurred in 84.2% of patients in Group I and 74.1% in Group II. Diabetes was prevalent in 15.8% of Group I compared to 5.7% seen in Group II patients. The mean BMI in Group I was 30.5 kg/m2 compared to 27.8 kg/m2 in Group II (p-value 0.88). Implant infection rate of Group I at 90 days was 8.3% (3/36 total expanders) compared to 8.6% (25/290 total expanders) in Group II. Implant loss in Group I was 5.5% (2/26 total expanders) compared to 7.6% (22/290) in Group II. CONCLUSION: The incidence of infection in high risk patients who have absorbable antibiotic beads placed during the time of reconstruction appears to be normalized to the control group in this pilot study, suggesting that absorbable antibiotic beads may decrease postoperative infection complications. Future studies may further clarify its benefit in selected groups.
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    A phenomenological study of the lived experience of nurses in the battle of COVID-19
    (Springer Nature, 2021) Gunawan, Joko; Aungsuroch, Yupin; Marzilli, Colleen; Fisher, Mary L.; Nazliansyah; Sukarna, Ade; School of Nursing
    Background: Roles and responsibilities of nurses are crucial in the battle of Coronavirus disease 2019 (COVID-19), but nursing duties also put them at risk for infections. Purpose: The purpose of this study was to explore the lived experience of nurses in combatting COVID-19 in Belitung, Indonesia. Methods: This study employed a phenomenological study design. Online interviews and chatting were conducted among 17 clinical nurses who were purposively selected from March to June 2020. Data were audio-recorded, transcribed, and validated among researchers. The thematic approach was used for data analysis. Findings: Seven themes emerged (1) feeling "nano-nano", (2) lack of N95 masks, (3) we are just pawns, (4) being rejected, (5) please do not spread our identity, (6) we miss home, and (7) feeling betrayed by regulation. Discussion: Findings of this study should be used by government agencies, nurses, and the general population in combatting COVID-19.
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    Autophagy modulates CD4+ T-cell lineage recommitment upon pathogen infection
    (Springer Nature, 2020-07) Yang, Kai; Chi, Hongbo; Pediatrics, School of Medicine
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    Daily Situational Brief, February 9, 2015
    (MESH Coalition, 2/9/2015) MESH Coalition