| 1. |
- Hjalmarsson, Claes, et al.
(författare)
-
Orally Administered Trimethoprim-Sulfamethoxazole and Metronidazole as Infection Prophylaxis in Elective Colorectal Surgery
- 2015
-
Ingår i: Surgical Infections. - : MARY ANN LIEBERT, INC. - 1096-2964 .- 1557-8674. ; 16:5, s. 604-610
-
Tidskriftsartikel (refereegranskat)abstract
- Background: This randomized clinical trial evaluated orally administered trimethoprim-sulfamethoxazole and metronidazole (TSM) in elective colorectal surgery as prophylactic for post-operative surgical site infections (SSI). Methods: Patients undergoing elective colorectal resection were evaluated for inclusion. Randomized subjects received either orally administered TSM or intravenously administered cefuroxime and metronidazole (control group, CXM). The primary endpoint was the rate of SSI. Results: A total of 1073 subjects were randomized to either control (540) or TSM (533). 486 patients in the TSM group and 499 in the control group were followed-up with after 4 weeks. Thirty-seven (3.8%) patients were afflicted by SSI at discharge from hospital and 69 (7.0%) at follow-up four weeks after surgery. After four weeks, the rate of incisional SSI was 7.0% in the TSM group and 3.6% in the control group (p=0.022). For organ/space SSI and the other complications monitored in the study, no differences were observed between the groups. Conclusion: Orally administered TSM as prophylaxis before elective colorectal surgery results in a low rate of organ/space SSI but an increased rate of incisional SSI compared with intravenously administered cefuroxime and metronidazole. Thus, when considering orally administered TSM, because of environmental concerns or for economic reasons, the slightly increased infection rate has to be kept in mind.
|
|
| 2. |
- Modin, Marina, et al.
(författare)
-
Postoperative impact of daily life after primary treatment of proximal/distal tibiafracture with Ilizarov external fixation
- 2009
-
Ingår i: JOURNAL OF CLINICAL NURSING. - : Wiley. - 0962-1067 .- 1365-2702. ; 18:24, s. 3498-3506
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe patients’ experience of the impact of their health-related life situation on their daily life two and four weeks after primary fracture treatment with Ilizarov external fixation. Background. A few studies have been conducted postoperatively focussing on fracture treatment with Ilizarov fixation. Design. A prospective descriptive research design. Method. Patients who had been treated for a proximal/distal tibial fracture were invited to participate in the study. Data were collected with a semi-structured questionnaire where 20 patients described in their own words their situation at home two and four weeks postoperatively. The process used when analysing the data was similar to content analysis. Results. Four key themes were identified: ‘limitations in the home environment’, ‘limitations outside the home’, ‘limitations to social relations’ and ‘experience of having an Ilizarov fixation’. The patient’s life situation was strongly affected during the first postoperative month. This took the form of clear limitations on activities outside the home and a degree of limitation on coping with household chores and personal hygiene. These limitations became less severe after between 2–4 weeks and were very much a consequence of using crutches. Conclusion. This study points to limitations in the patient’s daily life situation in the home. The results from the study make it obvious that the information given to patients prior to discharge, concerning the value of putting weight on the leg, had not been clear or that the patients had not understood it. This had a negative impact on the patient’s daily life after discharge. Further data are needed to uncover the extent of the issue to be able to optimise patient outcomes. Relevance to clinical practice. There is a need for clearer and more active information from the nurse before discharge but also a need to follow up how the information given is understood.
|
|
| 3. |
- Wennström, Berith, et al.
(författare)
-
Patient symptoms after colonic surgery in the era of enhanced recovery--a long-term follow-up.
- 2010
-
Ingår i: Journal of clinical nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 19:5-6, s. 666-672
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS: The main purpose of this study was to analyse, prospectively, patient symptoms during the first four weeks following elective colon surgery. A secondary aim was to find areas to improve inpatient information and postoperative care. BACKGROUND: Fast-track recovery following colon surgery has been proven beneficial to patients in the early postoperative phase. Less is known about the continuous recovery at home. DESIGN: A prospective follow-up survey. METHODS: Consecutive patients (n = 32) planned for elective colon surgery were evaluated. Both open and laparoscopic operations were included. All followed a fast-track protocol in hospital. Patient symptoms were recorded by validated quality of life questionnaires (EORTC QLQ-C 30, EORTC QLQ-CR 38 and Brief Pain Inventory). An interview was conducted five weeks and one year after surgery. RESULTS: The hospital stay was six days, and 10% of patients were readmitted. The fast-track concept worked well. The main problems after discharge were fatigue, nausea and bowel disturbances. Pain was not a significant issue. Most symptoms had disappeared after four weeks. CONCLUSIONS: The first period at home is troublesome, and better information about common symptoms is needed. A direct telephone line has been set up to answer questions and to lower patient anxiety. RELEVANCE TO CLINICAL PRACTICE: Clinical guidelines for patient's discharge planning can be performed based on the results from this study. Further improvement regarding the epidural anaesthesia is needed to reduce minor side effects.
|
|
