RESUMEN
Background: Surgical site infections (SSIs) are the most common nosocomial infections suffered by surgical patients. They increase medical costs and prolong hospital stay. With respect to gastrointestinal surgery, SSIs are reported to have an incidence of up to 30%, and they frequently cause morbidity. The aim of this study was to prospectively investigate whether use of triclosan-coated sutures for abdominal incision closure during colorectal surgery reduces the incidence of SSI. Patients and Methods: This was a double-blinded randomized controlled trial in a single academic surgical hospital. Patients who underwent laparoscopic or open colorectal surgery were included. Patients were pre-operatively randomly assigned to either the Vicryl® Plus (VP) or Vicryl® (Ethicon Inc., Somerville, NJ) group. The patients and medical staff were blinded. Results: The primary end point was overall SSI rate and SSI at 30 days. Over a six-year period, 811 patients who underwent colorectal surgery and provided informed consent were randomly assigned (VP group, 396 patients; Vicryl group, 415 patients). No differences in baseline demographics were observed between the groups. The overall incidence of SSI was 4.8% (39/811 patients). There were no statistically significant differences in mean length of post-operative hospital stay between the groups (VP group, 9.3 days; Vicryl group, 9.6 days; p = 0.587). Statistically significant differences in SSI rate after post-operative day 30 were observed between the groups (VP group, 1 patient [7.1%]; Vicryl group, 7 patients [28.0%]; p = 0.039). Conclusions: Although use of triclosan-coated sutures did not reduce incidence of SSI within 30 days post-operatively, it is associated with reduced SSI rate after post-operative day 30.
Asunto(s)
Antiinfecciosos Locales , Infecciones Intraabdominales , Triclosán , Humanos , Infección de la Herida Quirúrgica/epidemiología , Incidencia , Poliglactina 910 , Infecciones Intraabdominales/complicaciones , SuturasRESUMEN
For water electrolysis, a rare earth material (eg., platinum) is often used as an electrode, but because of the high cost and toxicity of chemicals, researchers are searching for cost effective and eco-friendly alternative materials. Various alloys and metals have been long explored for use as electrode materials in different media. Stainless steel (SS 304) electrodes are cost effective and have a large surface area; further their catalytic performance is comparable to that of carbon coated noble metals cathodes. Stainless steel has good mechanical properties and durability so it is widely used in desalination plants, oil and gas industries, ship building, etc. However, over a period of time it corrodes very quickly in saline water. To improve the stability and durability of the electrodes (i.e., to minimize corrosion), we anneal the samples under two different sets of conditions and test the electrodes in 3.5% NaCl solution. The anodic peak (-0.25â¯V) observed for bare stainless steel result from the formation of iron (II) hydroxide [Fe(OH)2]. The Raman bands observed at 210 and 274â¯cm-1 for bare stainless steel result from the formation of α-Fe2O3 owing to partial, anodic, and cathodic reactions occurring on the electrode which disrupts the surface layers. High intensity X-ray diffraction (XRD) and Raman peaks of Cr2O3 and MnCr2O4 observed in argon and hydrogen annealed sample after cyclic voltammetry reveal that this sample is more stable than bare and air annealed samples. XRD reveals mixed oxide phases in addition to eskolaite and magnetite phases. Scanning electron microscope (SEM) images show that although the air-annealed sample has a soft, spongy structure, Na and Cl ions are adsorbed in the voids on the outer surface of the electrode leading to quick degradation. For the air-annealed sample the oxide appears to adhere poorly to the stainless steel. Oxygen (ie., oxide composition) may play a key role in adherence and growth of Cr2O3 formed at high temperature. X-ray photoelectron spectroscopy (XPS) reveals that large amounts of Cr and Mn are dissolved/corroded into the electrolyte for air annealed sample which is in good agreement with the Raman and SEM results.