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This concise and practical handbook covers the basics of pathophysiology, diagnosis, interdisciplinary surgical management, prevention and rehabilitation of patients with deep sternal wound infections and sternal osteomyelitis. All relevant aspects and surgical procedures are explained in an easily understandable way. Additionally special approaches and preventive measures are highlighted with regard to the perioperative handling as well as the rehabilitation possibilities. Through concise texts with numerous illustrations, the book is ideal for the practice and as a supplement to further studies. This book is suitable for all specialists who are involved into the treatment and diagnosis of sternal wound infections, particularly cardio-thoracis, thoracic, plastic, vascular surgeons, cardiologists, radiologists, and rehabilitation physicians.
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.
This work provides a one-of- a-kind volume that includes all aspects of heart transplantation from its historic beginning to its current day standards which now make the procedure a long-term treatment option for heart failure patients. The subjects covered include technical aspects of the procurement and implant procedures, as well as the medical nuances of pre-operative preparation and post-transplant immunosuppression management; the current day multi-disciplinary make up of the transplant team along with information on the keys to building and running a successful transplant program; regulatory standards and listing policies and the impact of the growing mechanical circulatory support technologies on the transplant field; and emerging technologies and future possibilities. All chapters are written by experts in the field and include the most up-to-date peer reviewed studies and clinical guidelines. This book gives an ever-changing reference that will become the text of choice for those beginning or continuing their transplant careers.
Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy.
Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
This volume offers extensive information on preventive and infection surveillance procedures, routines and policies adapted to the optimal infection control level needed to tackle today’s microbes in hospital practice. It especially focuses on preventive measures for serious hospital infections. Each chapter includes a practical section that addresses the main aspects of procedures and treatment, and a theoretical section that contains updated documentation that can be used for further study, or to help select infection control measures. Infection control concerns all healthcare professional working directly or indirectly with patients; in diagnosis, treatment, isolation measures, operations, equipment, drugs, cleaning, textiles, transport, porter service, food and water, building and maintenance, etc. Hygiene and environmental control is central to infection prevention for patients, visitors and staff alike. Good hygienic practices, individual infection control, well implemented and frequent environmental cleaning, and a high professional standard of hygiene in the treatment and care of patients, are essential to patient safety and a safe working environment. Addressing this essential topic, this book is intended for doctors, nurses and other healthcare workers, students in health-related subjects, hospital managers and health bureaucrats, as well as patients and their families.
Adhesions can cause a wide range of problems, complaints and hazards, even after simple abdominal procedures, such as appendectomy, with complications ranging from recurrent discomfort and pain to intestinal obstruction. Postsurgical adhesions increase the risk of following operations of the abdominal and thoracic cavity. They impair peritoneal dialysis and chemotherapy and play a crucial part in laparoscopic procedures. Adhesion-related problems account for a large amount of clinical work and have a significant socioeconomic impact. This book presents the current knowledge on the aetiopathogenesis of adhesion formation as well as the available methods for their prevention and control. Experts in the field contribute to clinical standards for preventive measures to control the formation of postoperative adhesions
Acute Rheumatic Fever and Rheumatic Heart Disease is a concise, yet comprehensive, clinical resource highlighting must-know information on rheumatic heart disease and acute rheumatic fever from a global perspective. Covering the major issues dominating the field, this practical resource presents sufficient detail for a deep and thorough understanding of the latest treatment options, potential complications, and disease management strategies to improve patient outcomes. - Divided into four distinct sections for ease of navigation: Acute Rheumatic Fever, Rheumatic Heart Disease, Population-Based Strategies for Disease Control, and Acute and Emergency Presentations. - International editors and chapter authors ensure a truly global perspective. - Covers all clinical aspects, including epidemiology, pathophysiology, clinical features, diagnosis, management, and treatment. - Includes key topics on population-based measures for disease control for effective primary, secondary, and tertiary prevention. - Consolidates today's available information and guidance into a single, convenient resource.
The latest diagnostic and therapeutic modalities in the management of coronary artery disease by coronary artery bypass graft surgery and by percutaneous coronary intervention with stenting and in the interventional management of other atherosclerotic vascular disease have led to a reduction in cardiovascular mortality and morbidity. This book entitled Artery Bypass provides an excellent update on these advances which every physician seeing patients with atherosclerotic vascular disease should be familiar with. This book includes 27 chapters written by experts in their topics.
Robotic Cardiac Surgery is a comprehensive guide to robotic/totally endoscopic cardiac surgery. The book is intended to provide in-depth information regarding the history of robotic surgical systems, their components and principles. It emphasizes patient selection, perioperative management, anesthesia considerations and management, operative techniques and management, postoperative care and results. Extensive, detailed photographs and illustrations of different kinds of robotic surgery are also included. It provides cardiac surgeons, cardiac anesthesiologists, and perfusionists with a comprehensive review of current robotic cardiac surgeries and related knowledge. Changqing Gao, MD, is a professor at the Department of Cardiovascular Surgery, PLA General Hospital, Beijing, China.