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PRESENTATION OF SURGICAL INFECTION Major and minor surgical site infection (SSI) Infection acquired from the environment or the sta ff following surgery or admission to hospital is termed hospital-acquired infection (HAI). There are four main groups: respirator...

Postoperative wound infections The majority of wound infections arise from endogenous sources within the patient, but exogenous SSIs may also occur HOSPI TA L __________________________________ __ __ ____ ____ _ __ ____ __ ___________ DA DA TE OF BIR TE OF BI...

Prophylactic antibiotics Prophylactic antibiotics are used when there is a risk of wound contamination with bacteria during surgery . The theoretical Council (USA) over 40 years ago, relates well to infection rates ( T able 5.2 ). The value of antibiotic pro...

Reduced resistance to infection Reduced resistance to infection has several causes, particularly those that impair the inflammatory response. Host response is weakened by malnutrition associated with a low or high body mass index. Metabolic diseases such as dia...

Sources of infection The infection of a wound can be defined as the invasion of - organisms into tissues following a breakdown of local and systemic host defences, leading to cellulitis, lymphangitis, abscess formation or bacteraemia. The infection of most ...

Systemic infection Bacteraemia Bacteraemia is unusual following superficial SSIs, which tend to drain through the wound, but common after deep space SSIs, such as following an intestinal anastomotic breakdown. It is usually transient and can follow procedures u...

Systemic inflammatory response syndrome Systemic inflammatory response syndrome (SIRS) is a systemic manifestation of sepsis ( Table 5.1 ), although the syndrome may also be caused by multiple trauma, burns or pancreatitis without infection. Serious infection, ...

The decisive period There is up to a 4-hour interval before bacterial growth becomes established enough to cause an infection after a breach in the tissues, whether caused by trauma or by surgery . This interval is called the ‘decisive period’ and strategies a...

Viral infections relevant to surgery Hepatitis Both hepatitis B and hepatitis C carry risks in surgery as they are blood-borne pathogens that can be transmitted both from - the patient to the surgeon and vice versa . The usual mode of transmission is blood-to-...

prophylaxis of surgical infection Antimicrobials may be produced by living organisms (anti - - biotics) or by synthetic methods. Some are bactericidal, e.g. penicillins and aminoglycosides, and others are bacteriostatic, e.g. tetracycline and erythromycin. In ...

Aetiology Non-syndromic cleft lip and/or palate may present as new diagnosis within a family or with a clear family history . A family history of cleft lip and palate in which a first-degree relative is a ff ected increases the risk of subsequent cleft cases i...

Age 1–7 years: early years care/ follow-up Following primary surgery , regular review by an MDT is essential. Many aspects of cleft care require review during the early years of childhood: /uni25CF hearing; /uni25CF speech; /uni25CF dental development; /uni2...

Age 7–12 years: late childhood care/ follow-up Alveolar bone grafting - ABG is a key surgical intervention for patients with alveolar involvement. The procedure can be carried out at the same time as primary cleft lip surgery and is defined as primary bone graf...

CLASSIFICATION OF CRANIOFACIAL ABNORMALITIES van der Meulen and his colleagues proposed a classification system that has significant utility in helping to understand the variety and complexity of craniofacial malformations. This classification considers the emb...

CLEFT LIP AND PALATE

Classification of cleft Cleft lip and/or palate presents in a heterogeneous manner. In simple terms these conditions can be divided into two clinical types (phenotypes): - 1 isolated cleft palate; 2 cleft lip with or without involvement of the alveolus (tooth-...

Cleft lip and/or palate: embryology and pathogenesis Embryologically , the lip and palate are derived from facial prominences/processes. 1 The lip/nose complex is derived from a mixture of the median nasal process and the maxillary processes. 2 The primary pa...

Cleft lip/nose revision Indications for revisional surgery to a previously repaired cleft lip are dependent on the site and severity of the residual deformity . Relative indications for lip revision include: /uni25CF misaligned vermilion; /uni25CF lip asymmet...