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Asepsis

The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform

A P R Wilson – 1st expert on this subject based on the ideXlab platform

  • AGE, ASA AND BMI AS RISK FACTORS FOR SURGICAL SITE INFECTION MEASURED USING Asepsis IN TRAUMA AND ORTHOPAEDIC SURGERY
    , 2012
    Co-Authors: Elizabeth Ashby, A P R Wilson, M.j. Davies, Fares S. Haddad

    Abstract:

    There is mixed evidence in the literature regarding increasing age, ASA and BMI as risk factors for surgical site infection in orthopaedic surgery. To investigate the matter further, we examined 1055 wounds in 1008 patients in the Department of Trauma and Orthopaedic Surgery at University College London Hospital between 2000 and 2006. All patients with a minimum two-night stay were included. Data was collected by four designated research nurses. The age, height, weight and ASA status of each patient was recorded. All wounds were classified using Asepsis. This is a quantitative wound scoring method which is a summation of scores calculated from visual wound characteristics and the clinical consequences of infection. Our results showed a strong linear association between age and Asepsis scores. Single variable regression analysis showed a t value of 3.32 and p value of 0.001. A similar linear association was seen between ASA grading and Asepsis scores. Single variable regression analysis showed a t value of 2.75 and p value of 0.006. The association between BMI and Asepsis scores was markedly different from that seen with age and ASA. The graph was U-shaped with patients with a BMI of 25-30 having the lowest average Asepsis scores. Patients with a lower and a higher BMI had higher average Asepsis scores. Single variable regression analysis was not significant since the relationship between BMI and Asepsis scores is not linear. In conclusion, there are clearly defined patient groups who are at increased risk of developing a surgical site infection: older patients, patients with a higher ASA, and patients with both a low and high BMI. These patients should be targeted to reduce overall infection rates. This can be achieved by ensuring adequate antibiotic prophylaxis, having a low threshold to treat suspected infection and arranging regular follow-up.

  • ORTHOPAEDIC WOUND SURVEILLANCE USING Asepsis
    , 2009
    Co-Authors: Elizabeth Ashby, A P R Wilson, M.j. Davies, Fares S. Haddad

    Abstract:

    Aims: To determine the rate of orthopaedic wound infection using Asepsis and compare this to the rate of infection as defined by the US Centres for Disease Control (CDC) and the UK Surgical Site Infection Surveillance Service (SSISS). Background: It is a common misconception that reported rates of orthopaedic wound infection are accurate, reliable and reproducible. Most definitions of infection, including CDC and SSISS, are subjective and depend on the interpretation of the surgeon. Asepsis1 is a method of wound scoring which grades wounds as uninfected, disturbed healing, minor infection, moderate infection and severe infection. Asepsis scoring has been proven to be both objective and repeatable2. Method: Over 4 years, 1113 orthopaedic wounds were prospectively evaluated using the CDC definition for surgical site infections, the SSISS definition and the Asepsis scoring method. Patients were seen pre-operatively and at 3 and 5 days post-operatively. They also completed a wound surveillance questionnaire at 2 months post-discharge. Results: The overall infection rates were 8% as defined by CDC, 4% as defined by SSISS and 3% as defined by Asepsis. Further classification of the wounds as defined by Asepsis revealed that 91% of wounds showed no evidence of infection (score 40). Conclusion: This study illustrates that accurate wound surveillance is not simple. Different wound infection definitions give very different rates of infection and make comparisons between surgeons and hospitals impossible. We propose that Asepsis provides the most accurate and reproducible results and also provides more information with the grading of wound infection. The overall rate of orthopaedic wound infection using the Asepsis method is 3%. If all hospitals used this scoring method, more accurate comparisons of infection rates could be made.

  • the use of the wound scoring method Asepsis in postoperative wound surveillance
    Journal of Hospital Infection, 1990
    Co-Authors: A P R Wilson, C Weavill, J Burridge, M C Kelsey

    Abstract:

    Abstract For the purposes of wound surveillance programmes and clinical trials, a wound scoring method, Asepsis, makes assessment of wound sepsis more objective and reproducible by allotting points both for the appearance of the wound in the first week and for the clinical consequences of infection. Asepsis was compared with other definitions of wound infection in 1029 surgical patients and its suitability for surveillance and detection of risk factors were examined. Satisfactory healing was recorded in 867 patients, disturbance of healing in 74 and minor, moderate and severe wound infection in 41, 24 and 23 patients respectively. An Asepsis score over 20 points was more sensitive and as specific as the presence of pus as an indicator of changes in management resulting from infection. Multiple regression analysis of Asepsis scores indicated that operation type, ward, degree of contamination, age, body mass index, and preoperative stay in hospital were significant risk factors. In matching 52 infected patients with uninfected controls, any wound score over 10 points was associated with a significant delay in discharge from hospital (median 3 days, P

M C Kelsey – 2nd expert on this subject based on the ideXlab platform

  • the use of the wound scoring method Asepsis in postoperative wound surveillance
    Journal of Hospital Infection, 1990
    Co-Authors: A P R Wilson, C Weavill, J Burridge, M C Kelsey

    Abstract:

    Abstract For the purposes of wound surveillance programmes and clinical trials, a wound scoring method, Asepsis, makes assessment of wound sepsis more objective and reproducible by allotting points both for the appearance of the wound in the first week and for the clinical consequences of infection. Asepsis was compared with other definitions of wound infection in 1029 surgical patients and its suitability for surveillance and detection of risk factors were examined. Satisfactory healing was recorded in 867 patients, disturbance of healing in 74 and minor, moderate and severe wound infection in 41, 24 and 23 patients respectively. An Asepsis score over 20 points was more sensitive and as specific as the presence of pus as an indicator of changes in management resulting from infection. Multiple regression analysis of Asepsis scores indicated that operation type, ward, degree of contamination, age, body mass index, and preoperative stay in hospital were significant risk factors. In matching 52 infected patients with uninfected controls, any wound score over 10 points was associated with a significant delay in discharge from hospital (median 3 days, P

J Burridge – 3rd expert on this subject based on the ideXlab platform

  • the use of the wound scoring method Asepsis in postoperative wound surveillance
    Journal of Hospital Infection, 1990
    Co-Authors: A P R Wilson, C Weavill, J Burridge, M C Kelsey

    Abstract:

    Abstract For the purposes of wound surveillance programmes and clinical trials, a wound scoring method, Asepsis, makes assessment of wound sepsis more objective and reproducible by allotting points both for the appearance of the wound in the first week and for the clinical consequences of infection. Asepsis was compared with other definitions of wound infection in 1029 surgical patients and its suitability for surveillance and detection of risk factors were examined. Satisfactory healing was recorded in 867 patients, disturbance of healing in 74 and minor, moderate and severe wound infection in 41, 24 and 23 patients respectively. An Asepsis score over 20 points was more sensitive and as specific as the presence of pus as an indicator of changes in management resulting from infection. Multiple regression analysis of Asepsis scores indicated that operation type, ward, degree of contamination, age, body mass index, and preoperative stay in hospital were significant risk factors. In matching 52 infected patients with uninfected controls, any wound score over 10 points was associated with a significant delay in discharge from hospital (median 3 days, P