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Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study

Surgical site infections (SSIs) represent a potential complication in any type of surgery and can occur up to one year after the procedure in the case of implant placement. In the field of orthopedic and hand surgery, the rate of SSIs is a relevant issue, considering the need for the placement of sy...

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Autores principales: Opri, Francesca, Bianchini, Sonia, Nicoletti, Laura, Monaco, Sara, Opri, Roberta, Di Pietro, Marilia, Carrara, Elena, Rigotti, Erika, Auriti, Cinzia, Caminiti, Caterina, Donà, Daniele, Lancella, Laura, Lo Vecchio, Andrea, Pizzi, Simone, Principi, Nicola, Simonini, Alessandro, Tesoro, Simonetta, Venturini, Eisabetta, Villani, Alberto, Staiano, Annamaria, Marchesini Reggiani, Leonardo, Esposito, Susanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944525/
https://www.ncbi.nlm.nih.gov/pubmed/35326754
http://dx.doi.org/10.3390/antibiotics11030289
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author Opri, Francesca
Bianchini, Sonia
Nicoletti, Laura
Monaco, Sara
Opri, Roberta
Di Pietro, Marilia
Carrara, Elena
Rigotti, Erika
Auriti, Cinzia
Caminiti, Caterina
Donà, Daniele
Lancella, Laura
Lo Vecchio, Andrea
Pizzi, Simone
Principi, Nicola
Simonini, Alessandro
Tesoro, Simonetta
Venturini, Eisabetta
Villani, Alberto
Staiano, Annamaria
Marchesini Reggiani, Leonardo
Esposito, Susanna
author_facet Opri, Francesca
Bianchini, Sonia
Nicoletti, Laura
Monaco, Sara
Opri, Roberta
Di Pietro, Marilia
Carrara, Elena
Rigotti, Erika
Auriti, Cinzia
Caminiti, Caterina
Donà, Daniele
Lancella, Laura
Lo Vecchio, Andrea
Pizzi, Simone
Principi, Nicola
Simonini, Alessandro
Tesoro, Simonetta
Venturini, Eisabetta
Villani, Alberto
Staiano, Annamaria
Marchesini Reggiani, Leonardo
Esposito, Susanna
author_sort Opri, Francesca
collection PubMed
description Surgical site infections (SSIs) represent a potential complication in any type of surgery and can occur up to one year after the procedure in the case of implant placement. In the field of orthopedic and hand surgery, the rate of SSIs is a relevant issue, considering the need for the placement of synthesis devices and the type of some interventions (e.g., exposed fractures). This work aims to provide guidance on the management of peri-operative antibiotic prophylaxis for the pediatric and neonatal population undergoing orthopedic and hand surgery in order to standardize the management of patients and to reduce, on the one hand, the risk of SSI and, on the other, the development of antimicrobial resistance. The following scenarios were considered: (1) bloodless fracture reduction; (2) reduction of unexposed fracture and grade I and II exposed fracture; (3) reduction of grade III exposed fracture or traumatic amputation; (4) cruel fracture reduction with percutaneous synthesis; (5) non-traumatic amputation; (6) emergency intact skin trauma surgery and elective surgery without synthetic media placement; (7) elective orthopedic surgery with prosthetic and/or synthetic media placement and spinal surgery; (8) clean elective hand surgery with and without bone involvement, without use of synthetic means; (9) surgery of the hand on an elective basis with bone involvement and/or with use of synthetic means. This manuscript has been made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies and represents, in our opinion, the most complete and up-to-date collection of recommendations regarding the behavior to be adopted in the peri-operative setting in neonatal and pediatric orthopedic and hand surgery. The specific scenarios developed are aimed at guiding the healthcare professional in practice to ensure the better and standardized management of neonatal and pediatric patients, together with an easy consultation.
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spelling pubmed-89445252022-03-25 Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study Opri, Francesca Bianchini, Sonia Nicoletti, Laura Monaco, Sara Opri, Roberta Di Pietro, Marilia Carrara, Elena Rigotti, Erika Auriti, Cinzia Caminiti, Caterina Donà, Daniele Lancella, Laura Lo Vecchio, Andrea Pizzi, Simone Principi, Nicola Simonini, Alessandro Tesoro, Simonetta Venturini, Eisabetta Villani, Alberto Staiano, Annamaria Marchesini Reggiani, Leonardo Esposito, Susanna Antibiotics (Basel) Article Surgical site infections (SSIs) represent a potential complication in any type of surgery and can occur up to one year after the procedure in the case of implant placement. In the field of orthopedic and hand surgery, the rate of SSIs is a relevant issue, considering the need for the placement of synthesis devices and the type of some interventions (e.g., exposed fractures). This work aims to provide guidance on the management of peri-operative antibiotic prophylaxis for the pediatric and neonatal population undergoing orthopedic and hand surgery in order to standardize the management of patients and to reduce, on the one hand, the risk of SSI and, on the other, the development of antimicrobial resistance. The following scenarios were considered: (1) bloodless fracture reduction; (2) reduction of unexposed fracture and grade I and II exposed fracture; (3) reduction of grade III exposed fracture or traumatic amputation; (4) cruel fracture reduction with percutaneous synthesis; (5) non-traumatic amputation; (6) emergency intact skin trauma surgery and elective surgery without synthetic media placement; (7) elective orthopedic surgery with prosthetic and/or synthetic media placement and spinal surgery; (8) clean elective hand surgery with and without bone involvement, without use of synthetic means; (9) surgery of the hand on an elective basis with bone involvement and/or with use of synthetic means. This manuscript has been made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies and represents, in our opinion, the most complete and up-to-date collection of recommendations regarding the behavior to be adopted in the peri-operative setting in neonatal and pediatric orthopedic and hand surgery. The specific scenarios developed are aimed at guiding the healthcare professional in practice to ensure the better and standardized management of neonatal and pediatric patients, together with an easy consultation. MDPI 2022-02-22 /pmc/articles/PMC8944525/ /pubmed/35326754 http://dx.doi.org/10.3390/antibiotics11030289 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Opri, Francesca
Bianchini, Sonia
Nicoletti, Laura
Monaco, Sara
Opri, Roberta
Di Pietro, Marilia
Carrara, Elena
Rigotti, Erika
Auriti, Cinzia
Caminiti, Caterina
Donà, Daniele
Lancella, Laura
Lo Vecchio, Andrea
Pizzi, Simone
Principi, Nicola
Simonini, Alessandro
Tesoro, Simonetta
Venturini, Eisabetta
Villani, Alberto
Staiano, Annamaria
Marchesini Reggiani, Leonardo
Esposito, Susanna
Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title_full Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title_fullStr Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title_full_unstemmed Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title_short Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study
title_sort surgical antimicrobial prophylaxis in patients of neonatal and pediatric age undergoing orthopedic and hand surgery: a rand/ucla appropriateness method consensus study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944525/
https://www.ncbi.nlm.nih.gov/pubmed/35326754
http://dx.doi.org/10.3390/antibiotics11030289
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