Browsing by Author "Kayaalp, C."

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A Detailed Analysis of Surgical Site Infections and Risk Factors: A Multicentric Cohort Study in Türkiye
(Ondokuz Mayis Universitesi, 2024) Aktaş, A.; Güner, A.; Güneş, O.; Karagül, S.; Karaköse, O.; Mangan Çolak, E.; Kayaalp, C.
There is limited data on surgical site infection (SSI) in developing countries. The aim of this study was to investigate the incidence and risk factors of SSI following general surgical operations in Türkiye. This multicenter cohort study was conducted at 10 centers. Patients who underwent thyroid/parathyroid, breast, hernia and abdominal surgery between September 2017 and March 2018 were included in the study. Center for Disease Control and Prevention 2016 (CDC-2016) criteria was used for the diagnosis of SSI. Patients were followed for 30 days (90 days for mesh patients). Out of 1871 patients included, SSI occurred in 181 (9.7%) patients. Of these SSI, 101 (55.8%) were superficial, 41 (22.7%) deep, and 39 (21.5%) organ/space SSI. SSI incidence was seen to be high (>15.0%) following some surgeries (40.0% in pancreas, 39.1% in biliary duct, 30.3% in small bowel, 27.9% in colorectal, 27.3% in esophagus, 24.1% in liver, 15.7% in gastric). SSI incidences were generally <5.0% after some surgeries (4.4% in hernia, 4.2% in gallbladder, 3.3% in morbid obesity, 1.4% in breast, 0.8% in thyroid/parathyroid, and zero in spleen and surrenal). In univariate analysis, age ≥60 years, female sex, preoperative weight loss, presence of comorbidities, preoperative albumin <3.5 g/dL and hemoglobin <12 g/dL, wound classification, ASA score, general anesthesia, emergency surgery, open surgery, operation time ≥4 hours, intraoperative blood loss ≥400 ml, perioperative blood transfusion, drain placement, distant infection and malignant disease were associated with SSI. In multivariate analysis preoperative weight loss, clean-contaminated wound, general anesthesia, emergency surgery, open surgical technique, prolonged operation duration (≥4 hours), drain placement, and distant infection were found to be independent variable for SSI risk. In order to reduce the incidence of SSI, patients with a weight loss of 10% or more in six months preoperatively should be identified, and nutritional status of the patients should be corrected preoperatively, laparoscopic technique should be preferred in abdominal surgeries, and drain placement should be avoided, especially in clean-contaminated wounds. © 2024 Ondokuz Mayis Universitesi. All rights reserved.
Treatment of Pilonidal Disease by Combination of Pit Excision and Phenol Application
(Springer-verlag Italia Srl, 2013) Olmez, A.; Kayaalp, C.; Aydin, C.
To examine the results of our minimal invasive treatment for pilonidal disease. Total 83 patients treated by pit excision and consecutive phenol applications on an outpatient setting. All procedures were performed under local anesthesia, without any preoperative testing, colon cleansing, prophylactic antibiotics or sedation. A pit excision (mean length 1.3 +/- A 0.5 cm) including several close midline orifices was done. Separated pit excisions were done to the remaining midline and lateral orifices. Sinus cavity was cleared of hair and debris, and the walls of the cavity were sclerosed using a cotton bud dipped in 80 % liquid phenol. Phenolization was repeated twice on day one and seven. Mean procedure time was 22.2 +/- A 7.4 min. Rates of patients who did not required analgesics at first, second, third and fourth days after surgery were 58, 85, 91 and 100 %, respectively. All the patients returned to work/school after 3 days. Mean wound closure time was 28.5 +/- A 14.9 days. Total 86.7 % of the patients were asymptomatic after a mean 25.7 +/- A 8.5 months follow-up. Simple pit excision and sclerosing the pilonidal sinus cavity consecutively was an effective and minimal invasive method for relief of pilonidal symptoms.