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Physician as an Infective Vector at a Department of Surgery

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Paduszyńska K., Rucińska L. G. M., Pomorski L.
Polish Journal of Surgery
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2015
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vol. 86
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issue 11
511-517
EN
This study was designed to assess the degree of risk of bacterial transmission from physician to patient through hands, equipment and enclosing surfaces (shoe soles). Material and methods. The study was conducted in the Clinical Department of General and Oncological Surgery UM in Łódź. In days 16.10.2013, 17.10.2013, 18.10.2013 there were done swabs from hands, stethoscopes and soles of shoes from the same group of physicians before and after doctor's rounds. The presence of alert-pathogens in swabs was regarded as positive result. Results. Isolates included mostly aerobic saprophytic bacilli and Staphylococcus species coagulase-negative. There were detected a singly cases of Acinetobacter Baumani and Escherichia coli. Alert-pathogens were found in 4 (16%) swabs taken from hand before doctor's rounds and in 7 (28%) swabs taken after rounds. Stetoscopes were contaminated by alert-pathogens in 3 (12%) cases before doctor's rounds and in 3 (12%) cases taken after doctor's rounds. Soles of shoes were contaminated by alert-pathogens in 14 (56%) cases taken before and 16 (65%) cases taken after doctor's rounds. Conclusions. 1. Physicians are important factor of bacterial transmission in hospital. 2. Hands, stetoscopes and particularly soles of shoes of medical staff is the source of infection.
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Patients Subject to Surgery due to Acute Abdominal Disorders during the Period between 2001-2004

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Paduszyńska K., Celnik A., Pomorski L.
Polish Journal of Surgery
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2012
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vol. 84
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issue 10
488-494
EN
was to evaluate the clinical spectrum of emergency surgery for acute abdominal disorders and their outcome. Material and methods. The study group comprised 1426 patients, aged between 10 and 92 years subject to emergency surgery, due to an acute abdomen during the period 2001-2004. Analysis comprised age, sex, concomitant diseases, ASA scale classification, postoperative diagnosis, type of surgery, complications, mortality and duration of hospitalization. Patients were divided into two age groups: <60 and ≥60 years. Results. Appendicitis was the most common diagnosis (52.9%) in patients under 60 years, while cholecystitis (32.5%) and ileus (30.9%) in patients over 60 years. Complications were observed in 14.8% patients, the most common being related with wound healing (5.6%). The mortality rate amounted to 5.7%. Mortality was most often associated with bowel obstruction (29.2%), surgery for acute bowel ischemia (25.5%), and bowel perforation (20.7%). The mean duration of hospitalization was 7.9 days. Conclusions. 1. In comparison to elective surgery, emergency abdominal operations, particularly in elderly patients are related with a higher mortality rate. 2. In elderly patients, the high mortality rate and substantial number of complications is associated with the advanced primary disease and severe coexisting comorbidities, which significantly reduce the overall health condition.
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Evaluating the Prognostic Value of Selected Prognostic Scales in Patients Operated on Due to Peritonitis

88%
Paduszyńska K., Kaczka K., Dworzyńska A., Sieniawski K., Pomorski L.
Polish Journal of Surgery
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2015
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vol. 86
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issue 9
422-428
EN
The aim of the study was to assess the usefulness of prognostic scales: ASA (American Society of Anesthesiologist), MPI (Meinheim Peritonitis Index), MOFS (the Multiple Organ Failure Score) and SPI (the Simple Prognostic Index) in the prognosis of the course of disease in patients operated on for peritonitis. Material and methods. The study was conducted in the Clinical Department of General and Oncological Surgery of the Medical University in Łódź between January 2009 to December 2010. During this period 263 patients were operated on for peritonitis. Before surgery all patients were classifed into particular groups according to the above mentioned prognostic scales according to their criteria. Results. There were 29 (11%) deaths. ASA ≥4 (p<0.0001), MPI >30 (p<0.0001) MOFS ≥2 (p<0.0001), SPI II, III, IV (p<0.0001) were important risk factors of death. Conclusions. 1. ASA, MPI, MOFS and SPI scales are of high signifcance in predicting the outcome in patients operated on for peritonitis. 2. The ASA scale in spite and due to its simplicity is adequate enough to be used in everyday practice in patients operated on for peritonitis. 3. The MPI scale is most suitable in the scientifc aims and in comparing the outcomes of patients operated on for peritonitis.
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