Markose, Mathew (2020) An Observational study to assess the adherence to Medical Therapy, Complications Associated and Outcomes in patient Post-surgical Debridement for Atypical Mycobacterial Infection from January 2015 to March 2019. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: Over the past several years the prevalence of nontuberculous mycobacterial infection of the skin has increased, which may be attributed to chronic diseases, poor immune status and also the increased awareness of the disease and its pathogenesis. Of the many species, the most common agent causing skin and soft tissue infections belong to the rapidly growing mycobacteria group. These organisms are detected by clinical presentation, site of infection, immune status, pathological biopsy and microbiological cultures. Limitations in diagnostic techniques, fastidious microorganisms and prolonged incubation periods have made the diagnosis and treatment challenging. AIM OF THE STUDY: To study the wound status, adherence to medical therapy, adverse effects and outcomes associated with treatment in a patient post-surgical debridement for atypical mycobacterial infection of the skin. MATERIALS AND METHODS: This was a bidirectional study and participants were patients who underwent surgical debridement for atypical mycobacterial skin infection. They were grouped as retrospective group- January 2015 to November 2017 and prospective group- December 2017 to March 2019. After initial biochemical and audiological assessment, they were started on medical therapy by the department of infectious diseases and followed up in the inpatient and outpatient department. The details of all the patients were analyzed and studied. RESULT: A total of 96 patients were recruited (retrospective group-70 and prospective group-26). Most of the patients were young aged females (n=68) and 41 of these patients had undergone prior gynecological procedure. 64 patients had complete wound healing with no recurrence. Of the 32 patients with non-healed wound, 17 patients had recurrence of infection. Adherence to therapy was studied in prospective group and was medium-low in this group (n=15). 59 patients had multiple medical and surgical complications noted in the recruited patients. CONCLUSIONS: NTM is not an uncommon infection and is more likely to occur after a surgical procedure, most commonly after laparoscopic surgery. Wound healing was noted after adequate surgical debridement and recurrence was low. However the risk of recurrence was more in patients whose wound did not adequately heal. The adherence to medications was mostly medium-low. There was no statistical significant association between the adherence to medical therapy and complications in the prospective group. There was statistically significant association between risk of recurrence of wound and non-healed wound.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711456 |
| Uncontrolled Keywords: | Medical Therapy, Complications Associated and Outcomes, Post-surgical Debridement, Atypical Mycobacterial Infection. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 16:46 |
| Last Modified: | 12 Feb 2021 16:46 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14065 |
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