Dr. Punit R Fulzele, Dr. Syed Z Quazi, Dr. Abhay Gadhane. Datta Meghe Institute of Medical Sciences(Deemed to be University), Wardha, Maharashtra, INDIA.

Email: punitr007@gmail.com

Poster # 94Session name: POS1, “POSTER DIAGNOSTICS”Day: Thursday 13 December 2018

A Non-contact System for Early Detection of Surgical Site Infection in Postoperative Patients.

Conclusions: The device will facilitate early detection of SSIs and reduce morbidity, hospital stay and cost for patients.

References: 1. Kitembo S. K., Chugulu S. G. Incidence of surgical site infections and microbial pattern at kilimanjaro christian medical centre. Annals of African Surgery. 2013;10(1) 2.Motie M. R.,

Ansari M., Nasrollahi H. R. Assessment of surgical site infection risk factors at imam Reza Hospital, Mashhad, Iran between 2006 and 2011. Medical Journal of the Islamic Republic of Iran. 2006;28:p. 52.3.Rajkumari N, Gupta AK, Mathur P, Trikha V, Sharma V, Farooque K, Misra MC. Outcomes of surgical site infections in orthopedic trauma surgeries in a tertiary care centre in India. Journal of postgraduate medicine. 2014 Jul 1;60(3):254. 4.Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 2011 Jan 15;377(9761):228-41.

Disclaimer: The presentation of this material does not imply any endorsement or recommendation by WHO. WHO disclaims any and all liability and responsibility whatsoever for any injury, death, loss, damage, use of personal data, or other prejudice of any kind whatsoever that may arise as a

result of, or in connection with the procurement, distribution and/or use of any technology presented in the 4th WHO Global Forum on Medical Devices.

Objectives : A non-contact device to detect SSI in its earliest sub-clinical stage, leading to early initiation of necessary treatment.

Introduction: Surgical site infection (SSI) is an infection that develops within 30 days aftersurgery. SSIs remain a major cause of morbidity and death among the operated patients andcontinue to represent about a fifth of all healthcare-associated infections. The incidence ofSSI range from 5% to 34% across literature1. In developing countries, where resources arelimited, even basic life-saving operations, such as appendectomies and caesarean sections,are associated with high infection rates and mortality2. Patients who develop SSI requiresignificantly more medical care. If SSI occurs, a patient is 60 percent more likely to spend timein the ICU after surgery than is an uninfected surgical patient and increases the length ofhospital stay by a median of two weeks3. In current scenario, SSI are detected only afterappearance of clinical signs and symptoms, at this stage the infection is at its advanced stageand needs significant medical care to control it. Allegranzi B et.al. The Lancet 2011 377, 228-241

DOI: (10.1016/S0140-6736(10)61458-4)

Rational : The five phases of infectious disease.

Method : Early inflammatory changes like “calor” (increased heat) could be useful in identifying SSIs in subclinical stage. Thermal imaging ofsurgical site can detect rise in temperature (related to inflammation) even before appearance of clinical signs and symptoms. A device usingthermal imaging and image processing can be used to detect SSI in its initial stages. This novel, non invasive, non contact technique can beused to take images of the surgical site daily during routine care of the site.During a pilot study, 100 patient were screened for 30 days after surgery. This technique was able to detect SSIs at early stage, 24 to 30 hoursprior to onset of clinical signs and symptom. Marked changes could be appreciated on thermal images of the surgical site which latermanifested in clinical signs and symptom of infection. Further, study is required to determine sensitivity and specificity of the device.

Chapter 15 | Microbial Mechanisms of Pathogenicity. OpenStax College Microbiology, Microbiology . OpenStax CNX.

Inflammation is characterized by five cardinal signs: rubor (redness), calor (increased heat), tumor (swelling), dolor (pain), and functio laesa(loss of function). Early inflammatory changes (clinically undetectable) start in prodromal period. Early diagnosis of SSI in prodromal period,could result in early treatment and rapid recovery. But current modalities are unable to detect SSI in early subclinical stage.

2nd day post operative: No inflammation on suture line

3nd day post operative: inflammation on suture line, No signs clinically

4th day post operative: inflammation on suture line, SSI clinically present.

1st day post operative - No inflammation on suture line

Incubation period

Prodromal period

Period of illness

Period of decline

Period of convalescence

Entry of the pathogen into the host (patient).(clinically undetected)

The host begins to experience general signs and symptoms of illness. (early stage clinically undetected)

The signs and symptoms of disease are most obvious and severe. (clinically detected)

The signs and symptoms ofillness begin to decline.(clinically detected)

The patient generally returns to normal

functions.