Cultura

The Role of Infection Control Systems in Combating Contamination in Healthcare Facilities

VOLUME 22, 2025

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Hanaa Mohammed Saeed Al-Mowalled, Sultan Bashir Hassan Asha, Haya Mubarak Hussein Al-Beshi, Yasir Siraj Abdulaziz Almatrafi, Amal Mohammed Ahmad Oteaf , Faisal Fahad Algethami
Naif Jarad Hassan Alzahrani, Alaa Mohammed Saif , Mohana Abdulaziz Marzog Alsolimy , Hana Mubarak Mohammed Albalawi, Atallah Sulaiman Homud Albalawi, Khalid Abdullaha Tawakkul

Abstract

The existing disconnect between the design and practical implementation of the infection control policy within healthcare facilities has not been properly defined, even though it has severe consequences on the patient safety. This research thus examined the correlation existing between the fidelity of implementation of infection control systems and the contamination results in different hospital wards with different risk levels of classifications. The design was a cross-sectional correlational design across ten inpatient wards of a tertiary care hospital of two high-risk intensive care units, three medium-risk surgical wards, and five low-risk general medical wards. Fidelity of implementation was measured by a WHO-based, observational checklist and environmental contamination was measured by microbiological samples and rates of healthcare-associated infections were measured through institutional surveillance data. Statistical tests were Pearson correlation analysis, multiple regression analysis, and ANOVA. The implementation scores had strong negative correlations with the environmental contamination (r = -0.927, p < 0.001) and HAI rates (r = -0.915, p < 0.001). The hand hygiene compliance and the frequency of surface cleaning became the most predictive independent variables and jointly predicted the infection rates by 91.8%. Significant effects on the implementation fidelity were not noticed between risk strata (p = 0.637). These results indicate that implementation fidelity is important to infection control system efficacy and that hand hygiene and environment cleaning are priority areas of intervention.

Keywords : Environmental contamination, Hand hygiene, Healthcare-associated infections, Infection control systems, Patient safety.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty