Persson Mikael, van der Linden Jan
Division of Medical Engineering, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
Med Hypotheses. 2008;71(1):8-13. doi: 10.1016/j.mehy.2007.12.016. Epub 2008 Mar 4.
Surgical wound infections may ruin otherwise successful operations, and are associated with extended hospital stay, extra costs, and high mortality rates. In open surgery the wound's exposure to ambient air increases the risk of wound infection via several independent factors. The open surgical wound is subjected to airborne bacterial contamination, desiccation, and heat loss that increase the bacterial load, cause superficial necrosis, and impair tissue oxygenation and cellular immune functions, respectively. The present hypothesis is that topically applied carbon dioxide in the open surgical wound can be used intraoperatively to avoid these risks, and thus help to prevent postoperative wound infection. We also criticize existing methods and describe the theoretical background and supporting evidence for our suggested method. If the hypothesis would prove to be correct in a clinical trial, the new method may be an effective complement, or even an alternative, to antibiotics in preventing surgical site infection.
手术伤口感染可能会毁掉原本成功的手术，并与住院时间延长、额外费用以及高死亡率相关。在开放手术中，伤口暴露于环境空气中会通过多种独立因素增加伤口感染的风险。开放手术伤口会受到空气传播的细菌污染、干燥和热量散失的影响，这些分别会增加细菌负荷、导致表面坏死并损害组织氧合和细胞免疫功能。目前的假设是，在开放手术伤口局部应用二氧化碳可在术中用于避免这些风险，从而有助于预防术后伤口感染。我们还对现有方法提出批评，并描述我们所建议方法的理论背景和支持证据。如果该假设在临床试验中被证明是正确的，那么新方法可能是预防手术部位感染的抗生素的有效补充，甚至是替代方法。
