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医疗保健相关感染:预防手术部位感染的新策略和抗菌植入物

Healthcare associated infection: novel strategies and antimicrobial implants to prevent surgical site infection.

作者信息

Leaper David, McBain Andrew J, Kramer Axel, Assadian Ojan, Sanchez Jose Luis Alfonso, Lumio Jukka, Kiernan Martin

机构信息

Wound Healing Research Unit, Cardiff University, Cardiff, UK.

出版信息

Ann R Coll Surg Engl. 2010 Sep;92(6):453-8. doi: 10.1308/003588410X12699663905276.

Abstract

This report is based on a Hygienist Panel Meeting held at St Anne's Manor, Wokingham on 24-25 June 2009. The panel agreed that greater use should be made of antiseptics to reduce reliance on antibiotics with their associated risk of antibiotic resistance. When choosing an antiseptic for clinical use, the Biocompatibility Index, which considers both the microbiocidal activity and any cytotoxic effects of an antiseptic agent, was considered to be a useful tool. The need for longer and more proactive post-discharge surveillance of surgical patients was also agreed to be a priority, especially given the current growth of day-case surgery. The introduction of surgical safety checklists, such as the World Health Organization's Safe Surgery Saves Lives initiative, is a useful contribution to improving safety and prevention of SSIs and should be used universally. Considering sutures as 'implants', with a hard or non-shedding surface to which micro-organisms can form biofilm and cause surgical site infections, was felt to be a useful concept.

摘要

本报告基于2009年6月24日至25日在沃金厄姆圣安妮庄园召开的卫生学家小组会议。小组一致认为,应更多地使用防腐剂,以减少对抗生素的依赖及其相关的抗生素耐药性风险。在选择临床使用的防腐剂时,生物相容性指数被认为是一个有用的工具,该指数同时考虑了防腐剂的杀菌活性和任何细胞毒性作用。鉴于日间手术目前的增长情况,对手术患者出院后进行更长时间、更积极主动的监测也被一致认为是一个优先事项。引入手术安全检查表,如世界卫生组织的“安全手术拯救生命”倡议,对提高安全性和预防手术部位感染是一项有益的贡献,应普遍使用。将缝线视为“植入物”,其表面坚硬或不易脱落,微生物可在其上形成生物膜并导致手术部位感染,这一概念被认为是有用的。

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