Abboud Elia Charbel, Settle Judson C, Legare Timothy B, Marcet Jorge E, Barillo Dave J, Sanchez Jaime E
University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
University of South Florida, Department of Surgery, Morsani College of Medicine, Tampa, FL, USA.
Burns. 2014 Dec;40 Suppl 1:S30-9. doi: 10.1016/j.burns.2014.09.011.
Surgical site infections (SSIs) are the most common hospital acquired infection in surgical patients, occurring in approximately 300,000-500,000 patients a year. SSIs occur across all surgical specialties, but have increased importance in abdominal, colorectal, obstetrical, gynecological, cardiac, vascular, neurological, transplant, and orthopedic procedures where either the inherent risk is elevated or the consequence of an infection would be severe. Current prevention guidelines reduce, but do not completely eliminate, the occurrence of SSIs. We have found the use of silver-nylon wound dressings to significantly reduce the risk SSI associated with colorectal surgery. In this review, we examine the incidence of SSI in high-risk groups, and identify procedures where silver dressings, and other silver products, have been evaluated for the prevention of SSI. Silver-nylon dressings are a useful adjunct in the prevention of SSI in colorectal surgery, neurological surgery, spinal surgery, and certain cardiovascular and orthopedic procedures. Gynecologic, obstetric, breast, transplant, neck, and bariatric procedures, and surgery in obese and diabetic patients, represent other areas where patients are at increased risk of SSI, but in which silver dressings have not been adequately evaluated yet. Recommendation is made for large prospective studies of silver dressings in these populations.
手术部位感染（SSIs）是外科手术患者中最常见的医院获得性感染，每年约有30万至50万患者发生。SSIs在所有外科专科中都有发生，但在腹部、结直肠、产科、妇科、心脏、血管、神经、移植和骨科手术中更为重要，这些手术要么固有风险较高，要么感染后果严重。目前的预防指南可降低但不能完全消除SSIs的发生。我们发现使用银尼龙伤口敷料可显著降低结直肠手术相关的SSI风险。在本综述中，我们研究了高危人群中SSI的发生率，并确定了已对银敷料及其他银产品预防SSI进行评估的手术。银尼龙敷料是预防结直肠手术、神经外科手术、脊柱手术以及某些心血管和骨科手术中SSI的有用辅助手段。妇科、产科、乳腺、移植、颈部和减肥手术，以及肥胖和糖尿病患者的手术，是患者发生SSI风险增加的其他领域，但银敷料在这些领域尚未得到充分评估。建议对这些人群中的银敷料进行大型前瞻性研究。
