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结肠手术中的感染控制

Infection control in colon surgery.

作者信息

Fry Donald E

机构信息

MPA Healthcare Solutions, 1 East Wacker Drive, Suite 1210, 60601, Chicago, IL, USA.

Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

Langenbecks Arch Surg. 2016 Aug;401(5):581-97. doi: 10.1007/s00423-016-1467-3. Epub 2016 Jun 27.

Abstract

PURPOSE

The aim of this study is to provide a comprehensive review of strategies that should be employed in the prevention of infection at the surgical site in patients undergoing colon surgery.

METHODS

The world's literature on the pathogenesis and prevention of infections at the surgical site in colon resection were reviewed to identify those methods that are associated with improved rates of infection at the surgical site. The pathogenesis, microbiology, diagnosis, and surveillance of surgical site infection have been reviewed in the context of better understanding the accepted methods for prevention. Recommendations are provided based upon evidence-based information when available.

RESULTS

Surgical site infection rates in colon surgery have been reduced consistently over the last 60 years of surgical practice. Preoperative and intraoperative techniques are described which have been useful in this improvement, while postoperative methods including the extension of postoperative systemic antibiotics have not been of value.

CONCLUSIONS

Many methods have been demonstrated to improve surgical site infection rates in colon surgery. However, consistent and standardized applications of these principals in prevention currently do not exist. Application of evidence-based practices can further reduce the morbidity and cost of infection following colon surgery.

摘要

目的

本研究旨在全面综述结肠手术患者手术部位感染预防应采用的策略。

方法

回顾了全球关于结肠切除术手术部位感染的发病机制及预防的文献,以确定那些与手术部位感染发生率降低相关的方法。在更好地理解公认的预防方法的背景下,对手术部位感染的发病机制、微生物学、诊断和监测进行了综述。如有循证信息,则据此提供建议。

结果

在过去60年的外科实践中,结肠手术的手术部位感染率持续下降。描述了术前和术中技术,这些技术对这种改善很有用,而术后方法,包括延长术后全身使用抗生素,并无价值。

结论

已证明许多方法可提高结肠手术的手术部位感染率。然而,目前在预防中这些原则尚未得到一致和标准化的应用。应用循证实践可进一步降低结肠手术后感染的发病率和成本。

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