Kobets Andrew J, Goodrich James T
Leo M. Davidoff Department of Neurological Surgery, Division of Pediatric Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, First Floor, Bronx, New York, USA.
Childs Nerv Syst. 2018 Oct;34(10):1849-1857. doi: 10.1007/s00381-018-3888-5. Epub 2018 Jul 10.
The 19th and 20th centuries heralded the advancement of our understanding of surgical infections, reducing the risk of morbidity and mortality to patients by overturning long-held dogmas surrounding infections and perioperative care. These advancements impacted the development and establishment of the field of neurological surgery by minimizing surgical risk through aseptic techniques and promoting surgical benefit via improved neurological localization and surgical technique. Infections were significant contributors to morbidity and mortality for all surgical patients, and historically almost half of patients lost their lives as a consequence of perioperative wound contamination. With advancing understanding of germ theory, contagion, antisepsis, and subsequently asepsis, the surgeon began embracing the knowledge and techniques which would hone their craft and allow for a renaissance in the management of neurological disorders in an unprecedented manner.
19世纪和20世纪标志着我们对外科感染的认识取得了进展,通过推翻围绕感染和围手术期护理的长期教条,降低了患者发病和死亡的风险。这些进展通过无菌技术将手术风险降至最低,并通过改进神经定位和手术技术提高手术效益,从而影响了神经外科领域的发展和建立。感染是所有外科患者发病和死亡的重要因素,历史上几乎有一半的患者因围手术期伤口污染而丧生。随着对细菌理论、传染、防腐以及随后的无菌技术的认识不断提高,外科医生开始接受这些知识和技术,这些知识和技术将磨练他们的技艺,并以前所未有的方式实现神经疾病管理的复兴。