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普通外科预防腹腔内感染的策略

Tactics to Prevent Intra-Abdominal Infections in General Surgery.

作者信息

Weiser Thomas G, Forrester Joseph D, Forrester Jared A

机构信息

Department of Surgery, Section of Trauma & Critical Care, Stanford University Stanford, California.

出版信息

Surg Infect (Larchmt). 2019 Feb/Mar;20(2):139-145. doi: 10.1089/sur.2018.282. Epub 2019 Jan 10.

Abstract

BACKGROUND

Abdominal infections following surgery have many severe consequences. Several effective, well-evaluated infection prevention and control processes exist to avoid these infections.

METHODS

This manuscript reviews and provides supporting evidence for common management strategies useful to avoid postoperative abdominal infection.

RESULTS

Prevention of abdominal infection begins with preparation of the environment using standard infection control practices. Peri-operative use of systemic antibiotics, an antibiotic bowel preparation in colorectal surgery, and effective antiseptic preparation of the surgical site all reduce infection rates. Peri-operative supplemental oxygenation, maintenance of core body temperature, and physiologic euglycemia will reduce both incisional and organ-space infections in the abdominal surgery patient. Strategic use of irrigation and drain placement may be useful in some circumstances.

CONCLUSION

Specific methods of prevention are documented to reduce intra-abdominal infections. Prevention requires a multi-disciplinary team including the surgeon, anesthesiologist, and all operating room personnel.

摘要

背景

术后腹部感染会产生许多严重后果。现已有多种有效且经过充分评估的感染预防与控制措施来避免这些感染。

方法

本文回顾了有助于避免术后腹部感染的常见管理策略并提供了支持证据。

结果

腹部感染的预防始于采用标准感染控制措施来准备手术环境。围手术期使用全身性抗生素、在结直肠手术中进行抗生素肠道准备以及对手术部位进行有效的消毒准备均可降低感染率。围手术期补充氧气、维持核心体温以及生理性血糖正常可降低腹部手术患者的切口感染和器官间隙感染。在某些情况下,战略性地使用冲洗和放置引流管可能会有帮助。

结论

有文献记载特定的预防方法可减少腹腔内感染。预防需要一个多学科团队,包括外科医生、麻醉医生和所有手术室人员。

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