手术部位感染——当前知识综述及预防方法

Surgical site infections - review of current knowledge, methods of prevention.

作者信息

Kolasiński Wojciech

机构信息

Wojewódzki Szpital Specjalistyczny w Zgierzu Oddział Chirurgii Ogólnej i Onkologicznej z Pododdziałem Urologii.

出版信息

Pol Przegl Chir. 2018 Nov 6;91(4):41-47. doi: 10.5604/01.3001.0012.7253.

Abstract

UNLABELLED

This paper presentes the current state of konwledge regarding the everlasting problem in surgery- surgical site infections.

INTRODUCTION

Surgical site infections have accompanied humanity since the dawn of time. Development of medicinie has reduced their percentage, but still they are a huge problem to face with. Surgical site infections cause a significant increase in a cost of hospitalization. This is the main reason why the whole scientific world is looking for prevention of these complications.

MATERIALS AND METHODS

The aim of the paper is to present current views on the etiology and methods of prevention of surgical site infection.

RESULTS

Patients own pathogens are most often responsible for surgical site infections. In hospitalizations over 5-7 days exogenous and hospital flora have the advantage. The most common isolated pathogen is Staphylococcus aureus. The percentage of MRSA-resistant methicillin strains is increasing. Pre-operative antibiotic therapy reduces the frequency of surgical site infection in many surgical procedures. Time of administration, type and dose of antibiotic play an important role in preventing post-operative infections. Pre-operative skin antiseptic is also important. The two most commonly used ingredients are chlorhexidine gluconate and povidone iodine. Recent reports point the chlorhexidine alcohol solution as an agent with a higher degree of efficacy.

CONCLUSIONS

In 2017 Centers for Disease Control and Prevention published the new guidelines for prevention of surgical site infections. This practical tips and tricks should be implemented to every surgical procedure.

摘要

未标注

本文介绍了关于外科手术中一个长期存在的问题——手术部位感染的当前知识状态。

引言

自人类诞生以来,手术部位感染就一直伴随着我们。医学的发展降低了其发生率,但它们仍然是一个亟待解决的重大问题。手术部位感染导致住院费用大幅增加。这就是整个科学界都在寻求预防这些并发症的主要原因。

材料与方法

本文旨在介绍关于手术部位感染的病因及预防方法的当前观点。

结果

手术部位感染最常由患者自身的病原体引起。在住院时间超过5 - 7天的情况下,外源性和医院内的菌群占优势。最常见的分离病原体是金黄色葡萄球菌。耐甲氧西林金黄色葡萄球菌(MRSA)菌株的比例在增加。术前抗生素治疗在许多外科手术中可降低手术部位感染的发生率。抗生素的给药时间、类型和剂量在预防术后感染方面起着重要作用。术前皮肤消毒也很重要。两种最常用的成分是葡萄糖酸氯己定和聚维酮碘。最近的报告指出氯己定醇溶液是一种疗效更高的制剂。

结论

2017年,疾病控制与预防中心发布了预防手术部位感染的新指南。这些实用的提示和技巧应应用于每一台外科手术。

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