Badia Josep M, Rubio Pérez Inés, Manuel Alba, Membrilla Estela, Ruiz-Tovar Jaime, Muñoz-Casares Cristóbal, Arias-Díaz Javier, Jimeno Jaime, Guirao Xavier, Balibrea José M
Servicio de Cirugía General y Aparato Digestivo, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, España.
Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario La Paz, Madrid, España.
Cir Esp (Engl Ed). 2020 Apr;98(4):187-203. doi: 10.1016/j.ciresp.2019.11.010. Epub 2020 Jan 23.
Surgical site infection is associated with prolonged hospital stay and increased morbidity, mortality and healthcare costs, as well as a poorer patient quality of life. Many hospitals have adopted scientifically-validated guidelines for the prevention of surgical site infection. Most of these protocols have resulted in improved postoperative results. The Surgical Infection Division of the Spanish Association of Surgery conducted a critical review of the scientific evidence and the most recent international guidelines in order to select measures with the highest degree of evidence to be applied in Spanish surgical services. The best measures are: no removal or clipping of hair from the surgical field, skin decontamination with alcohol solutions, adequate systemic antibiotic prophylaxis (administration within 30-60minutes before the incision in a single preoperative dose; intraoperative re-dosing when indicated), maintenance of normothermia and perioperative maintenance of glucose levels.
手术部位感染与住院时间延长、发病率、死亡率和医疗费用增加相关,同时患者生活质量也较差。许多医院已采用经科学验证的预防手术部位感染指南。这些方案大多已改善了术后结果。西班牙外科学会手术感染分会对科学证据和最新国际指南进行了批判性审查,以选择具有最高证据等级的措施应用于西班牙的外科服务。最佳措施包括:不剃除或剪除手术区域毛发、用酒精溶液进行皮肤去污、适当的全身抗生素预防(术前单次剂量在切口前30 - 60分钟内给药;必要时术中再次给药)、维持正常体温以及围手术期维持血糖水平。