Farrell Michael Steven, Agapian John Varujan, Appelbaum Rachel D, Filiberto Dina M, Gelbard Rondi, Hoth Jason, Jawa Randeep, Kirsch Jordan, Kutcher Matthew E, Nohra Eden, Pathak Abhijit, Paul Jasmeet, Robinson Bryce, Cuschieri Joseph, Stein Deborah M
Department of Surgery, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.
Surgery, University of California Riverside, Rancho Cucamonga, California, USA.
Trauma Surg Acute Care Open. 2024 Jun 3;9(1):e001305. doi: 10.1136/tsaco-2023-001305. eCollection 2024.
The use of prophylactic measures, including perioperative antibiotics, for the prevention of surgical site infections is a standard of care across surgical specialties. Unfortunately, the routine guidelines used for routine procedures do not always account for many of the factors encountered with urgent/emergent operations and critically ill or high-risk patients. This clinical consensus document created by the American Association for the Surgery of Trauma Critical Care Committee is one of a three-part series and reviews surgical and procedural antibiotic prophylaxis in the surgical intensive care unit. The purpose of this clinical consensus document is to provide practical recommendations, based on expert opinion, to assist intensive care providers with decision-making for surgical prophylaxis. We specifically evaluate the current state of periprocedural antibiotic management of external ventricular drains, orthopedic operations (closed and open fractures, silver dressings, local, antimicrobial adjuncts, spine surgery, subfascial drains), abdominal operations (bowel injury and open abdomen), and bedside procedures (thoracostomy tube, gastrostomy tube, tracheostomy).
采取包括围手术期使用抗生素在内的预防措施来预防手术部位感染，是所有外科专业的医疗标准。不幸的是，用于常规手术的常规指南并不总能考虑到急诊/紧急手术以及重症或高危患者所面临的诸多因素。由美国创伤外科协会重症监护委员会制定的这份临床共识文件是一个三部曲系列中的一部分，回顾了外科重症监护病房中手术及操作的抗生素预防。这份临床共识文件的目的是基于专家意见提供实用建议，以协助重症监护人员进行手术预防决策。我们具体评估了外部脑室引流管、骨科手术（闭合性和开放性骨折、银敷料、局部抗菌辅助、脊柱手术、筋膜下引流）、腹部手术（肠损伤和开放性腹部）以及床边操作（胸腔造瘘管、胃造瘘管、气管造口术）围手术期抗生素管理的现状。
