Nichols R L
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Am J Surg. 1996 Jul;172(1):68-74. doi: 10.1016/S0002-9610(96)00049-9.
During the 30 year period from 1965-1995, significant advances have been made in the prevention, diagnosis, and management of surgical infections. To a great degree these advances have been provided by surgeons who developed a primary interest in this area. The Surgical Infection Society (SIS) was established in 1980 for surgeons and other physicians and scientists in order to better coordinate efforts in education and research concerning the infected surgical patient. The most significant of these advances were initially the accurate microbiologic definition of the human endogenous microflora in health and disease. Improvements in the techniques utilized to isolate and identity anaerobic microorganisms were of paramount importance. These lead to improvements in the choice of antibiotic agents for prophylaxis and treatment which resulted in improved clinical results. Most recently, emphasis has been placed on the perioperative identification of the high-risk patient who is more likely to develop infection in the postoperative period. By separating high-risk from low-risk patients in each operative procedure, rather than assuming their risk based on the traditional classification of surgical procedure, a more rationale plan of prospective alterations of treatment can be offered.
在1965年至1995年的30年期间,外科感染的预防、诊断和管理取得了重大进展。在很大程度上,这些进展是由对该领域产生主要兴趣的外科医生实现的。外科感染协会(SIS)于1980年成立,面向外科医生以及其他内科医生和科学家,以便更好地协调有关感染外科患者的教育和研究工作。这些进展中最重要的最初是对健康和疾病状态下人类内源性微生物群的准确微生物学定义。用于分离和鉴定厌氧微生物的技术改进至关重要。这导致在预防和治疗中抗生素药物选择的改善,从而带来了更好的临床效果。最近,重点已放在围手术期识别术后更易发生感染的高危患者上。通过在每个手术过程中将高危患者与低危患者区分开来,而不是基于传统的手术分类来假定他们的风险,可以提供一个更合理的前瞻性治疗调整计划。