Hansis M
Klinik und Poliklinik für Unfallchirurgie, Universität Bonn.
Chirurg. 1996 Nov;67(11):1123-8. doi: 10.1007/s001040050113.
The prevention of perioperative infection requires an interplay of technical equipment, good surgical technique and proper attention to hygiene. The basis for this is a well-structured and well-organized department using well-known, generally practised routine procedures and solid, realistic time planning. The most important technique for supervising and optimizing behaviour (with regard to both operative technique and hygiene) is the example of "being there" ("inter-esse"). In this way, mistakes regarding details are noticed immediately. Moreover, the best form of quality control is a long-term, honest survey of infection statistics that is managed by one responsible person only. Above all, the infection statistics should detect factors predisposing to infection that can be modified by everyday staff attention. The protection of staff against infection is equally as important as the protection of patients. The question of whether routine perioperative antibiotic prophylaxis or treatment in trauma surgery is useful under the present conditions has not yet been answered.
预防围手术期感染需要技术设备、良好的手术技巧以及对卫生的恰当关注相互配合。其基础是一个结构良好、组织有序的科室，采用广为人知、普遍应用的常规程序以及扎实、切实可行的时间规划。监督和优化行为（涉及手术技巧和卫生两方面）的最重要技巧是“亲临现场”（“参与其中”）的示范。通过这种方式，能立即发现细节方面的错误。此外，最佳的质量控制形式是由专人负责进行长期、如实的感染统计调查。最重要的是，感染统计应能发现那些可通过日常工作人员的关注加以改变的易感染因素。保护工作人员免受感染与保护患者同样重要。在当前情况下，创伤手术中常规围手术期抗生素预防或治疗是否有用的问题尚未得到解答。
