Current possibilities to influence surgical site infection
Authors:
F. Bělina
Authors place of work:
Chirurgická klinika 2. LF a ÚVN, Ústřední vojenská nemocnice, Praha
přednosta: prof. MUDr. M. Ryska, CSc.
Published in the journal:
Rozhl. Chir., 2017, roč. 96, č. 5, s. 189-196.
Category:
Review
Summary
Infections associated with surgical procedures, also referred to as surgical site infections (SSIs), are the most common nosocomial infections (HAIs – Health Care-Associated Infections) in surgery departments. Although effectively preventable in most cases, they are still associated with significant morbidity and mortality, prolonged or repeated hospitalizations and increased treatment costs. Therefore, compliance with applicable procedures and guidelines is essential for SSI prevention, which was also shown in numerous EBM studies. Relevant procedures and clinical guidelines involve all phases of perioperative care, covering preoperative patient preparation, the course of the surgical procedure itself, as well as post-operative care. In order to effectively reduce the risk of postoperative infectious complications, these proven principles and procedures need to be implemented into daily practice with every single surgical patient. Continuous monitoring of compliance with these procedures, staff education, recording the incidence of SSI in individual departments with regular evaluation and presentation of results should form an integral part of these measures.
Key words:
surgical site infection – incidence – risk factors – prevention – guidelines
Zdroje
1. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999;27:97−132; quiz 133-4; discussion 96.
2. Sievert DM, Ricks P, Edwards JR, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009−2010. Infect Control Hosp Epidemiol 2013;34:1−14.
3. Anderson DJ, Kaye KS, Classen D, et al. Strategies to prevent surgical site infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29 Suppl 1:S51−61.
4. Yokoe DS, Anderson DJ, Berenholtz SM, et al. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infect Control Hosp Epidemiol 2014;35 Suppl 2:S21−31.
5. Anderson DJ, Pyatt DG, Weber DJ, et al. Statewide costs of health care-associated infections: estimates for acute care hospitals in North Carolina. Am J Infect Control 2013;41:764−8.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med 2013;173:2039−46.
7. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–78; quiz 279−80.
8. Meeks DW, Lally KP, Carrick MM, et al. Compliance with guidelines to prevent surgical site infections: As simple as 1-2-3? Am J Surg 2011;201:76−83.
9. Umscheid CA, Mitchell MD, Doshi JA, et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32:101−14.
10. Anderson DJ, Podgorny K, Berrios-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35 Suppl 2:S66−88.
11. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606−8.
12. Gurlich R, Adamkova V, Ulrych J, et al. [Basic principles of diagnosis and treatment of secondary peritonitis - recommendations of experts with the support of SIS.] Czech, Rozhl Chir 2014;93:334−48,350−2.
13. Haley RW, Culver DH, Morgan WM, et al. Identifying patients at high risk of surgical wound infection. A simple multivariate index of patient susceptibility and wound contamination. Am J Epidemiol 1985;121:206−15.
14. Martone WJ, Nichols RL. Recognition, prevention, surveillance, and management of surgical site infections: introduction to the problem and symposium overview. Clin Infect Dis 2001;33 Suppl 2:S67−8.
15. Neumayer L, Hosokawa P, Itani K, et al. Multivariable predictors of postoperative surgical site infection after general and vascular surgery: results from the patient safety in surgery study. J Am Coll Surg 2007;204:1178−87.
16. Yokoe DS, Anderson DJ, Berenholtz SM, et al. Introduction to “A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates”. Infect Control Hosp Epidemiol 2014;35 Suppl 2:S1−5.
17. Bratzler DW, Hunt DR. The surgical infection prevention and surgical care improvement projects: national initiatives to improve outcomes for patients having surgery. Clin Infect Dis 2006;43:322−30.
18. Global Guidelines for the Prevention of Surgical Site Infection. Geneva 2016.
19. Bode LG, van Rijen MM, Wertheim HF, et al. Long-term mortality after rapid screening and decolonization of staphylococcus aureus carriers: Observational follow-up study of a randomized, placebo-controlled trial. Ann Surg 2016;263:511−5.
20. Havel E. [When a surgical patient needs parenteral nutrition.], Czech, Rozhl Chir 2013;92:368–72.
21. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced recovery after surgery (ERASR) society recommendations. World J Surg 2013;37:259−84.
22. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced recovery after surgery (ERAS(R)) society recommendations. World J Surg 2013;37:240−58.
23. Braga M, Ljungqvist O, Soeters P, et al. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr 2009;28:378−86.
24. Bafford AC, Powers S, Ha C, et al. Immunosuppressive therapy does not increase operative morbidity in patients with Crohn’s disease. J Clin Gastroenterol 2013;47:491−5.
25. Waterman M, Xu W, Dinani A, et al. Preoperative biological therapy and short-term outcomes of abdominal surgery in patients with inflammatory bowel disease. Gut 2013;62:387−94.
26. Classen DC, Evans RS, Pestotnik SL, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281−6.
27. Antimicrobial prophylaxis in surgery. Med Lett Drugs Ther 2001;43:92−7.
28. Anderson DJ. Prevention of surgical site infection: beyond SCIP. AORN J 2014;99:315−9.
29. Bratzler DW1, Houck PM; Surgical Infection Prevention Guidelines Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004;38:1706−15.
30. Leaper D, Burman-Roy S, Palanca A, et al. Prevention and treatment of surgical site infection: summary of NICE guidance. BMJ 2008;337:a1924.
31. Leaper DJ, Edmiston CE. World Health Organization: global guidelines for the prevention of surgical site infection. J Hosp Infect 2017;95:135−6.
32. Eskicioglu C, Forbes SS, Fenech DS, et al. Preoperative bowel preparation for patients undergoing elective colorectal surgery: a clinical practice guideline endorsed by the Canadian Society of Colon and Rectal Surgeons. Can J Surg 2010;53:385−95.
33. Owens P, McHugh S, Clarke-Moloney M, et al. Improving surgical site infection prevention practices through a multifaceted educational intervention. Ir Med J 2015;108:78−81.
34. Tanner J, Woodings D, Moncaster K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev 2006, available from: https://www.ncbi.nlm.nih.gov/pubmed/16625596.
35. Maiwald M, Chan ES. The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. PLoS One 2012;7:e44277, available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434203/
36. Darouiche RO, Wall MJ, Jr., Itani KM, et al. Chlorhexidine-alcohol versus povidone-Iodine for surgical-site antisepsis. N Engl J Med 2010;362:18−26.
37. WHO Guidelines on Hand Hygiene in Health Care: First global atient safety challenge clean care Is safer care. Geneva 2009.
38. Tanner J. Surgical hand antisepsis: the evidence. J Perioper Pract 2008; 18:330−4,339.
39. Tanner J, Dumville JC, Norman G, et al. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev 2016, available from: https://www.ncbi.nlm.nih.gov/pubmed/26799160
40. Qadan M, Akca O, Mahid SS, et al. Perioperative supplemental oxygen therapy and surgical site infection: a meta-analysis of randomized controlled trials. Arch Surg 2009;144:359−66; discussion 366–7.
41. Meyhoff CS, Jorgensen LN, Wetterslev J, et al. Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery: follow-up of a randomized clinical trial. Anesth Analg 2012;115:849−54.
42. Qadan M, Gardner SA, Vitale DS, et al. Hypothermia and surgery: immunologic mechanisms for current practice. Ann Surg 2009;250:134−40.
43. Wong PF, Kumar S, Bohra A, et al. Randomized clinical trial of perioperative systemic warming in major elective abdominal surgery. Br J Surg 2007;94:421−6.
44. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209−15.
45. Melling AC, Ali B, Scott EM, et al. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial. Lancet 2001;358:876−80.
46. Scheeren TW, Wiesenack C, Gerlach H, et al. Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicentre study. J Clin Monit Comput 2013;27:225−33.
47. Benes J, Chytra I, Altmann P, et al. Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study. Crit Care 2010;14:R118.
48. Vermeulen H, Hofland J, Legemate DA, et al. Intravenous fluid restriction after major abdominal surgery: a randomized blinded clinical trial. Trials 2009;10:50.
49. Mayer J, Boldt J, Mengistu AM, et al. Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial. Crit Care 2010;14:R18.
50. Pearse R, Dawson D, Fawcett J, et al. Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445]. Crit Care 2005;9:R687−93.
51. Ata A, Lee J, Bestle SL, et al. Postoperative hyperglycemia and surgical site infection in general surgery patients. Arch Surg 2010;145:858−64.
52. Jacobi J, Bircher N, Krinsley J, et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med 2012;40:3251−76.
53. Kotagal M, Symons RG, Hirsch IB, et al. Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg 2015;261:97−103.
54. Kao LS, Phatak UR. Glycemic control and prevention of surgical site infection. Surg Infect (Larchmt) 2013;14:437−44.
55. Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2012;97:16−38.
56. Edwards JP, Ho AL, Tee MC, et al. Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials. Ann Surg 2012;256:53−9.
57. Mihaljevic AL, Schirren R, Ozer M, et al. Multicenter double-blinded randomized controlled trial of standard abdominal wound edge protection with surgical dressings versus coverage with a sterile circular polyethylene drape for prevention of surgical site infections: a CHIR-Net trial (BaFO; NCT01181206). Ann Surg 2014;260:730−7; discussion 737−9.
58. Gheorghe A, Roberts TE, Pinkney TD, et al. The cost-effectiveness of wound-edge protection devices compared to standard care in reducing surgical site infection after laparotomy: an economic evaluation alongside the ROSSINI trial. PLoS One 2014, available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991705/
59. Surgical site infection: Prevention and treatment of surgical site infection. London 2008.
60. Anderson DJ, Podgorny K, Berrios-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35:605−27.
61. Crolla RM, van der Laan L, Veen EJ, et al. Reduction of surgical site infections after implementation of a bundle of care. PLoS One 2012;7:e44599.
62. Prospero E, Cavicchi A, Bacelli S, et al. Surveillance for surgical site infection after hospital discharge: a surgical procedure-specific perspective. Infect Control Hosp Epidemiol 2006;27:1313−7.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2017 Číslo 5
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
Najčítanejšie v tomto čísle
- Autologous cranioplasty with a bone flap preserved subcutaneously in the mesogastrium
- Current possibilities to influence surgical site infection
- Malignant fibrous histiocytoma as a rare cause of acute limb ischemia
- Thoracoscopic, epicardial ablation of atrial fibrillation using the COBRA Fusion system as the first part of hybrid ablation