Surgical wound infection: Difference between revisions
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===Site preparation=== | ===Site preparation=== | ||
In "clean-contaminated surgery" (defined as "colorectal, small intestinal, gastroesophageal, biliary, thoracic, gynecologic, or urologic operations performed under controlled conditions without substantial spillage or unusual contamination"<ref name="pmid20054046">{{cite journal| author=Darouiche RO, Wall MJ, Itani KM, Otterson MF, Webb AL, Carrick MM et al.| title=Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. | journal=N Engl J Med | year= 2010 | volume= 362 | issue= 1 | pages= 18-26 | pmid=20054046 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20054046 | doi=10.1056/NEJMoa0810988 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20436136 Review in: Evid Based Nurs. 2010 Apr;13(2):36-7] </ref>), chlorhexidine–alcohol may be better than povidone–iodine in preventing surgical wound infection.<ref name="pmid20054046"/> | In "clean-contaminated surgery" (defined as "colorectal, small intestinal, gastroesophageal, biliary, thoracic, gynecologic, or urologic operations performed under controlled conditions without substantial spillage or unusual contamination"<ref name="pmid20054046">{{cite journal| author=Darouiche RO, Wall MJ, Itani KM, Otterson MF, Webb AL, Carrick MM et al.| title=Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. | journal=N Engl J Med | year= 2010 | volume= 362 | issue= 1 | pages= 18-26 | pmid=20054046 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20054046 | doi=10.1056/NEJMoa0810988 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20436136 Review in: Evid Based Nurs. 2010 Apr;13(2):36-7] </ref>), chlorhexidine–alcohol may be better than povidone–iodine in preventing surgical wound infection.<ref name="pmid20054046"/> | ||
Topical [[collagen]]-[[gentamicin]] sponges placed in sternotomy wounds may not reduce infections<ref name="pmid20716738">{{cite journal| author=Bennett-Guerrero E, Ferguson TB, Lin M, Garg J, Mark DB, Scavo VA et al.| title=Effect of an implantable gentamicin-collagen sponge on sternal wound infections following cardiac surgery: a randomized trial. | journal=JAMA | year= 2010 | volume= 304 | issue= 7 | pages= 755-62 | pmid=20716738 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20716738 | doi=10.1001/jama.2010.1152 }} </ref> in spite of a prior positive randomized controlled trial<ref name="pmid15620935">{{cite journal| author=Friberg O, Svedjeholm R, Söderquist B, Granfeldt H, Vikerfors T, Källman J| title=Local gentamicin reduces sternal wound infections after cardiac surgery: a randomized controlled trial. | journal=Ann Thorac Surg | year= 2005 | volume= 79 | issue= 1 | pages= 153-61; discussion 161-2 | pmid=15620935 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15620935 | doi=10.1016/j.athoracsur.2004.06.043 }} </ref>. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 22:02, 26 August 2010
A surgical wound infection, sometimes called a surgical site infection, occurs at the site of a surgical incision.[1] The term assumes that no clinically evident infection was at the site prior to the procedure.
Quality improvement has not identified specific techniques for reducing the incidence, other than good surgical practice.[2]
Prevention
Clinical practice guidelines are available.[3]
Site preparation
In "clean-contaminated surgery" (defined as "colorectal, small intestinal, gastroesophageal, biliary, thoracic, gynecologic, or urologic operations performed under controlled conditions without substantial spillage or unusual contamination"[4]), chlorhexidine–alcohol may be better than povidone–iodine in preventing surgical wound infection.[4]
Topical collagen-gentamicin sponges placed in sternotomy wounds may not reduce infections[5] in spite of a prior positive randomized controlled trial[6].
References
- ↑ Anonymous (2024), Surgical wound infection (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Darrell A. Campbell, et al. (1 December 2008), "Surgical Site Infection Prevention: The Importance of Operative Duration and Blood Transfusion—Results of the First American College of Surgeons–National Surgical Quality Improvement Program Best Practices Initiative", Journal of the American College of Surgeons 207 (6): 810-820, DOI:10.1016/j.jamcollsurg.2008.08.018
- ↑ Anderson DJ, Kaye KS, Classen D, Arias KM, Podgorny K, Burstin H et al. (2008). "Strategies to prevent surgical site infections in acute care hospitals.". Infect Control Hosp Epidemiol 29 Suppl 1: S51-61. DOI:10.1086/591064. PMID 18840089. Research Blogging.
- ↑ 4.0 4.1 Darouiche RO, Wall MJ, Itani KM, Otterson MF, Webb AL, Carrick MM et al. (2010). "Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis.". N Engl J Med 362 (1): 18-26. DOI:10.1056/NEJMoa0810988. PMID 20054046. Research Blogging. Review in: Evid Based Nurs. 2010 Apr;13(2):36-7
- ↑ Bennett-Guerrero E, Ferguson TB, Lin M, Garg J, Mark DB, Scavo VA et al. (2010). "Effect of an implantable gentamicin-collagen sponge on sternal wound infections following cardiac surgery: a randomized trial.". JAMA 304 (7): 755-62. DOI:10.1001/jama.2010.1152. PMID 20716738. Research Blogging.
- ↑ Friberg O, Svedjeholm R, Söderquist B, Granfeldt H, Vikerfors T, Källman J (2005). "Local gentamicin reduces sternal wound infections after cardiac surgery: a randomized controlled trial.". Ann Thorac Surg 79 (1): 153-61; discussion 161-2. DOI:10.1016/j.athoracsur.2004.06.043. PMID 15620935. Research Blogging.