Postoperative wound infections : Pathophysiology, risk factors and preventive concepts.
Summary of "Postoperative wound infections : Pathophysiology, risk factors and preventive concepts."
Postoperative wound infections are the third most common type of nosocomial infection in German emergency hospitals after pneumonia and urinary infections. They are associated with increased morbidity and mortality, prolonged hospital stay and increased costs. The most important risk factors include the microbiological state of the skin surrounding the incision, delayed or premature prophylaxis with antibiotics, duration of surgery, emergency surgery, poorly controlled diabetes mellitus, malignant disease, smoking and advanced age. Anesthesiological measures to decrease the incidence of wound infections are maintaining normothermia, strict indications for allogenic blood transfusions and timely prophylaxis with antibiotics. Blood glucose concentrations should be kept in the range of 8.3-10 mmol/l (150-180 mg/dl) as lower values are associated with increased complications. Intraoperative and postoperative hyperoxia with 80% O(2) has not been shown to effectively decrease wound infections. The application of local anesthetics into the surgical wound in clinically relevant doses for postoperative analgesia does not impair wound healing.
Affiliation
Klinik für Anaesthesiologie und Intensivtherapie, Universitätsklinikum A.ö.R., Otto-von-Guericke-Universität, Leipziger Str. 44, 39120, Magdeburg, Deutschland, Thomas.Hachenberg@med.ovgu.de.
Journal Details
This article was published in the following journal.
Name: Der Anaesthesist
ISSN: 1432-055X
Pages: 851-868
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20830460
- DOI: http://dx.doi.org/10.1007/s00101-010-1789-4
Medical and Biotech [MESH] Definitions
Mycobacterium Chelonae
A species of gram-positive, aerobic bacteria commonly found in soil and occasionally isolated from sputum. It causes postoperative wound infections as well as gluteal abscesses.
Negative-pressure Wound Therapy
The application of a vacuum across the surface of a wound through a foam dressing cut to fit the wound. This removes wound exudates, reduces build-up of inflammatory mediators, and increases the flow of nutrients to the wound thus promoting healing.
Causality
The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.
Confounding Factors (epidemiology)
Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.
Age Factors
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
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