Postoperative infection

Maitland, A. Ian L.

doi:10.1002/bjs.1800521207

Cited by 9 publications

(2 citation statements)

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“…Each also has its owntypical group of pathogenic organisms, among which Staphylococcus aureus is found at a rate close to 50% [6] and gramnegative enteric bacteria almostas often (table 1). In a representativestudy extendingover5 years and encompassing 247 postoperative infections, S. aureus was responsible for 138 infections and gram-negative enteric organisms for the majority of the others [7]. Although recent studies have described the growing role of many other microorganisms, includinganaerobes, the control of S. aureus and coagulasenegative staphylococci would reducetheprevalence ofpostsurgical infectionsby >50 %.…”

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Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy

Waldvogel¹,

Vaudaux²,

Pittet³

et al. 1991

Clinical Infectious Diseases

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Numerous microbial factors are responsible for perioperative infections and influence the efficacy of antibiotic prophylaxis. These factors include the staphylococcal carrier state, bacterial adherence to a number of host proteins, the production of glycocalyx by sessile bacteria, and shifts in antibiotic resistance. A full understanding of the mechanisms involved will lead to further reductions in the number of postoperative infections. Unfortunately, the microbial factors affecting prophylaxis cannot be evaluated separately under clinical conditions; they are easier to study under circumstances whose bacteriologic features are well defined and in which the presence offoreign materials (e.g., sutures) greatly potentiates pathogenic mechanisms. Such circumstances exist, for example, in infections developing after "clean" surgery and in experimental models. Since even clean wounds are found to be contaminated when sampled carefully, the control of infection is more a quantitative than a qualitative problem. The critical period for the development of infection is short: an antibiotic course not exceeding 24 hours seems effectivein preventing infection.Wounds produced by surgical intervention, their spontaneoushealing,their complications (including infections), and methods to accelerate their closure havebeen described for thousandsof years. The use of sutures, for example, is clearly depicted in the Smithpapyrus, which datesback to 4000 B.C. [1]. Postoperative infectionevidently has always been a feared complication of surgical procedures, and many techniques and devices have been developed throughout history to prevent such infection. Withthe advent of antibiotics, it wasbelieved that the prevalence of this type of infection would decrease drastically. This was not the case. For instance, in a study on herniorrhaphy between. 1937 and 1957, the incidence of postoperativeinfection hoveredsteadilyaround4 %[2]. Over the past 15 years, however, considerable workhas shownthe benefitof shortcoursesof antimicrobial agents for the prevention of infection in a widevarietyof surgical procedures [3][4][5].The factthat skinincision, organmanipulation,or the consequences thereof increase the incidence of local infection points toward alteration of local host factors influencing microbial elimination. Demonstrations of the efficacy of antimicrobial agents are indicative of the impact of bacterial factors on the postsurgical evolution of wounds. The role of bacterial factors is further underscored by the clear demonstrationthat prophylacticantibioticsare effective in contaminatedand clean-contaminated surgery, whereas their efficacy is more controversial in clean surgery-a situation in which the bacterial load is very low and therefore more difficultto evaluate.It hasbecomealmostaxiomatic to categorize surgical proceduresas clean, clean-contaniinated, contaminated,and purulent. Each category probably has common as well as specific risks and pathogenicfactors [1]. Each also has its owntypical group of pathogenic organisms, among ...

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confidence: 99%

Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy

Waldvogel¹,

Vaudaux²,

Pittet³

et al. 1991

Clinical Infectious Diseases

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“…Σημαντικός παράγων έπιμολύνσεως τοο εγχειρητικού τραύματος είναι ό άήρ των θαλάμων νοσηλείας καί εις μείζονα βαθμόν ό άήρ της αιθούσης εγχειρήσεων καί των χώρων ενδύσεως του προσωπικού τοΰ χειρουργείου γενικώς (Maitland 1965). Κατά μέσον öpov, είς τον αέρα τής αιθούσης εγ χειρήσεων υπάρχουν 3,8 ζωντα βακτηρίδια άνά κυβικόν πόδα (28,3mm…”

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Δευτερογενης Συγκλεισις Μεμολυσμενων Κοιλιακων Τραυματων: Προσχεδιασθεισα Και Ελεγχομενη Κλινικη Μελετη

Αυγουστησ¹

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Θεωρώ υποχρέωσίν μου να εκφράσω τάς θερμάς μου ευχαριστίας προς τον είσηγητήν της παρούσης εργασίας, σεβαστον καθηγητήν κ. Νικόλαον ΟΙκονόμον δια την αμέριστον συμπαράστασίν του. Εις τον εμπνευστήν της παρούσης διατριβής, διδάσκαλόν μου κ. Άναξαγόραν Παπαϊωάννου, εκφράζω τάς ευχαριστίας μου και την άπεριόριστον εκτί μηση και ευγνωμοσύνην μου, διότι ή σωστή καθοδήγησίς του υπήρξεν δ πο λύτιμος συμπαραστάτης μου εις τήν προσπάθειαν δια την εργασίαν ταύτην. 'Ωσαύτως, θεωρώ καθήκον μου να ευχαριστήσω τους συνάδελφους κ.κ. Αημήτριον Κιντζονίδην, Άντώνιον Κριτσέλην, Δημήτριον Γκίκαν και Ίωάννην Όλυμπίτην, ώς επίσης τήν κ. Σοφίαν Κανδρεβιώτου, διευθύντριαν του κυττα ρολογικού εργαστηρίου, τήν κ. "Ηρα Τσιμάρα-Παπασταματίου, επιμελήτριαν τοΰ παθολογοανατομικοΰ εργαστηρίου και τήν κ. Δέσποινα Πετροπούλου, επιμελή τριαν τοΰ μικροβιολογικού εργαστηρίου, δια τήν πολύτιμον βοήθειαν και συμβολήν τους εις τήν ήμετέραν εργασίαν. Τέλος, εκφράζω τάς ευχαριστίας μου εις τους φίλους "Αννα Βακάλη και Δημήτριον Τσικλέα δια τήν επιμέλειαν τοΰ κειμένου και τήν στατιστικήν άνάλυσιν των αποτελεσμάτων της διατριβής. '3 e TEXNiKH ΣΥΓΚΛΕΙΣΕΩΝ TOY ΑΝΟΙΚΤΟΥ ΤΡΑΥΜΑΤΟΣ ι ΙΤύ-ρίπτωαις δκξιας ήμικο'λεκτομης μετά «υγ^ρονον άπολινώσεως •ι•ης κοινής ηπατικής άρτηρίβς κο.Ι «σαγωγής χαΟ«τί]ρος axa 'εήν ιδίως ήττ«τι.κήν άραηρύχν 'Άμέσν.>ς μετά -νή ν <5γχί".ίρϊ[{.ην :Ä «siisi Χύγκλ«σι<ί δι« ταινκον λε\ΐκοπλά«ΐτου (3η μ6τεγχ«ι.ρητο<ή ημέρα) ΜΕΡΟΣ ΤΡΙΤΟΝ 3. ΠΑβΟΦΥΣΙΟΛΟΠΑ ΜΕΤΕΓΧΕΙΡΗΤΙΚΗΣ ΦΛΕΓΜΟΝΗΣ ΤΟΥ ΤΡΑΥ ΜΑΤΟΣ 45 3.1.

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Suction drainage. A study in wound healing

Maitland¹,

Mathieson²

1970

Journal of British Surgery

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ye le pansay, Dieu le guarit ' -AMBRO' I' SE PAR6 (I 5 10-1 590) SUMMARY This paper relates the results of a clinical investigation into the value of suction drainage in general surgery which has covered 5 years and was conducted under some measure of control.The number of drained wounds observed is 1193; the results obtained show that the method produces great improvement in the healing of operations on the genito-urinary tract. In operations on the breast and thyroid, in herniotomies in which drainage has been indicated, and in a miscellaneous group, some improvement has been noted clinically. In the biliary tract fringe benefits have also occurred, but in these five groups statistical analysis of the figures obtained has not disclosed truly significant differences.It has not been found satisfactory in operations involving the lumen of the alimentary tract or in cases where frank infection with purulent exudate was present at operation.The results of two other investigations are also shown. One related to comparative studies of Lugol's solution, iodophor solution, and antibiotic sprays as methods of preoperative preparation, and the other to the time of the preliminary preoperative skin preparation and the effect this may have on wound healing.

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Postoperative infection

Cited by 9 publications

References 35 publications

Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy

Perioperative Antibiotic Prophylaxis of Wound and Foreign Body Infections: Microbial Factors Affecting Efficacy

Δευτερογενης Συγκλεισις Μεμολυσμενων Κοιλιακων Τραυματων: Προσχεδιασθεισα Και Ελεγχομενη Κλινικη Μελετη

Suction drainage. A study in wound healing

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