Surgical site infections: Causative pathogens and associated outcomes

Weigelt, John A.; Lipsky, Benjamin A.; Tabak, Ying P.; Derby, Karen G.; Kim, Myoung; Gupta, Vikas

doi:10.1016/j.ajic.2009.06.010

Cited by 162 publications

(123 citation statements)

References 23 publications

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“…En otros reportes este porcentaje varía entre 2,6% y 13,8% [8][9][10][11][12] . El panorama se complica si se tiene en cuenta que muchas veces estas infecciones están asociadas con la presencia de gérmenes resistentes, lo que dificulta la terapia antibiótica apropiada; en un estudio de cohorte realizado por Weigelt y col. los pacientes que presentaron ISO por Staphylococcus aureus resistente a meticilina (SARM) tuvieron una mayor tasa de mortalidad (1,4% vs 0,8%, P=0,03), estancia hospitalaria (mediana 6 vs 5 días, P<0,0001), y mayor costo para el hospital ($ 7.036 vs $ 6.134 dólares, P<0,0001) 13 . Álvarez et al describieron en cinco hospitales de Colombia la circulación de SARM de la comunidad, principalmente en bacteriemias e ISO, asímismo asociado a una alta tasa de mortalidad 10 .…”

Section: Introductionunclassified

“…Por lo anterior, la Organización Mundial de la Salud con su estrategia "la Cirugía segura salva vidas" y, desde tiempo atrás, otras instituciones científicas han procurado establecer recomendaciones que permitan minimizar el riesgo de ISO mediante la intervención de los factores asociados modificables, priorizando en los que han mostrado mayor impacto [11][12][13] . A manera de ejemplo, el proyecto para el mejoramiento del cuidado quirúrgico (del inglés, "The Surgical Care Improvement Project"), recomienda el seguimiento de 6 indicadores de resultados y de proceso con el fin de disminuir la ISO: profilaxis antibiótica prequirúrgica (tiempo de administración, selección del antimicrobiano y duración del mismo), control de la glucosa, remoción adecuada del vello y normotermia en la cirugía colorrectal 14,15 .…”

Section: Introductionunclassified

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Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Guevara

Valderrama

Sefair

et al. 2017

Infect

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ResumenLa búsqueda de estrategias para la disminución de la infección de sitio operatorio (ISO) es una prioridad, dado el impacto que ésta tiene en los resultados de la atención de los pacientes. Recientemente ha tomado gran relevancia en la prevención de la ISO, la preparación prequirúrgica de la piel del paciente como uno de los factores clave, en los que se puede intervenir y disminuir el riesgo. En los últimos años han aparecido revisiones exhaustivas dedicadas no solo a la comparación de las soluciones antisépticas, y técnica de aplicación, también acerca de la importancia del baño pre operatorio, uso de cintas y compresas quirúrgicas impregnadas con antisépticos y el recorte de cabello preoperatorio. En esta publicación se describen los hallazgos más importantes relacionados con la preparación antiséptica de la piel del paciente y se propone un protocolo con recomendaciones prácticas para ser implementado en las instituciones del país. Se incluyen recomendaciones basadas en niveles de evidencia sobre el uso de las soluciones antisépticas (yodopovidona, clorhexidina, clorhexidina mas alcohol, entre otras) con énfasis en las ventajas y desventajas de cada una de ellas. Keywords: Preoperative care, disinfection, Anti-Infective agents, Surgical Wound Infection Practical recommendations for skin preparation of Surgical Site AbstractThe search for strategies for reduction of Surgical Site infection (SSI) is a priority, given the impact that infections have on the outcome of the patients. The preoperative patient skin antisepsis, has recently gained greater significance in the prevention of SSI, as one of the critical factors, which can be intervened and can reduce the risk of infection. In recent years, comprehensive investigations have been published not only dedicated to the comparison of antiseptic solutions, application techniques, but also about the importance of preoperative bathing, use of surgical tapes and dressings impregnated with antiseptics, and preoperative shaving. This review outlines the key findings related to the preoperative patient's skin antisepsis and offers a protocol with practical recommendations to be implemented in the institutions of our country. It provides evidence based recommendations about the use of antiseptic solutions (povidone iodine, chlorhexidine, chlorhexidine plus alcohol, etc.) with emphasis on the advantages and disadvantages of each one.Palabras clave: Cuidados preoperatorios, desinfección, antisépticos, infección del sitio quirúrgico. REVISIÓN DE TEMA6 Médico especialista en cirugía general, departamento de cirugía, Universidad del Rosario,

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Section: Introductionunclassified

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Guevara

Valderrama

Sefair

et al. 2017

Infect

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“…The air quality is essential to infection control and reducing the number of surgical site infections (SSIs). SSIs are regarded as being one of the most common causes of serious surgical complications (World Alliance for Patient Safety, 2008) and account for 14% to 17% of all hospitalacquired infections (Centers for Disease Control and Prevention, 2004;Weigelt et al, 2010). Air quality control is also significant for achieving safety and comfort, which are directly associated with the well-being and productivity of personnel.…”

Section: Introductionmentioning

confidence: 99%

Influence of Surgical Smoke on Indoor Air Quality in Hospital Operating Rooms

Choi

Kang

2017

Aerosol Air Qual. Res.

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The objective of this study is to analyze the volatile organic compounds (VOCs) in the surgical smoke generated during laparoscopic surgery, and determine their influence on the indoor air quality in hospital operating rooms (ORs). Field measurements were carried out during eight surgeries in conventional and robotic ORs in which an electrosurgery system was being used, thus continuously generating surgical smoke. The VOCs were measured at three different locations, in the patients' abdominal cavities, beside the surgical table, and at the exhaust vent. Other indoor pollutants including carbon monoxide (CO), carbon dioxide (CO 2 ), and total airborne bacteria (TAB) in the indoor air were measured at the exhaust to assess the general indoor air quality in the ORs. The results from the patients' abdominal cavities confirmed that the surgical smoke contained abundant VOCs, with the levels of benzene and toluene exceeding the health guidelines. Compared to the results obtained in the abdominal cavity, the measurements obtained at the surgical table and exhaust vent exhibited low levels of VOCs, indicating that the actual exposure to these compounds was minimized in a highlyventilated operating room. However, the benzene concentration in the operating room approached a level that threatens the health of the occupants. Therefore, the results of this study suggest that there is a potential health risk to the surgeon who is closest to the point of origin of the surgical gas, as well as a need for further attention to identify the local pollutant dispersion near the surgical table while the ventilation system is operating.

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“…Therefore, the World Health Organization with its strategy "Safe Surgery Saves Lives" and, other scientific institutions have tried to establish recommendations to minimize the risk of SSI by the intervening in modifiable associated factors prioritizing those with the greatest impact [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Practical Recommendations for Preoperative Skin Antisepsis

Guevara

Valderrama

Sefair

et al. 2017

Infect

View full text Add to dashboard Cite

The search for strategies for the reduction of Surgical Site infection (SSI) is a priority, given the impact those infections have on the outcome of the patients. The preope rative patient skin antisepsis, has recently gained greater significance in the prevention of SSI, as one of the critical factors, which can be intervened and can reduce the risk of infection. In recent years, comprehensive investigations have been published, not only dedicated to the comparison of antiseptic solutions, application techniques, but also about the importance of preoperative washing, use of surgical tapes and dressings impregnated with antiseptics, and preoperative shaving. This review outlines the key findings related to the preoperative patient's skin antisepsis and offers a protocol with practical recommendations to be implemented in the institutions of our country. It provides evidence based recommendations about the use of antiseptic solutions (povidone iodine, chlorhexidine, chlorhexidine plus alcohol, etc.) with emphasis on the advantages and disadvantages of each one.

show abstract

Surgical site infections: Causative pathogens and associated outcomes

Cited by 162 publications

References 23 publications

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Recomendaciones prácticas para la antisepsia de la piel del paciente antes de cirugía

Influence of Surgical Smoke on Indoor Air Quality in Hospital Operating Rooms

Practical Recommendations for Preoperative Skin Antisepsis

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