Postoperative wound infections. Pathophysiology, risk factors and preventive concepts


HACHENBERG T., Sentuerk M., JANNASCH O., LIPPERT H.

ANAESTHESIST, cilt.59, sa.9, ss.851-866, 2010 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 59 Sayı: 9
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1007/s00101-010-1789-4
  • Dergi Adı: ANAESTHESIST
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.851-866
  • İstanbul Üniversitesi Adresli: Evet

Özet

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.