Академический Документы
Профессиональный Документы
Культура Документы
infections
• Postoperative infections
purulent
material situated in the dermis or
subcutaneous
tissue
SURGICAL SITE
INFECTION
The term “surgical site infection”
now replaces “surgical wound
infection”
• Superficial incisional SSI;
CLEAN
• Nontraumatic
• No inflammation encountered
• No break in technique
• Respiratory, alimentary,
genitourinary tracts not
entered
CLASSIFICATION OF OPERATIVE
WOUNDS
CLEAN CONTAMINATED
• Gastrointestinal or respiratory tracts
entered without significant spillage
• Appendectomy
• Oropharynx entered
• Vagina entered
• Genitourinary tract entered in absence
of infected urine
• Biliary tract entered in absence of
infected bile
• Minor break in technique
CLASSIFICATION OF OPERATIVE
WOUNDS
CONTAMINATED
• Major break in technique
• Gross spillage from
gastrointestinal tract
• Traumatic wound, fresh
• Entrance of genitourinary or
biliary tracts in presence of
infected urine or bile
CLASSIFICATION OF OPERATIVE
WOUNDS
DIRTY and INFECTED
• Acute bacterial inflammation
encountered, without pus
• Transection of clean tissue for the
purpose of surgical access to a
collection of pus
• Traumatic wound with retained
devitalized tissue,foreign bodies,
fecal contamination, and/or delayed
treatment, or from dirty source.
Treatment
Principles of Antibiotic Therapy
• Why to use antibiotics?
• Where is infection?
• What are the most probable
pathogens?
• How about antibiotic
susceptibility?
• Pharmacological properties
• Is combination of antibiotics
necessary?
• Host factors
• Monitoring accuracy of therapy