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Zentralbl Chir. 2017 Oct;142(5):516-523. doi: 10.1055/s-0043-120575. Epub 2017 Oct 27.

[Prevention of Surgical Site Infections - with Special Focus on Vascular Surgery].

[Article in German; Abstract available in German from the publisher]

Author information

1
Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Deutschland.

Abstract

in English, German

Background Surgical site infections range between the most commonly and second most commonly reported health-care-associated infections worldwide, depending on the analysis. They are associated with increased morbidity and mortality. Not only for the individual patient, the negative consequences of acquiring a surgical site infection affect the patient's relatives, the hospital and health systems in general. In vascular surgery, gram-positive pathogens of the normal flora of the patient's skin and mucosa (nose/throat) represent the almost half of the number of pathogens detected at the infected surgical site. Staphylococcus aureus itself accounts for about one third of these positive samples. Measures of infection prevention and control Several general and more specific infection prevention and control measures exist, which when applied consistently, reliably, and in a timely manner protects patients and health workers, strengthens the health systems, and optimizes financial resources. In 2016 the World Health Organization launched the first Global Guidelines for the Prevention of surgical site infections. This guideline provides a comprehensive range of evidence-based recommendations for interventions related to the prevention of surgical site infections during the pre-, intra-, and postoperative periods. This article points out the value of this guideline and highlights relevant infection prevention and control measures with a special focus on the evidence in vascular surgery. Conclusion Among generally applicable recommendations and measures, in the field of vascular surgery, a special focus should be put on the interventions aiming at the reduction of the patient's flora on the skin and mucosa (nose/throat). This is relevant with regard to the relatively high percentage of pathogens being associated with surgical site infections in this field of surgery, and which are normally residing on these tissues. These measures compromise preoperative bathing or showering with soap, decolonization of Staphylococcus aureus in nasal carriers undergoing surgery with mupirocin ointment with or without CHG body wash or surgical skin preparation with an alcohol-based solution containing an antiseptic compound. Surgeons should closely cooperate with colleagues from other disciplines, the infection prevention and control team as well as with the hospital management in order to implement the infection prevention and control measures into the daily routine. Step-by-step implementation should be based upon the local needs and specifications.

PMID:
29078249
DOI:
10.1055/s-0043-120575
[Indexed for MEDLINE]

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