Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature

World Journal of Emergency Surgery

Gian Luca Baiocchi¹  Stefano Gitto²  Carlos Ordonez³  Fausto Catena⁴  Mario Improta⁵  Raffaele Bova⁵  Massimo Sartelli⁶  Federico Coccolini⁷  Massimo Chiarugi⁷  Dario Tartaglia⁷  Camilla Cremonini⁷  Enrico Cicuttin⁷  Nicola de’ Angelis⁸ 

[1] Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy;Department of Experimental and Clinical Medicine, Firenze University, Firenze, Italy;Department of Surgery, Fundación Valle del Lili, Cali, Colombia;Emergency Surgery Department, Parma University Hospital, Parma, Italy;General Surgery Department, Bologna University Hospital, Bologna, Italy;General Surgery Department, Macerata Hospital, Macerata, Italy;General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa 1, 56100, Pisa, Italy;Unit of Digestive and Hepato-biliary-pancreatic Surgery, Henri Mondor Hospital, Créteil, France;UPEC, University Paris Est, Créteil, France;

关键词: Infection;    Immunity;    Wound;    Care;    Costs;    Drugs;    Inflammatory;   

DOI  :  10.1186/s13017-021-00375-y

来源: Springer

【 摘 要 】

BackgroundImmunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients.MethodsA systematic review of the literature was conducted.ResultsLiterature review shows that partial skin closure is effective to reduce SSI in this population. There is not sufficient evidence to definitively suggest in favour of prophylactic negative pressure wound therapy. The use of mammalian target of rapamycin (mTOR) and calcineurin inhibitors (CNI) in transplanted patient needing ad emergent or undeferrable abdominal surgical procedure must be carefully and multidisciplinary evaluated. The role of antibiotic prophylaxis in transplanted patients needs to be assessed.ConclusionStrict adherence to SSI infection preventing bundles must be implemented worldwide especially in immunocompromised patients. Lastly, it is necessary to elaborate a more widely approved definition of immunocompromised state. Without such shared definition, it will be hard to elaborate the needed methodologically correct studies for this fragile population.

【 授权许可】

CC BY