Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

World Journal of Emergency Surgery

Ari Leppaniemi¹  Davide Corbella²  Pietro Brambillasca²  Salomone Di Saverio³  Luca Ansaloni⁴  Fausto Catena⁵  Micheal D. Kelly⁶  Belinda De Simone⁷  Massimo Sartelli⁸  Imtiaz Wani⁹  Chad G. Ball^1,10  Fikri M. Abu-Zidan^1,11  Michael Sugrue^1,12  Raul Coimbra^1,13  Gian Luca Baiocchi^1,14  Andrew Peitzmann^1,15  Yoram Kluger^1,16  Gustavo Fraga^1,17  Massimo Chiarugi^1,18  Ernest E. Moore^1,19  Fabio Cesare Campanile^2,20  Andrew W. Kirkpatrick^2,21  Federico Coccolini^2,22  Elena Boschini^2,23  Richard ten Broek^2,24  Osvaldo Chiara^2,25  Walter Biffl^2,26  Dieter Weber^2,27  Gabriela Nita^2,28  Boris Sakakushev^2,29 

[1]Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

[2]Anesthesia and Critical Care Department, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy

[3]Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

[4]Department of Emergency and Trauma Surgery, Bufalini Hospital, 47521, Cesena, Italy

[5]Department of Emergency and Trauma Surgery, University Hospital of Parma, 43100, Parma, Italy

[6]Department of General Surgery, Albury Hospital, 2640, Albury, NSW, Australia

[7]Department of General Surgery, Azienda USL-IRCSS di Reggio Emilia, Guastalla Hospital, Via Donatori di sangue 1, 42016, Guastalla, RE, Italy

[8]Department of General Surgery, Macerata Hospital, 62100, Macerata, Italy

[9]Department of Minimal Access and General Surgery, Government Gousia Hospital, Sringar, Kashmir, India

[10]Department of Surgery and Oncology, Hepatobiliary and Pancreatic Surgery, Trauma and Acute Care Surgery, University of Calgary Foothills Medical Center, T2N 2T9, Calgary, Alberta, Canada

[11]Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates

[12]Department of Surgery, Letterkenny University Hospital and Donegal Clinical Research Academy, Letterkenny, Ireland

[13]Department of Surgery, UC San Diego Medical Center, San Diego, USA

[14]Department of Surgery, University of Brescia, Brescia, Italy

[15]Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA

[16]Division of General Surgery, Rambam Health Care Campus, Haifa, Israel

[17]Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil

[18]Emergency Surgery Unit and Trauma Center, Cisanello Hospital, Pisa, Italy

[19]Ernest E Moore Shock Trauma Center at Denver Health and University of Colorado, Denver, USA

[20]Fabio Cesare Campanile, Ospedale Andosilla, Civita Castellana, Italy

[21]Foothills Medical Centre and the University of Calgary, Calgary, AB, Canada

[22]General, Emergency and Trauma Surgery, Pisa University Hospital, 56124, Pisa, Italy

[23]Medical Library, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128, Bergamo, Italy

[24]Radboud University Nijmegen, Nijmegen, The Netherlands

[25]State University of Milan, Acute Care Surgery Niguarda Hospital, Milan, Italy

[26]Trauma and Acute Care Surgery, Scripps memorial Hospital, La Jolla, CA, USA

[27]Trauma and General Surgery, Royal Perth Hospital, Perth, Australia

[28]Unit of General Surgery, Castelnuovo ne’Monti Hospital, AUSL, Reggio Emilia, Italy

[29]University Hospital St George First, Clinic of General Surgery, Plovdiv, Bulgaria

关键词: Emergency;    Surgical site infection;    Prevention;    Intra-abdominal infection;    Operating room;   

DOI  :  10.1186/s13017-020-0288-4

来源: Springer

【 摘 要 】

BackgroundSurgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to prevent SSI.We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intra-abdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections.MethodsThe literature was searched for focused publications on SSI until March 2019. Critical analysis and grading of the literature has been performed by a working group of experts; the literature review and the statements were evaluated by a Steering Committee of the WSES.ResultsWound protectors and antibacterial sutures seem to have effective roles to prevent SSI in intra-abdominal infections. The application of negative-pressure wound therapy in preventing SSI can be useful in reducing postoperative wound complications.It is important to pursue normothermia with the available resources in the intraoperative period to decrease SSI rate.The optimal knowledge of the pharmacokinetic/pharmacodynamic characteristics of antibiotics helps to decide when additional intraoperative antibiotic doses should be administered in patients with intra-abdominal infections undergoing emergency surgery to prevent SSI.ConclusionsThe current position paper offers an extensive overview of the available evidence regarding surgical site infection control and prevention in patients having intra-abdominal infections.

【 授权许可】

CC BY