A review of current strategies to reduce intraoperative bacterial contamination of surgical wounds
- PMID: 20204082
- PMCID: PMC2831242
A review of current strategies to reduce intraoperative bacterial contamination of surgical wounds
Abstract
Surgical site infections are a mean topic in cardiac surgery, leading to a prolonged hospitalization, and substantially increased morbidity and mortality. One source of pathogens is the endogenous flora of the patient's skin, which can contaminate the surgical site. A number of preoperative skin care strategies are performed to reduce bacterial contamination like preoperative antiseptic showering, hair removal, antisepsis of the skin, adhesive barrier drapes, and antimicrobial prophylaxis. Furthermore we can also support the natural host defense by optimal intra-operative management of oxygen supply, normoglycemia, and temperature. Nevertheless we still have a number of patients, who develop a surgical site infection. Therefore new skin care strategies are introduced to reduce the contamination by the endogenous skin flora. We present the use of a new microbial sealant, InteguSeal((R)), which was evaluated in patients undergoing cardiac surgery. The preliminary results of this investigation showed a trend in surgical site infection reduction by the use of this new microbial sealant.
Die Prävention postoperativer Wundinfektionen ist ein wichtiges Anliegen in der Herzchirurgie, weil diese mit erhöhter Morbidität, Mortalität und verlängerter Krankenhausverweildauer verbunden sind. Eine gesicherte Infektionsquelle ist die residente Hautflora des Patienten, die die Op-Wunde kontaminieren kann. Deshalb wird eine Reihe präoperativer Maßnahmen zur Reduktion der Hautflora durchgeführt wie antiseptisches Ganzkörperduschen, Haarentfernung, Hautantiseptik, Inzisionsfolien und Antibiotikaprophylaxe. Weiterhin kann die natürliche Wirtsabwehr durch optimale intraoperative Sauerstoffversorgung, adäquate Einstellung des Blutglukosespiegels und Gewährleistung der Normothermie für die Op-Dauer unterstützt werden. Weil trotzdem postoperative Wundinfektionen auftreten können, werden neue Strategien zur Vermeidung der intraoperativen Kontamination durch die Hautflora benötigt. Hierfür wurde als neue aussichtsreiche Möglichkeit InteguSeal® entwickelt und die Effektivität dieser Versiegelungsmethode im Bereich der Hautdurchtrennung bei Patienten mit herzchirurgischen Operationen untersucht. Die vorläufigen Ergebnisse zeigen den Trend einer Reduktion der Rate postoperativer Wundinfektionen.
Keywords: antibiotic prophylaxis; antibiotic resistance; microbial sealant; skin bacteria; surgical site infections.
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