TY  - CHAP
M1  - Book, Section
TI  - Antimicrobial Prophylaxis in Surgery
A1  - Chiu, Louisa W.
A1  - Dellinger, E. Patchen
A1  - Anaya, Daniel A.
A2  - McKean, Sylvia C.
A2  - Ross, John J.
A2  - Dressler, Daniel D.
A2  - Scheurer, Danielle B.
PY  - 2017
T2  - Principles and Practice of Hospital Medicine, 2e
AB  - It  is  estimated  that  over  40  million  surgical  procedures  are  performed  every  year  in  the  United  States.  Surgical  site  infections  (Table  55-1)  complicate  approximately  2%  to  5%  of  these  procedures,  representing  38%  of  nosocomial  infections  occurring  in  surgical  patients.  Risk  factors  for  surgical  site  infections  (SSIs)  can  be  classified  as  either  patient-related  factors  or  surgical  factors,  and  can  be  stratified  into  modifiable,  potentially  modifiable,  and  nonmodifiable  risk  factors.  Modifiable  risk  factors  include  elective  operations  in  the  presence  of  associated  infections,  prolonged  preoperative  hospital  stays,  seromas,  dead  space,  foreign  bodies,  and  routine  drain  use,  among  others,  and  can  be  improved  with  the  use  of  good  surgical  practice  and  specific  preventive  strategies.  Nonmodifiable  risk  factors  are  most  commonly  patient-related  and  have  an  important  effect  on  the  incidence  of  SSI  for  each  individual  patient.  The  wound  class  (Table  55-2)  is  a  relatively  good  predictor  of  SSI  and  has  traditionally  been  used  to  estimate  the  risk  of  SSI  and  as  a  benchmark  for  comparisons  between  institutions.  However,  with  the  better  recent  understanding  of  SSI  and  its  multifactorial  risk  factors,  more  sophisticated  predictive  scores,  such  as  the  National  Nosocomial  Infection  Surveillance  (NNIS)  score,  have  been  developed  to  better  estimate  the  risk  of  SSI  for  each  individual  patient,  after  considering  the  interaction  between  different  risk  factors  (Table  55-3).  Specific  preventive  measures  have  been  identified  and  are  used  to  decrease  the  risk  of  SSI.  These  include  minimizing  the  presence  of  microorganisms  with  prophylactic  antibiotics  and  optimizing  the  patient’s  ability  to  fight  those  still  present  at  the  surgical  site  during  the  perioperative  period.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1137608359
ER  -