预防手术部位感染的方法

A. Morozov, A. Sergeev, V. Chervinets, J. V. Chervinets, O. N. Guskova, O. N. Skaryakina, E. N. Egorova
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引用次数: 0

摘要

医疗保健相关感染是最常见的,与所有类型的医疗保健机构都息息相关。手术部位感染是最常报告的医疗相关感染类型。手术部位感染也是导致住院时间延长、抗生素治疗时间延长、非计划性再次住院、患者长期预后恶化以及开具额外手术干预处方的主要原因之一。目前,预防已被确定为抗击手术部位感染的最重要策略。建议的三阶段模式结合了围手术期干预措施和跨学科合作,以不断提高护理质量。这种方法包括术前、术中和术后预防方法。目前预防手术部位感染的术前策略可以大大降低发生这种疾病的风险;术前预防的一个重要方面包括识别、消除和/或纠正可改变和不可改变的风险因素。此外,还可以识别术中风险因素,其中手术干预的持续时间至关重要。术后风险因素包括高血糖和糖尿病、术后伤口护理和输血。目前已开发出许多预防手术部位感染的有效方法,包括术前、术中和术后预防的不同方法,但只有通过实施一种综合模式,将所有围手术期措施结合起来,医疗机构才能有效降低医疗相关感染的发生率,改善患者的预后。尽管目前正在积极开发预防手术部位感染的新方法,但将这些技术直接应用于专科医生的实践活动才是最重要的。
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Methods of preventing surgical site infections
Healthcare-associated infections are the most common and relevant to all healthcare facilities of all types. Surgical site infections are the most frequently reported type of healthcare-associated infections. Surgical site infections are also one of the main causes of prolonged hospital stays, prolonged antibiotic therapy, unplanned re-hospitalizations, worsened long-term patient outcomes and the prescription of additional surgical interventions. At present, it is prevention that has been identified as the single most important strategy to combat surgical site infection. The proposed three-stage model combines perioperative interventions as well as interdisciplinary collaboration to continuously improve the quality of care. This approach includes preoperative, intraoperative, and postoperative prevention methods. Current preoperative strategies for the prevention of surgical site infections can significantly reduce the risk of developing this nosology; one important aspect of preoperative prophylaxis includes the identification, elimination, and/or correction of modifiable as well as non-modifiable risk factors. In addition, it is possible to identify intraoperative risk factors, of which the duration of surgical intervention is fundamentally important. Postoperative risk factors include hyperglycemia and diabetes mellitus, postoperative wound care and blood transfusion. Many effective ways of preventing surgical site infections have been developed, which include separate methods of preoperative, intraoperative and postoperative prophylaxis, however, only through the implementation of a comprehensive model that combines all perioperative measures, health care institutions will be able to effectively reduce the incidence of healthcare-associated infections and improve patient outcomes. Despite the fact that currently there is an active development of new methods of surgical site infections prophylaxis, the direct implementation of these technologies in the practical activity of specialists is of primary importance.
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