Healthcare associated infection: novel strategies and antimicrobial implants to prevent surgical site infection

Abstract

This report is based on a Hygienist Panel Meeting held at St Anne's Manor, Wokingham on 24–25 June 2009. The panel agreed that greater use should be made of antiseptics to reduce reliance on antibiotics with their associated risk of antibiotic resistance. When choosing an antiseptic for clinical use, the Biocompatibility Index, which considers both the microbiocidal activity and any cytotoxic effects of an antiseptic agent, was considered to be a useful tool. The need for longer and more proactive post-discharge surveillance of surgical patients was also agreed to be a priority, especially given the current growth of day-case surgery. The introduction of surgical safety checklists, such as the World Health Organization's Safe Surgery Saves Lives initiative, is a useful contribution to improving safety and prevention of SSIs and should be used universally. Considering sutures as ‘implants’, with a hard or non-shedding surface to which micro-organisms can form biofilm and cause surgical site infections, was felt to be a useful concept.

Systematic Review and Cost Analysis Comparing Use of chlorhexidine with Use of Iodine for Preoperative Skin Antisepsis to Prevent Surgical Site Infection

“…It decreases the concentration of bacteria colonizing the skin, with the goal of sterilizing the surgical field. The use of skin antisepsis is recommended by professional and public health organizations, including the Royal College of Surgeons of England, 5 the Centers for Disease Control and Prevention, 3 the Association of peri-Operative Registered Nurses, 6 and the National Association of Theater Nurses. 7 …”

Surgical Site Infections after Open Appendectomy and Effectiveness of Complex Approach to Their Prevention

“…Этот феномен лежит в основе концепции рассмотрения хирургической нити как импланта, в присутствии которого риск развития ИОХВ возрас-тает многократно [18,19]. Имеющиеся в настоящий момент экспериментальные и клинические иссле-дования свидетельствуют в пользу положительного потенциала нитей с триклозаном в снижении часто-ты ИОХВ в абдоминальной и торакальной хирургии при совместном их применении с АБП [20,21].…”

Controlled release drug delivery systems to improve post-operative pharmacotherapy

“…Current wound dressings available for this purpose include Contreet ® Foam (silver), PolyMem Silver ® (silver), Urgotul SSD ® (silver sulphadiazine particles), Silvercel ® (silver), Aquacel ® (silver) and Acticoat ® (silver) [63]. Recently, interest has increased around the CR of bioactives from surgical sutures to control post-operative infections [64]. The anti-microbial efficacy of triclosan-coated polyglactin 910 sutures (VICRYL ® Plus) to decrease the incidence of surgical site infection (SSI) was demonstrated against conventional VICRYL ® sutures in a retrospective controlled trial in patients undergoing abdominal surgeries [8].…”