手術部位感染対策

Abstract

Surgical site infections (SSIs) not only decrease patient satisfaction with surgery but also consume medical resources. Furthermore, they can affect not only hospital management but also the national health care budget. Preventive measures need to be taken to prevent the occurrence of SSIs as much as possible. Thus, scientifically based measures that are cost effective are needed. There are more than 3,000 articles on SSIs published annually, and it is physically impossible for medical professionals to study SSIs on their own. Thus, they need to refer to medical practice guidelines to develop countermeasures. Several guidelines have already been published, but the issue is which of them should be used for reference.Among the issues to be addressed before surgery are the confirmation of nasal carriage of MRSA and its eradication. Before colorectal surgery, there is likely to be a discussion regarding bowel preparation. Regarding the measures to be taken during surgery, disinfectants used for the surgical site, additional intraoperative administration of prophylactic antibacterial agents, double-wearing of surgical gloves, use of antibacterial sutures, and prophylactic drains are to be addressed. Some institutions have not adapted the recommendations in the guidelines to clinical practice, and there is room for improvement in this area.In this article, we first review the usefulness and limitations of the guidelines. Then, we examine the differences among the various guidelines and explain how to incorporate them into daily practice.