#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Surgical site infection and local management of the wound − meta-analysis


Authors: J. Stryja
Authors‘ workplace: Salvatella, s. r. o., Třinec
Published in: Rozhl. Chir., 2021, roč. 100, č. 7, s. 313-324.
Category: Review
doi: https://doi.org/10.33699/PIS.2021.100.7.313–324

Overview

Surgical site infections are relatively common complications observed in patients during postoperative period. SSIs worsen the outcomes of the surgery, impair patient’s quality of life, increase morbidity and mortality after the surgery, the treatment become longer and more expensive. SSIs form around 18% of healthcare-associated infections. In developed countries the incidence of SSI varies from 2 to 15%. Intrinsic and extrinsic factors affect the incidence of SSI. CDC classification from 1992 differentiate 3 types of SSI: superficial, deep and organ/space infections. Controversial results of already published studies focused on the postoperative management of surgical wounds did not provide a space for strong clinical evidence-based guidelines. Early diagnostics of wound-healing complications related to high-risk patients provides for individualized surgery and postoperative management of the incision. 

Keywords:

infection − surgical site – surgical wound − management


Sources
  1. European Centre for Disease Prevention and Control. Surgical site infections. In: ECDC. Annual epidemiological report for 2016. Stockholm 2018.
  2. Global guidelines for the prevention of surgical site infection, second edition. Geneva, World Health Organization 2018.
  3. Castella A, Argentero PA, Farina EC, et al. Incidence of surgical-site infections in orthopaedic surgery: a northern Italian experience. Epi­demiol Infect. 2011;139(5):777–782. https://doi.org/10.1017/S0950268810001627.
  4. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection. JAMA Surg. 2017;152(8):784–791. https://doi.org/10.1001/jamasurg.2017.0904.
  5. Coello R, Charlett A, Wilson J, et al. Adverse impact of surgical site infections in English hospitals. J Hosp Infect. 2005;60(2):93–103. https://doi.org/10.1016/j.jhin.2004.10.019.
  6. Broex EC, van Asselt AD, Bruggeman CA, et al. Surgical site infections: how high are the costs? J Hosp Infect. 2009;72(3):193–201. https://doi.org/10.1016/j.jhin.2009.03.020.
  7. Jodra VM, Soler LS, Pérez CD, et al. Excess length of stay attributable to surgical site infection following hip replacement: a nested case-control study. Infect Control Hosp Epidemiol. 2006;27(12):1299–1303. https://doi.org/10.1017/S0195941700075214.
  8. de Lissovoy G, Fraeman K, Hutchins V, et al. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009; 37(5):387–397. https://doi.org/10.1016/j.ajic.2008.12.010.
  9. McLaws ML, Taylor PC. The Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot. J Hosp Infect. 2003;53(4):259–267. https://doi.org/10.1053/jhin.2002.1361.
  10. Plowman R, Graves N, Griffin MA, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect. 2001;47(3):198–209. https://doi.org/10.1053/jhin.2000.0881.
  11. Umscheid CA, Mitchell MD, Doshi JA, et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011;32(2):101–114. https://doi.org/10.1086/657912.
  12. Stryja J, Sandy-Hodgetts K, Collier M, et al. Surgical site infection: preventing and managing surgical site infection across health care sectors. J Wound Care 2020;29:2, Suppl 2b, S1–S69.
  13. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection. Infect Control Hosp Epidemiol. 1999;20(4):247–280. https://doi.org/10.1086/501620.
  14. Centers for Disease Control and Prevention. Procedure-associated module. Surgical Site Infection Event. 2019.
  15. Berard F, Gandon J. Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg. 1964;160 Suppl 2:1–192.
  16. Vazquez-Aragon P, Lizan-Garcia M, Cascales-Sanchez P, et al. Nosocomial infection and related risk factors in a general surgery service: a prospective study. J Infect. 2003 Jan;46(1):17−22. doi: 10.1053/jinf.2002.1073.
  17. Lilani SP, Jangale N, Chowdhary A, et al. Surgical site infection in clean and clean-contaminated cases. Indian J Med Microbiol. 2005 Oct;23(4):249−252.
  18. Ortega G, Rhee DS, Papandria DJ, et al. An evaluation of surgical site infections by wound classification system using the ACS-NSQIP. J Surg Res. 2012 May 1;174(1):33−38. doi: 10.1016/j.jss.2011.05.056. Epub 2011 Jun 24.
  19. Mu Y, Edwards JR, Horan TC, et al. Improving risk-adjusted measures of surgical site infection for the national healthcare safety network. Infect Control Hosp Epidemiol. 2011;32(10):970–986. https://doi. org/10.1086/662016.
  20. Wiseman JT, Fernandes-Taylor S, Barnes ML, et al. Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery. J Vasc Surg. 2015; 62(4):1023–1031.e5. doi:10.1016/j.jvs.2015.04.453.
  21. Leong G, Wilson J, Charlett A. Duration of operation as a risk factor for surgical site infection: comparison of English and US data. J Hosp Infect. 2006;63(3):255–262. doi:10.1016/j. jhin.2006.02.007.
  22. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992; 13(10):606–608. doi:10.2307/30148464.
  23. World Health Organization. Patient safety. WHO guidelines for safe surgery 2009: safe surgery saves lives. Available from: https://tinyurl.com/rhsupup (accessed 21 November 2019).
  24. National Institute for Health and Clinical Excellence (NICE). Guidance. Surgical site infection: Prevention and treatment of surgical site infection. London, RCOG Press 2017. Available from: https://tinyurl.com/y9spc75p (accessed 21 November 2019).
  25. Cohen J, Powderly WG, Opal SM (eds). Infectious diseases. Volume 2, 4th ed. Elsevier Health Sciences 2017.
  26. Boffard KD. Manual of definitive surgical trauma care. 3rd ed. 2011 ISBN-13: 978-1444102826
  27. Garner JS. CDC guideline for prevention of surgical wound infections, 1985. Supersedes guideline for prevention of surgical wound infections published in 1982. (Originally published in November 1985). Revised. Infect Control. 1986 Mar;7(3):193−200. doi: 10.1017/s0195941700064080.
  28. Měšťák J. Úvod do plastické chirurgie. Praha, Karolinum 2005.
  29. Al-Mubarak L, Al-Haddab M. Cutaneous wound closure materials: An overview ISBN-13: 978-1444102826and update. J Cutan Aesthet Surg. 2013;6(4):178–188. doi:10.4103/0974-2077.123395.
  30. Apelqvist J, Willy C, Fagerdahl A-M, Fraccalvieri M, et al. EWMA document: negative pressure wound therapy. J Wound Care 2017; 26(Sup3):S1–154-doi: 10.12968/jowc.2017.26.Sup3.S1.
  31. Dumville JC, Gray TA, Walter CJ, et al. Dressings for the prevention of surgical site infection. Cochrane Database of Systematic Reviews 2016 Dec 20;12(12):CD003091.doi: 10.1002/14651858.CD003091.pub4.
  32. Gottrup F, Dissemond J, Baines C, et al. Use of oxygen therapies in wound healing. J Wound Care 2017; 26(Sup5):S1–43. doi:10.12968/jowc.2017.26.sup5.s.
  33. Surgical site infection: evidence update 43. Manchester, National Institute for Health and Care Excellence 2013. Available from: https://arms.evidence.nhs.uk/resources/hub/1006598/attachment.
  34. Preventing surgical site infections. 2018. Available from: https://www.hps.scot.nhs.uk/web-resources-container/preventing-surgical-site-infections-ssi/.
  35. High impact intervention. Care bundle to prevent surgical site infection. London, Department of Health 2011.
  36. Bredow J, et al. Randomized clinical trial to evaluate the performance of a flexible self-adherent absorbent dressing coated with a soft silicone layer after hip, knee or spinal surgery in comparison to standard wound dressing. Poster presentation at the 5th Congress of WUWHS. Florence, Italy 2016, 25−29 Sep.
  37. Zarghooni K. Effect of a modern dressing compared to standard dressings on outcome after primary hip and knee arthroplasty: a prospective, non-randomised controlled study. E-poster presentation at EWMA Conference. London 13−15 May 2015.
  38. Van Overschelde P, Beele H, Olivecrona C, et al. A randomised controlled trial comparing two wound dressings used after elective hip and knee arthroplasty. Poster presentation at the 5th congress of WUWHS. Florence, Italy 2016, 25−29 Sep.
  39. Tisosky AJ, Iyoha-Bello O, Demosthenes N, et al. Use of a silver nylon dressing following total hip and knee arthroplasty decreases the postoperative infection rate. J Am Acad Orthop Surg Glob Res Rev. 2017;1(7):e034. doi: 10.5435/JAAOSGlobal-D-17-00034.
  40. Abboud EC, Settle JC, Legare TB, et al. Silver-based dressings for the reduction of surgical site infection: Review of current experience and recommendation for future studies. Burns 2014;40 Suppl 1:S30–S39. doi: 10.1016/j.burns.2014.09.011.
  41. Stanirowski PJ, Bizoń M, Cendrowski K, et al. Randomized controlled trial evaluating dialkylcarbamoyl chloride impregnated dressings for the prevention of surgical site infections in adult women undergoing cesarean section. Surg Infect (Larchmt) 2016;17(4):427–435. doi:10.1089/sur.2015.223.
  42. Bělina F. Současné možnosti ovlivnění infekce v místě operačního výkonu. Rozhl Chir. 2017;96(5):189−196.
  43. Norman G, Goh EL, Dumville JC, et al. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane database of systematic reviews. 2020;(6):CD009261. doi:10.1002/14651858.CD009261.pub6.
  44. Smolle MA, Nischwitz SP, Hutan M, et al. Closed-incision negative-pressure wound management in surgery—literature review and recommendations. Eur Surg. 2020;52;249–267. doi:10.1007/s10353-020-00657-w.
  45. Onyekwelu I, Yakkanti R, Protzer L, et al. Surgical wound classification and surgical site infections in the orthopaedic patient. J Am Acad Orthop Surg Glob Res Rev. 2017;1(3):e022. doi:10.5435/JAAOSGlobal-D-17-00022.
  46. Karlakki S, Brem M, Giannini S, et al. Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery: A review of evidence and mechanisms for an emerging indication. Bone Joint Res. 2013 Dec 18;2(12):276−284. doi:10.1302/2046-3758.212.2000190.
  47. Webster J, Scuffham P, Sherriff KL, et al. Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD009261. doi: 10.1002/14651858.CD009261.pub2. Update in: Cochrane Database Syst Rev. 2014;(10):CD009261.
  48. Dumville JC, Coulthard P, Worthington HV, et al. Tissue adhesives for closure of surgical incisions. Cochrane Database Syst Rev. 2014 Nov 28;(11):CD004287. doi: 10.1002/14651858.CD004287.pub4.
  49. Daoud FC, Edmiston CE Jr, Leaper D. Meta-analysis of prevention of surgical site infections following incision closure with triclosan-coated sutures: robustness to new evidence. Surg Infect (Larchmt). 2014 Jun;15(3):165−181. doi: 10.1089/sur.2013.177. Epub 2014 Apr 16.
Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#