Abstract
Infection is the most important complication of surgical procedures, and it continues to be a disconcerting cause of death in surgical patients. Postoperative infections, too, increase morbidity and prolong hospitalization [1]. Surgical patients can develop several postoperative infections; wound infection — representing more than 19% of all postoperative infections — is the most common, but also respiratory tract infections (14%), urinary tract infections (13%), fever of unknown etiology (7%), and thrombophlebitis (2.5%) are important causes of postoperative morbidity. These complications add 10%–20% additional costs to the total hospital bill [1]. In the United States, for any given type of operation, the development of a wound infection will approximately double the cost of hospitalization. Proper antibiotic prophylaxis reduces these costs.
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References
Howard RJ, Simmons RL (1988) Surgical infectious diseases. Appleton and Lange, Norwalk
Page CP, Bohnen J, Fletcher R et al (1993) Antimicrobial prophylaxis for surgical wounds. Arch Surg 128: 79–88
Leaper DJ (1994) Prophylactic and therapeutic role of the antibiotics in wound care. Am J Surg 167: 15–20
Scher KS, Bernstein JM, Arenstein GL, Sorensen C (1990) Reducing the cost of surgical prophylaxis. Am Surg 56: 32–35
Sganga G, De Gaetano A, Gangeri G, Castagneto M (1991) Antibiotic strategies in intra-abdominal sepsis. In Gullo A (Ed) Recent advances in anaesthesia pain intensive care and emergency. APICE, Trieste, pp 575–580
Gilbert AI, Felton LL (1993) Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obst 177: 126–30
Dunn DL (2000) Diagnosis and treatment of infection. In: Norton JA, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, Pass HI Thompson RW (eds) Surgery. Basic science and clinical evidence. Springer-Verlag New York, 193–220
Pollock AV (1990) The treatment of infected wounds. Acta Chir Scand 156: 505–513
Delves PJ, Roitt IM (2000) Advances in immunology: the immune system. N Engl J Med 343: 37–49
Classen DC, Evans RS, Pestotnik A (1992) The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 326: 281–287
Citak MS, Cue JL, Peyton JC, Malangoni MA (1992) The critical relationship of antibiotic dose and bacterial contamination in experimental infection. J Surg Res 52: 127130
Gilbert Al, Felton LL (1993) Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 177: 126–131
Hulten L (1994) Dressings for surgical wounds. Am J Surg 67: 428–458
Velanovich V (1991) A meta-analysis of prophylactic antibiotics in head and neck surgery. Plast Reconstr Surg 87: 429–434
Nichols RL (1984) Update on preparation of the colon for resection. Current Surg 41: 7582
Coppa GF, Eng K, Gouge TH (1983) Parenteral and oral antibiotics in elective colon and rectal surgery: a prospective and randomized trial. Am J Surg 145: 62–67
Reed RL, Ericsson CD, Wu A et al (1992) The pharmacokinetics of prophylactic antibiotics in trauma. J Trauma 32: 21–27
D’Amico R, Pifferi S, Leonetti V et al (1998) Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials. BMJ 316: 1275–1285
Nathens AB, Marshall JC (1999) Selective decontamination of the digestive tract in surgical patients. A systematic review of the evidence. Arch Surg 134: 170–176
Silvestri L, Mannucci F, van Saene HKF (2000) Selective decontamination of the digestive tract: a life-saver. J Hosp Infect 45: 185–190
Van Saene HKF, Silvestri L, de la Cal M (2000) Prevention of nosocomial infections in the intensive care unit. Curr Opin Grit Care 6: 323–329
Rosman C, Wubbels GH, Manson WL, Bleichrodt RP (1992) Selective decontamination of the digestive tract prevents secondary infection of the abdominal cavity and endotoxemia and mortality in sterile peritonitis in laboratory rats. Crit Care Med 20: 16991704
Bion JF, Badger I, Crosby HA et al(1994) Selective decontamination of the digestive tract reduces gram-negative pulmonary colonization but not systemic edotoxemia in patients undergoing elective liver trasplantation. Crit Care Med 22: 40–49
Martinez-Pellus AE, Merino P, Bru M et al (1993) Can selective digestive decontamination avoid the endotoxemia and cytokine activation promoted by cardiopulmonary bypass? Crit Care Med 21: 1684–91
Martinez-Pellus AE, Merino P, Bru M et al (1997) Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Intensive Care Med 23: 1251–1257
Cunnion KM, Weber DJ, Broadhead WE et al (1996) Risk factors of nosocomial pneumonia: comparing adult critical-care populations. Am J Respir Crit Care Med 153: 158162
Mustard RA, Bohnen JMA, Rosati C et al (1991) Pneumonia complicating abdominal sepsis. Arch Surg 126: 170–175
Sganga G, Castagneto M (1999) Bacterial translocation. In: Guarnieri G, Iscra F (eds) Metabolism and artificial nutrition in the critically ill. Springer-Verlag, Berlin Heidelberg New York, pp 203–210
Sganga G, Gangeri G, Montemagno S, Castagneto M (1994) Prevention of translocation–prevention of multiple organ system failure. In: Mutz NJ, Koller W, Benzer H (eds-) Proceedings of the 7th European Congress on Intensive Care Medicine. Monduzzi, Bologna, pp 93–101
Vincent JL, Anaissie E, Bruining H et al (1998) Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care. Intensive Care Med 24: 206–216
Moore FA (2000) Common mucosal immunity: a novel hypothesis. Ann Surg 231: 9–10
Solomkin JS, Flohr AB, Quie PG, Simmons RL (1980) The role of Candida in intraperitoneal infections. Surgery 88: 524–530
Solomkin JS, Flohr AB, Simmons RL (1982) Indications for therapy for fungemia in postoperative patients. Arch Surg 117: 1272–1275
Emmerson AM (1990) The epidemiology of infections in intensive care units. Intensive Care Med 16 (S3): 197–200
Pittet D, Suter PM (1989) Judicious use of antibiotics in critically ill patients. In: Vincent JL (ed) Update in intensive care and emergency medicine, vol 8. Springer, Berlin Heidelberg New York, pp 154–163
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Sganga, G., Brisinda, G., Castagneto, M. (2001). Practical Aspects of Antibiotic Prophylaxis in High-Risk Surgical Patients. In: van Saene, H.K.F., Sganga, G., Silvestri, L. (eds) Infection in the Critically Ill: an Ongoing Challenge. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2242-3_6
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DOI: https://doi.org/10.1007/978-88-470-2242-3_6
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