APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
-
Review
Postoperative surgical site infections in cardiac surgery--an overview of preventive measures.
Postoperative surgical site infections are a major cause of postoperative morbidity and mortality in cardiac surgery. A surgical site infection occurs when the contaminating pathogens overcome the host defense systems and an infectious process begins. Bacteria may enter the operating site either by direct contamination from the patient's skin or internal organs, through the hands and instruments of the surgical staff or by bacteria-carrying particles that float around in the operating theatre and may land in the wound. ⋯ Compliance with these preventive procedures must be enforced through regular reviews of performance. Non-compliance with hygiene routines is often due to ignorance and poor planning. Education of personnel in these issues is a continuous process.
-
Appropriate antibiotic prophylaxis in cardiac surgery can substantially reduce the number of postoperative infections. To avoid misuse, special concerns - such as timing and duration of antibiotics - must be taken into account. ⋯ The prophylactic antibiotic should cover the spectrum of bacteria that are likely to be encountered. The emergence of MRSA raises special questions of antibiotic choice as well as route of administration.