Rivera-Ramírez OA, Anne-Marie K

Language: Spanish
References: 18
Page: 96-108
PDF size: 103.89 Kb.

ABSTRACT

Surgical infection prophylaxis is indicated for surgery with a high rate of postoperative infection, as well as surgery in which infectious complications seldom occur but may have serious consequences (e.g., prosthetic surgery). Alteimer class I and II surgery complies with these criteria. In type III and IV surgery, the antibiotic should be chosen as a therapeutic drug for an ongoing infection. When an infection is treated in the early stages (within the first six hours), curative treatment amounts to prophylaxis against progress of the infection already under way. Altemeier’s classification only takes into account the presence of bacteria in the surgical field. However, there are other risk factors, such as age, obesity, nutritional status, preparation of the surgical field and asepsis, surgical technique, experience of the surgeon, hemostasis, drainage of surgical site, and duration of surgery. The NNIS (National Nosocomial Infections Surveillance) further includes three factors reflecting the three elements of infectious risk: ASA score, duration of surgery and Altemeier’s classification of contamination. For each type of surgery, the NNIS has established a certain length of time beyond which the risk of postoperative infection increases. This paper intends to encourage anesthesiologists to fulfill protocols for surgical infection prophylaxis. Such protocols should be designed by the entire surgical team, and they must be periodically evaluated, depending upon the local bacteria encountered.

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