Zusammenfassung
Die moderne Chirurgie ermöglicht immer komplexere operative Eingriffe bei immer älteren und komorbiden Patienten. Dies geht mit einem potenziell erhöhten Risiko für perioperative Infektionen (SSI) einher. Für deren Vermeidung sind Sauberkeit, Händedesinfektion und steriles Arbeiten essenziell, während einige traditionelle Hygienemaßnahmen zur Prävention untauglich sind. In diesem Beitrag werden Unterschiede der relevantesten Leitlinien zu SSI ggf. besonders herausgestellt.
Abstract
The burden of surgical site infections (SSIs) is increasing. The number of surgical procedures continues to rise, and surgical patients present increasingly complex comorbidities. Half of SSIs are deemed preventable using evidence-based strategies. It is recommended for patients to bathe or shower prior to surgery. Hair should be removed only with a clipper. Shaving is strongly discouraged at all times. Antimicrobial prophylaxis should be administered only when indicated, based on guidelines, and timed correctly in order to achieve a bactericidal concentration in the tissues when the incision is made. Prophylaxis must not be continued beyond surgery. For skin preparation in the operating room an alcohol-based agent plus chlorhexidine or octenidine is recommended. During surgery, glycemic control and goal-directed fluid therapy should be implemented. Normothermia should be targeted in all patients. The perioperative use of an increased fraction of inspired oxygen may
reduce the risk of SSI. Using a surgical safety checklist during a team time-out immediately before surgery reduces the incidence of SSI.
Schlüsselwörter
chirurgische Wundinfektion - antibiotische Prophylaxe - Prävention - präoperative Behandlung - Antisepsis
Key words
surgical site infection - surgical wound infection - antibiotic prophylaxis - prevention - preoperative care - antisepsis
