抗生素PPT课件（英文精品） The Surgical Care Improvement ProjectPPT.ppt

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抗生素PPT课件（英文精品） The Surgical Care Improvement ProjectPPT.ppt

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抗生素PPT课件（英文精品） The Surgical Care Improvement ProjectPPT

Pre-operative shaving Shaving the surgical site with a razor induces small skin lacerations potential sites for infection disturbs hair follicles which are often colonized with S. aureus Risk greatest when done the night before Patient education be sure patients know that they should not do you a favor and shave before they come to the hospital! Temperature Control 200 colorectal surgery patients control - routine intraoperative thermal care (mean temp 34.7°C) treatment - active warming (mean temp on arrival to recovery 36.6°C) Results control - 19% SSI (18/96) treatment - 6% SSI (6/104), P=0.009 Kurz A, et al. N Engl J Med. 1996. Also: Melling AC, et al. Lancet. 2001. (preop warming) Cardiovascular Complication Prevention Prevention of Cardiac EventsIntroduction As many as 7 to 8 million Americans that undergo major noncardiac surgery have multiple cardiac risk factors or established coronary artery disease More than 1 million cardiac events annually Myocardial ischemia either clinically occult or overt confers a 9 - fold increase in risk of unstable angina, nonfatal myocardial infarction, and cardiac death Schmidt M, et al. Arch Intern Med. 2002;162:63-69. Mangano DT, et al. N Engl J Med. 1996;335:1713-1720. Selzman CH, et al. Arch Surg. 2001;136:286-290. Surgical Care Improvement ProjectPerformance measure - Process Perioperative cardiac events Perioperative beta blockers in patients who are on beta blockers prior to admission /clinical/guidelines/perio/periobetablocker.pdf Venous Thromboembolism Prevention Prevention of Venous Thromboembolism Recent estimates show that more than 900,000 Americans suffer VTE each year about 400,000 of these being DVT About 500,000 being manifest as PE In about 300,000 cases, PE proves fatal; it is the third most common cause of hospital-related deaths in the United States. Heit JA, Cohen AT, Anderson FA on behalf of the VTE Impact Assessment Group. [Abstract] American Society of Hematology Annual Meeting, 2005. National Bod