(精选)Surgical Infection.Acute Purulent Infection Of The Skin And Soft Tissues教学课件.pptVIP

Preoperative Care Antibiotics Start As Soon As Diagnosis Made But Try To Get Cultures If Possible First Want To Cover Gram Positives In Routine Skin Infections Gram Positives, Gram Negatives/Anerobes If Fasciitis Or Life/Limb Threatening Infection Preoperative Care Antibiotics Skin Infections-mssa Po Dicloxicillin Cephalexin Iv Nafcillin/Oxacillin Cefazolin Preoperative Care Antibiotics Skin Infections-mrsa Po Bactrim DS Clindamycin Doxycyline Linezolid Iv Vancomycin Linezolid Preoperative Care Antibiotics Life Or Limb Threatening Infections Diabetic Foot Infections Faciitis Cover Gram Negatives And Anerobes As Well As Gram Positives Vancomycin And Unasyn Timentin Zosyn Ertapenem/Imipenem/Meropenem Post Operative Care Once Purulence Is Controlled, Consider Wound Vacuum Assisted Closure (VAC) Drains Wound Lessens Need For Dressing Changes Often Less Painful For Patients Quickens Wound Closure Clinical Benefits Of V.A.C. Therapy Maintenance Of Moist, Protected Environment Removal Of Excess Interstitial Fluid From The Wound Periphery Increased Local Vascularity Decreased Bacterial Colonization Quantification/Qualification Of Wound Drainage Increased Rate Of Granulation Tissue Formation Increased Rate Of Contraction Increased Rate Of Epithelialization V.A.C. Therapy Indications Acute Wounds Full-thickness Surgical Wounds Chronic Wounds Stage 3 Pressure Ulcers Stage 4 Pressure Ulcers Diabetic Ulcers Venous Stasis Ulcers Traumatic Wounds Dehisced Wounds Surgical Infection.Acute Purulent Infection Of The Skin And Soft Tissues A. Letch Kline, MD, FACS Infections Skin And Soft Tissue Infections Are Common In Our VA Population Most Are Treated As Outpatients But Many Patient Come In Late And Require Admission Most Of The Hospitalized Infections Require Surgical Drainage Preoperative Preparation And Postoperative Nursing Care Is Critical To Successful Outcome Acute Purulent Aerobic Infections The Cause Of The Most Frequently Purulent Surgical Infections: Staphylococcal I