围手术期抗菌药物的使用详解演示文稿.pptVIP

手术情况 手术时间长(3h)、术中发生明显污染、置入人工材料、组织创伤大、止血不彻底、局部积血积液、存在死腔和/或失活组织、留置引流、术中低血压、大量输血、刷手不彻底、消毒液使用不良、器械敷料灭菌不彻底 容易导致手术部位感染的危险因素（3） 当前第63页\共有96页\编于星期三\21点 Preoperative Preparation of the patient (1) Where possible, identify and treat remote infections, and postpone surgery until such infections have resolved (1A) (2) Do not remove hair around the operation site, unless it will interfere with the operation (1A) (3) If hair is removed, this should be done immediately before the operation, preferably with clippers (1A) (4) Adequately control blood glucose in diabetic patients, and avoid perioperative hyperglycaemia (1B) (5) Encourage tobacco cessation (1B) (6) Do not withhold necessary blood products as a means of preventing SSIs (1B) (7) Require patients to shower or bathe with an antiseptic agent on at least the night before the operation (1B) (8) Thoroughly wash and clean around the incision site to remove gross contamination before performing antiseptic skin preparation (1B) (9) Use an appropriate antiseptic for skin preparation (1B) Hand/forearm antisepsis for surgical team members (1) Keep nails short and do not wear artificial nails (1B) (2) Perform preoperative surgical scrub for at least 2 5 min using an appropriate antiseptic. Scrub hands and forearms up to the elbows (1B) (3) After performing the surgical scrub, keep hands up and away from the body (elbows flexed). Dry hands with a sterile towel and don sterile gown and gloves (1B) Management of infected or colonised surgical personnel (1) Educate and encourage surgical personnel who have signs and symptoms of transmissible infectious illness to report conditions promptly to their supervisors and occupation health service (1B) (2) Develop well-defined policies concerning patient care responsibilities when personnel have potentially transmissible infectious conditions (1B) (3) Obtain appropriate cultures from, and exclude from duty, surgical personnel with draining skin lesions until infection has been ruled out