anesthesia providers role prevention of surgical site infections162麻醉人员在预防手术部位感染中作用.pdfVIP

CHAPTER162

TheAnesthesiaProvider’sRoleinthe

PreventionofSurgicalSiteInfections

WilliamJ.Mauermann,MD

Surgicalsiteinfections(SSIs)continuetobeasubstantialsourceofpatientTheeffectofhypothermiaonSSIsismultifactorial.Intheafore-

morbidityandfatalityaftersurgicalprocedures.Theyarethesecondmostmentionedstudy,thehighidenceofvasoconstrictioninthehypo-

commoncauseofnosocomialinfections,leadtoreasedlengthofstayinthermicgrouplikelymeansadecreaseinbloodflowandO2deliveryto

thehospitalandreasedmortalityrate,andcontributesignificantlytothesurgicalsiteand,thus,impairmentintheoxidativekillingcapacity

healthcarecosts.Morerecently,SSIshavebecomeamarkerofqualityofofneutrophils.Inaddition,animalmodelshaveshownthathypother-

careintheUnitedStates.RegulatoryagencieshavedeemedthatsomemiainducesanantiinfltoryT-cellcytokineprofilesimilartothat

SSIsareavoidable;intheUnitedStates,Medicarewillnolongerreimburseseeninpatientswiththermalinjuries.Lastly,irrespectiveoftheeffect

institutionsrtainSSIs,ludingmediastinitisaftercardiacsurgeryonbloodflowandO2deliverytothesurgicalwound,hypothermia

andSSIsfollowingbariatricsurgeryandsomeorthopedicoperations.Thisdecreasestheneutrophils’productionofsuperoxideradicalsfora