Prevention of Postoperative Infections: Assessment of Current Preventive Measures to Minimize the Risk of Infections Following Surgery, Including Antibiotic Administration and Sterilization Techniques
DOI:
https://doi.org/10.56294/saludcyt2023515Keywords:
Surgical Site Infections, Antibiotic Prophylaxis, Surgical Sterilization, Antimicrobial Resistance, Infection PreventionAbstract
Introduction: the incidence of Surgical Site Infections (SSIs) is a growing concern in contemporary healthcare due to its implications for patient prognosis and the additional costs it incurs on the healthcare system. While various preventive strategies have been employed, such as antibiotic administration and diverse sterilization techniques, the current landscape necessitates a meticulous evaluation of their efficacy in minimizing SSIs.
Objective: to evaluate the efficacy of current preventive measures, including prophylactic antibiotic administration and sterilization techniques, in minimizing the risk of postoperative infections.
Methodology: a systematic review of the literature was conducted, which included randomized clinical trials, cohort studies, and prior reviews, to assess the impact of preventive strategies on the incidence of SSIs. The databases consulted were MEDLINE, PubMed, EMBASE, and the Cochrane Library.
Results: the systematic review initially identified 85 relevant studies, of which 35 met the inclusion criteria. After a thorough analysis, only 12 articles remained that confirm the effectiveness of preventive measures, especially the administration of prophylactic drugs and advanced sterilization techniques, in reducing postoperative infections. The studies provide solid evidence of the reduction in infection incidence through these strategies.
Conclusions: current preventive measures, including antibiotic administration and advanced sterilization techniques, appear to be effective in reducing SSIs. However, careful monitoring is essential to prevent the emergence of antibiotic-resistant strains. A multidisciplinary approach that combines various preventive strategies is recommended for more effective management of SSIs
References
1. Pasachova Garzón, Jennifer; Ramirez Martinez, Sara; Muñoz Molina, l. staphylococcus aureus: generalities, mechanisms of pathogenicity and cell colonization. nova, 2019, vol. 17, no 32, p. 25-38. http://www.scielo.org.co/scielo.php?pid=S1794-24702019000200025&script=sci_abstract&tlng=pt
2. Leaper D, et al. Surgical site infection: poor compliance with guidelines and care bundles. Int Wound J. 2017 Apr;14(2):360-366. https://onlinelibrary.wiley.com/doi/full/10.1111/iwj.12243
3. Kurz A, et al. Perioperative normothermia to reduce the incidence of surgical-wound infection. N Engl J Med. 1996 Mar 28;334(13):1209-1215. https://www.nejm.org/doi/full/10.1056/nejm199605093341901
4. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008 Jul 12;372(9633):139-144. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60878-8/fulltext?isEOP=true
5. Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2017 Jan;224(1):59-74. https://journals.lww.com/journalacs/Fulltext/2017/01000/American_College_of_Surgeons_and_Surgical.8.aspx
6. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Hosp Epidemiol. 2011 Feb;32(2):101-114. https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/estimating-the-proportion-of-healthcareassociated-infections-that-are-reasonably-preventable-and-the-related-mortality-and-costs/85B4290844BF00DF4530EBB2E5BEDC2D
7. Arévalo Lozano, Katty Anita. Nivel de conocimiento y práctica del personal de enfermería del servicio de central de esterilización sobre limpieza y desinfección del material quirúrgico de un hospital nacional de tercer nivel en Lima 2020. 2020. https://repositorio.uwiener.edu.pe/handle/20.500.13053/41657
8. Rosenthal VD, et al. International Nosocomial Infection Control Consortium report, data summary of 43 countries for 2007-2012. Am J Infect Control. 2013 Nov;42(9):942-956. https://www.sciencedirect.com/science/article/pii/S0196655314008566
9. World Health Organization. Report on the burden of endemic health care-associated infection worldwide. https://apps.who.int/iris/bitstream/handle/10665/80135/?sequence=1
10. European Centre for Disease Prevention and Control. Annual epidemiological report for 2016.
11. Strugala V, Martin R. Meta-analysis of comparative trials evaluating a prophylactic single-use negative pressure wound therapy system for the prevention of surgical site complications. Surg Infect (Larchmt). 2017 Nov;18(7):810-819. https://www.liebertpub.com/doi/abs/10.1089/sur.2017.156
12. Cunha, Tiago. Surgical Site Infection Prevention in Colorectal Surgery: prevention bundles. 2022. https://www.researchgate.net/profile/Tiago-Cunha-3/publication/370005125_Surgical_Site_Infection_Prevention_in_Colorectal_Surgery_prevention_bundles/links/64393d5f1b8d044c6324f3ec/Surgical-Site-Infection-Prevention-in-Colorectal-Surgery-prevention-bundles.pdf
13. Bratzler DW, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2014 Feb 1;71(3):195-283. https://www.liebertpub.com/doi/abs/10.1089/sur.2013.9999
14. Zimlichman E, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1733452
15 Sartelli M, et al. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting. World J Emerg Surg. 2016 Nov 3;11:37. https://wjes.biomedcentral.com/articles/10.1186/s13017-016-0095-0
16. Allegranzi B, et al. Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. Lancet Infect Dis. 2016 Oct;16(10):1017-1025. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70163-4/fulltext
17. Cohen ME, Salmasian H, Li J, Liu J, Zachariah P, Wright JD, et al. Surgical antibiotic prophylaxis and risk for postoperative antibiotic-resistant infections. J Am Coll Surg. 2017 Nov;225(5):631-638. https://www.sciencedirect.com/science/article/pii/S1072751517317726
18. Dowdell J, Brochin R, Kim J, Overley S, Oren J, Freedman B, et al. Postoperative spine infection: diagnosis and management. Global Spine J. 2018 Aug;8(4_suppl):37S-43S. https://journals.sagepub.com/doi/full/10.1177/2192568217745512
19 Lin DM, Carson KA, Lubomski LH, Wick EC, Pham JC. Statewide collaborative to reduce surgical site infections: results of the Hawaii Surgical Unit-Based Safety Program. J Am Coll Surg. 2018 Aug;227(2):189-197. https://www.sciencedirect.com/science/article/pii/S1072751518303302
20. Ribed A, Monje B, García-González X, Sanchez-Somolinos M, Sanz-Ruiz P, Rodríguez-González CG, et al. Improving surgical antibiotic prophylaxis adherence and reducing hospital readmissions: a bundle of interventions including health information technologies. Eur J Hosp Pharm. 2020 Jul;27(4):237-242. https://ejhp.bmj.com/content/27/4/237?papetoc=&int_source=trendmd&int_medium=trendmd&int_campaign=trendmd
21. Allen C. Post-Operative Urinary Tract Infection Reduction: Discharge Bundle Implementation in Outpatient Urogynecology Patients. https://archive.hshsl.umaryland.edu/handle/10713/12930
22. Forrester JA, Koritsanszky L, Parsons BD, Hailu M, Amenu D, Alemu S, et al. Development of a surgical infection surveillance program at a tertiary hospital in Ethiopia: lessons learned from two surveillance strategies. Surg Infect (Larchmt). 2018 Jan;19(1):25-32. https://www.liebertpub.com/doi/abs/10.1089/sur.2017.136
23. Vieira ALG, Stocco JGD, Ribeiro ACG, Frantz CV. Curativos utilizados para prevenção de infecção do sítio cirúrgico no pós-operatório de cirurgia cardíaca: revisão integrativa. Rev Esc Enferm USP. 2018;52:e03393. https://www.scielo.br/j/reeusp/a/d64kLqktYw9cgQ6mtMfbKHD/?lang=en
24. Brocard E, Reveiz L, Régnaux J-P, Abdala V, Ramón-Pardo P, del Rio Bueno A. Antibiotic prophylaxis for surgical procedures: a scoping review [La profilaxis antibiótica para procedimientos quirúrgicos: una revisión exploratoria]. Rev Panam Salud Publica. 2021;45:e62. https://www.scielosp.org/article/rpsp/2021.v45/e62/en/
25. García ACU, Campoverde DXC, Idrovo SXS, Mejía VNP, Tenorio PAP. Explorando las medidas preventivas para las infecciones de heridas quirúrgicas. Arch Venez Farmacol Ter. 2020;39(1):9-12. https://www.redalyc.org/journal/559/55969798003/55969798003.pdf
26. Hernández Orozco HG, Castañeda Narváez JL. Prevención de infecciones. Un vistazo a la nueva" Guía global para prevención de infecciones de sitio quirúrgico". Acta Pediatr Mex. https://www.scielo.org.mx/scielo.php?pid=S0186-23912017000100001&script=sci_arttext
27. Hernández Cantú EI, Esparza Dávila SP, Sayeg Reyes Silva AK. Eficacia de un modelo de prevención de infección de sitio quirúrgico en un hospital de segundo nivel de atención. Index Enferm [Internet]. 2020 [citado el 19 de octubre de 2020];29(1-2). Disponible en: https://scielo.isciii.es/scielo.php?pid=S1132-12962020000100003&script=sci_arttext&tlng=pt
28. Diomedi A, Chacón E, Delpiano L, Hervé B, Jemenao MI, Medel M, Quintanilla M, Riedel G, Tinoco J, Cifuentes M. Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología. Rev Chil Infectol. https://www.scielo.cl/scielo.php?pid=s0716-10182017000200010&script=sci_arttext&tlng=en
29 Noé V, Sánchez M, Cedeño J. Manejo de sitio quirúrgico como riesgo de infección de heridas en pacientes hospitalizados. Rev Cient Soc Estud Med Univ Católica Cuenca. 2019;1(1):1-9. https://dialnet.unirioja.es/servlet/articulo?codigo=7164395
30. Allegranzi B, Zayed B, Bischoff P, Kubilay NZ, de Jonge S, de Vries F, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2019 Dec;19(12):e392-e404. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)30402-9/fulltext
Published
Issue
Section
License
Copyright (c) 2023 Mayra Viviana Chipantiza Barrera, Blanca Patricia Díaz Vacacela, Blanca Ofelia Pallango Espín (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
