J.A.Barth Verlag in Medizinverlage Heidelberg GmbH & Co.KG
Prävention postoperativer Wundinfektionen
„Evidence-based”-EmpfehlungenPrevention of surgical site infections. What is evidence-based?Christine Geffers1, 3
, Petra Gastmeier1, 3
, F. Daschner2, 3
, H. Rüden1, 3
1Institut für Hygiene (Direktor: Prof. Dr. H. Rüden) der Freien Universität Berlin
2Institut für Umweltmedizin und Krankenhaushygiene (Direktor: Prof. Dr. F. Daschner) Universitätsklinikum Freiburg
3Nationales Referenzzentrum für Krankenhaushygiene (Leitung: Prof. Dr. H. Rüden), Berlin
Prevention of surgical site infections. What is evidence-based?
Summary
Among all hospitalized patients, surgical site infections (SSI) are the third most frequently hospital-acquired-infection. SSIs remain a substantial cause of morbidity and mortality among surgical patients. This may be partially explained by the emergence of antimicrobial-resistant pathogens and the increased numbers of patients who are elderly and/or have a wide variety of chronic, debilitating, or immunocompromising underlying diseases. This is why it is essential to implement SSI prevention measures. In April 1999 the Centers for Disease Control and Prevention (CDC) presented the “Guideline for Prevention of Surgical Site Infection”. The recommendations represent the consensus of the Hospital Infection Control Practices Advisory Committee (HICPAC) regarding strategies for the prevention of SSIs. Whenever possible, the recommendations are based on data from well-designed scientific studies. This guideline is a major step forward and is also essential to optimize the management of surgical patients in Germany.
Zusammenfassung
Postoperative Wundinfektionen sind auch heute noch die dritthäufigste nosokomiale Infektionsart und erhöhen die Morbidität und Letalität chirurgischer Patienten. Teilweise läßt sich dies durch das Auftreten multiresistenter Erreger und das vermehrte Vorliegen prädisponierender Faktoren bei den Patienten, wie erhöhtes Alter und/oder chronische und das Immunsystem schwächende Grundkrankheiten, erklären. Daher ist die Einführung von Präventionsmaßnahmen zur Reduktion postoperativer Wundinfektionen von besonderer Bedeutung. Im April 1999 veröffentlichten die Centers for Disease Control and Prevention (CDC) aus den USA Empfehlungen zur Prävention von Wundinfektionen. Diese Empfehlungen wurden vom Hospital Infection Control Practices Advisory Committee (HICPAC) zur Vermeidung von Wundinfektionen in der Chirurgie entwickelt. Die Empfehlungen basieren im wesentlichen auf Erkenntnissen aus gut geplanten wissenschaftlichen Studien. Sie stellen einen großen Fortschritt bei der Entwicklung von Präventionsmaßnahmen dar und werden, da sie auch für die Behandlung chirurgischer Patienten in Deutschland essentiell sind, hier vorgestellt.
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