Evaluation of Surgical Site Infections

Yıl 2019, Cilt: 14 Sayı: 1, 16 - 19, 15.03.2019

Selma Ateş Selçuk Nazik Ahmet Rıza Şahin Fadime Kardaş Ayşegül Erdoğan

https://doi.org/10.17517/ksutfd.467381

Cited By: 1

Öz

Objective: The
aim of this study was to evaluate the preoperative and postoperative management
of patients with surgical field infection and to evaluate the factors related
to the host.

Material and Methods: The
study was planned as prospective, cross-sectional and descriptive. Patients who
were operated by different departments in the Faculty of Medicine of Kahramanmaraş
Sütçü İmam University and who developed infection were included in the study.

Results: The
study included 67 patients (59.7% male, 40.3% female). While
19.4% (n = 13) of the cases had blood transfusion in the preoperative period,
80.6% (n = 54) had no blood transfusions. 97% (n = 65) of the patients had
antiseptic shower in the preoperative period and 53.7% (n = 36) of the cases
had hair cleansing preoperatively. When the distribution
of the patients who developed infection at the wound site after the operation
is examined, 61 % Gram (-) bacteria, 25.5 % Gram (+) bacteria and 4.5 % fungus were
found.

Conclusion: Surgical
site infections increase the length of hospital stay and cause loss of labor
and economic loss. Surgical site infections are preventable
causes. Therefore, maximum attention should be given to taking the necessary
measures.

Anahtar Kelimeler

Surgical site infection, host factors, preoperative period

Cerrahi Alan Enfeksiyonlarının Değerlendirilmesi

Öz

Amaç: Bu
çalışmada operasyon sonrası cerrahi alan enfeksiyonu gelişen hastaların
operasyon öncesi ve sonrası yaptığı uygulamalar ve konağa ait faktörlerin
değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışma
prospektif, kesitsel ve tanımlayıcı olarak planlandı. Kahramanmaraş Sütçü imam
Üniversitesi Tıp Fakültesi Hastanesinde farklı bölümler tarafından opere edilen
ve enfeksiyon gelişen hastalar çalışmaya dahil edildi.

Bulgular: Çalışmaya
67 hasta dahil edildi (% 59.7’si erkek, %40.3’ü kadın). Olguların % 19.4’üne
(n=13) preoperatif dönemde kan transfüzyonu yapılmış iken, % 80.6’sına (n=54)
kan transfüzyonu yapılmamıştır. Olguların % 97’si (n=65) preoperatif dönemde
antiseptikli duş almış ve olguların % 53.7’si (n=36) preoperatif dönemde kıl
temizliği yapmıştır. Operasyon sonrası yara yerinde enfeksiyon gelişen
hastaların dağılımı incelendiğinde hastaların % 61’inde Gram (-) bakteri, % 25.5’inda
Gram (+) bakteri ve % 4.5’inde mantar üremesi saptanmıştır.

Sonuç: Cerrahi
alan enfeksiyonları hastaların hastanede yatış süresini arttırarak, iş gücü
kaybına ve ekonomik kayba neden olmaktadır. Cerrahi alan enfeksiyonlarının
önlenebilir nedenlerdir. Bu nedenle gerekli önlemleri almak konusunda azami
dikkat gösterilmelidir.

Anahtar Kelimeler

Cerrahi Alan enfeksiyonu, Konak faktörleri, Preoperatif dönem

Kaynakça

• Referans1. Tanner J, Padley W, Assadian O, Leaper D, Kiernan M, Edmiston C. Do surgical care bundles reduce the risk of surgical site infections in patients undergoing colorectal surgery? Asystematic review and cohort meta-analysis of 8,515 patients. Surgery, 2015;158(1):66-77.
• Referans2. Ulu AC. Cerrahi Alan Enfeksiyonları Turkiye Klinikleri J Inf Dis-Special Topics 2016;9(3):22-9.
• Referans3. Mangram AJ, Horan TC, Pearson ML, Silver LJ, Jarvis WR Guideline for prevention of surgical site infection,1999. AJIC 1999;27:97-134.
• Referans4. Moro ML, Toni A, Stolfi I, Carrieri MP, Braga M, Zunin C. Risk factors for nosocomial sepsis in newborn intensive and intermediate care units. Eur J Pediatr 1996;155:315-22.
• Referans5. Yalçın AN. Nozokomiyal Sepsis: Risk Faktörleri, Hastanede Yatış Süresi, Ek Maliyet, Prognozu Etkileyen Faktörler ve Mortalite. Hastane İnfeksiyonları Dergisi 1998;2:230236.
• Referans6. Bozfakioğlu Y. Cerrahi alan infeksiyonlarında patogenez ve sınıflama. Hastane İnfeksiyonları Dergisi 2001;5:91-94.
• Referans7. Kao LS, Meeks D, Moyer VA, Lally KP. Peri-operative glycaemic control regimens for preventing surgical site infections in adults. Cochrane Database Syst Rev. 2009;8;(3):CD006806.
• Referans8. Taş S, Dönmez AA, Tunçer EY, Adademir T, Yanartaş M, Sunar H. Açık Kalp Cerrahisi Hastalarında Diyabet ve Kan Glukozu Kontrolünün Cerrahi Alan Enfeksiyonları Üzerine Etkisi. Koşuyolu Kalp Dergisi 2013;16(3):199-204.
• Referans9. Fukuda Y, Yamamato K, Hiroa M, Nishikawa K, Maeda S, Haraquchi N, et al. Prevalance of malnutrition among gastric cancer patients undergoing gastrectomy and optimal preoperative nutritional support for preventing surgical site ınfections. Annals of Surgical Oncology 2015;22(3):778-85.
• Referans10. Klein JD, Hey LA, Yu CS, Klein BB, Coufal FJ, Young EP, et al. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine 1996; 21(22):2676-82.
• Referans11. Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res 2002;103(1):89-95.
• Referans12. Meng F, Cao J, Meng X. Risk factors for surgical site infection following spinal surgery. Journal of Clinical Neuroscience 2015;22(12):1862-6.
• Referans13. Mangram, AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. CDC Guideline for prevention of surgical site infection, 1999. Infection Control and Hospital Epidemiology 1999;20(4):247-278.
• Referans14. Nathens AB, Dellinger EP. Surgical site infections. Current Treatment Options in Infectious Diseases 2000;2:347-358.
• Referans15. Yavuz SŞ, Tarçın O, Ada S, Dinçer F, Toraman S, Birbudak S, et al. Incidence, aetiology, and control of sternal surgical site infections. J Hosp Infect. 2013;85(3):206-12.
• Referans16. Heys SD, Walker LG, Smith I, Eremin O. Enteral nutritional supplementation with key nutrients in patients with critical illness and cancer: A metaanalysis of randomized controlled clinical trials. Ann Surg 1999;229:467–77.
• Referans17. Garibaldi RA, Skolnick D, Lerer T, Poirot A, Graham J, Krisuinas E, et al. The impact of preoperative skin disinfection on preventing intraoperative wound contamination. Infect Control Hosp Epidemiol 1988;9:109-113.
• Referans18. Earnshaw JJ, Berridge DC, Slack RC, Makin GS, Hopkinson BR. Do preoperative chlorhexidine baths reduce the risk of infection after vascular reconstruction. Eur J Vasc Surg 1989;3:323-326.
• Referans19. Chosky SA, Modha D, Taylor GJ. Optimisation of ultraclean air. The role of instrument preparation. J Bone Joint Surg Br 1996;78:835-7.
• Referans20. Seropian R, Reynolds BM. Wound infections after preoperative depilatory versus razor preparation. Am J Surg. 1971;121(3):251-4.
• Referans21. Culver DH, Horan TC, Gaynes RP, Martoni WJ, Jarvis WR, Emori TG, et al. Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 1991;91:152-7.