MEDICINE

MICROBIOLOGY OF SURGICAL WOUND INFECTIONS

MICROBIOLOGY OF SURGICAL WOUND INFECTIONS

Abstract

Surgical wound infections constitute a major fraction of nosocomial infections and occur within 30 days of procedure or within one year if implant is in place. Surgical wound infections have been classified based on wound location and degree of microbial contamination. Causative agents of surgical wound infections and the routes by which they access surgical incision sites have been recognized. The risk factors of surgical wound infections; patient characteristics and operative characteristics and management of these factors have been identified. Despite knowledge of the factors that influence surgical wound infections and means to prevent and/or control them, surgical patients still get infections. Diagnosis and treatment of surgical wound infections are appropriately undertaken to reduce economic costs and morbidity rate. Different surveillance methods have been adopted to reduce surgical wound infections rate.

CHAPTER ONE

INTRODUCTION

Before the mid-19th century, surgical patients commonly developed postoperative “irritative fever” followed by purulent discharge from their incision, overwhelming sepsis and often death. It was not until the late 1860s, after Joseph Lister introduced the principles of antisepsis that postoperative infection morbidity decreased substantially. Among surgical patients, surgical wound infections are the most common nosocomial infections. Surgical wound infections occur within 30 days of procedure or within one year if implant is in place and has been classified into three according to wound location and into four according to degree of microbial contamination. Risk factors and management techniques have been identified. The pathogens isolated from surgical wound infections differ depending on the underlying problem, location and type of surgical procedure. Surgical wound infections should be diagnosed and treated appropriately, to return patients home early and reduce morbidity. Surveillance of surgical wound infections with appropriate feedback would be desirable to reduce surgical wound infections rate.