Chapter 5 Surgical Infection

Surgical infections have always been a major complication related to surgery and trauma and have been documented for 4000–5000 years. Egyptians popularised some concepts about infection, as they were able to prevent putrefaction using their skills in mummification. Louis Pasteur recognised through his germ theory that microorganisms were responsible for infecting humans and causing disease. Streptococci form chains and are Gram positive on staining. Staphylococci form clumps and are Gram positive. Staphylococcal infections are usually suppurative and localised. Clostridial organisms are Gram-positive, obligate anaerobes that produce resistant spores. Reduced resistance to infection has several causes, particularly those that impair the inflammatory response. Infection acquired from the environment or the staff following surgery or admission to hospital is termed hospital-acquired infection.

Multiple Choice Questions
Weblinks

Journal articles

https://pubmed.ncbi.nlm.nih.gov/33110590/ (free)

This large international study aimed to clarify the current global surgical practice, including coronavirus disease 2019 (COVID-19) screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. It highlighted the insufficient preoperative screening of COVID-19 in current surgical practice.

https://pubmed.ncbi.nlm.nih.gov/33400359/ (free)

This study looked at antimicrobial resistance and persistence, which are associated with an elevated risk of treatment failure and relapsing infections. They are, thus, important drivers of increased morbidity and mortality rates, resulting in growing healthcare costs.

https://pubmed.ncbi.nlm.nih.gov/21036796/ (paid)

Severe sepsis is likely to account for around 37 000 deaths annually in the UK. This study supports the Surviving Sepsis Campaign resuscitation bundle and is suggestive of an association with reduced mortality, although it does not demonstrate causation. It demonstrates that simplified pathways, such as the sepsis six, and education programmes, such as survive sepsis, can contribute to improving the rate of delivery of these life-saving interventions.

https://pubmed.ncbi.nlm.nih.gov/31481640/ (free)

This paper presents the current state of knowledge regarding the everlasting problem in surgery – surgical site infections. In 2017, the US Centers for Disease Control and Prevention (CDC) published the new guidelines for prevention of surgical site infections. These practical tips and tricks should be implemented for every surgical procedure.

https://pubmed.ncbi.nlm.nih.gov/34760756/ (free)

The COVID-19 pandemic highlighted the paramount importance of compliance with hand hygiene and implementation of standard infection control practices, as recommended by the World Health Organization and the CDC, as these can drastically reduce the range of hospital-acquired infections.

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