Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update
Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update
复制标题
DOI：
10.1086/591064
复制
发表时间：
2014-09-01
影响因子：
4.5
通讯作者：
Kaye, Keith S.
中科院分区：
文献类型：
--
作者：
Anderson, Deverick J.;Podgorny, Kelly;Kaye, Keith S.
先前发布的指南为检测和预防医疗保健相关感染提供了全面的建议。本文件的目的是以简洁的格式强调实用的建议，旨在帮助急症护理医院实施并优先考虑其手术部位感染（SSI）预防工作。参考美国医疗保健流行病学学会/美国传染病学会“预防医疗保健相关感染的策略纲要”执行摘要和介绍以及随附的社论进行更多讨论。急性护理设施中SSI作为并发症的负担。在美国，SSI发生在2%-5%的住院手术患者中。每年大约发生50万起SSI。2.与SSIa相关的结果。每例SSI均与大约7-10个额外的术后住院日相关。与未发生SSI的手术患者相比，发生SSI的患者死亡风险高2-11倍。SSI患者中77%的死亡可直接归因于SSI。SSI的归因成本因手术程序类型和感染病原体类型而异;已公布的估计数范围为每年100亿美元的医疗保健支出。注意事项a。疾病控制和预防中心国家医院感染监测系统和国家医疗安全网络对SSI的定义被广泛使用。SSI分类如下（图）：i.浅表切口（仅涉及切口的皮肤或皮下组织）ii.深切口（涉及筋膜和/或肌肉层）iii.器官/腔隙
Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals to implement and prioritize their surgical site infection (SSI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Burden of SSIs as complications in acute care facilities.a. SSIs occur in 2%-5% of patients undergoing inpatient surgery in the United States.b. Approximately 500,000 SSIs occur each year.2. Outcomes associated with SSIa. Each SSI is associated with approximately 7-10 additional postoperative hospital days.b. Patients with an SSI have a 2-11 times higher risk of death, compared with operative patients without an SSI.i. Seventy-seven percent of deaths among patients with SSI are direcdy attributable to SSI.c. Attributable costs of SSI vary, depending on the type of operative procedure and the type of infecting pathogen; published estimates range from $10 billion annually in healthcare expenditures.1. Definitionsa. The Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System and the National Healthcare Safety Network definitions for SSI are widely used.b. SSIs are classified as follows (Figure):i. Superficial incisional (involving only skin or subcutaneous tissue of the incision)ii. Deep incisional (involving fascia and/or muscular layers)iii. Organ/space