Clinical Study of Surgical Site Infection

Surgical wound infections continue to consume a considerable portion of health care finance. Even though the complete elimination of wound infections is not possible, a reduction of the observed wound infection rate to a minimum level could have marked benefits in terms of both patient comfort and resources used. These initial principles helped to change surgical therapy from a dreaded event, with infection and death commonplace, to one that alleviates suffering and prolongs life with predictable success when carefully performed. With the introduction of antibiotic therapy in the middle of the 20th century a new adjunctive method to treat and prevent surgical infections was fostered. However, not only have postoperative wound and hospital-acquired infections continued, but widespread antibiotic therapy has not often made prevention and control of surgical infections more difficult. The present generation of surgeons has seen increasing numbers of serious infections related to a complex combination of factors, including the performance of more complicated and longer operations, an increase in the number of geriatric patients with accompanying chronic or debilitating diseases, many new surgical procedures with implants of foreign materials, a rapidly expanding number of organ transplants requiring the use of immunosuppressive agents, and increased use of diagnostic and treatment modalities that cause greater bacterial exposures or the suppression of normal host resistance. The modern surgeon cannot escape the responsibility of dealing with infections and in dealing with them, of having the knowledge for the appropriate use of aseptic and antiseptic technique, proper use of prophylactic and therapeutic antibiotics, and adequate monitoring and support with novel surgical andpharmacologic as well as nonpharmacologic aids. Basic understanding of how the body defends itself against infection is essential to a rational application of surgical and other therapeutic principles to the control of infection.