%0 Journal Article
%T The Prevention of Surgical Site Infection in Elective Colon Surgery
%A Donald E. Fry
%J Scientifica
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/896297
%X Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes. 1. Introduction Elective colon surgery continues to have the highest rate of infection at the surgical site among all elective surgical procedures. These infections span a continuum of mild superficial infection to those that are deep-seated within the abdominal cavity and pose a serious threat to the patient¡¯s survival. These infections are associated with considerable patient morbidity as a general rule and frequently require reoperation, prolonged hospitalization, and readmission to the hospital during the course of management. Surgical site infection (SSIs) have proven to be very costly in addition to the attendant patient morbidity [1, 2]. Because of the frequency and severity of these infections, there has been nearly a full century of efforts to define improved processes for prevention. Numerous methods have been proposed and employed before and during elective colon surgery to prevent infection at the surgical site. Many have strong scientific foundation, while others are driven solely by expert opinion. This presentation will attempt to provide a comprehensive context of the pathogenesis of SSI following elective colon surgery and to define those methods that have evidence to support use for prevention. In past decades it has been the practice to refer to wound infections as separate entities from infections that occur in
%U http://www.hindawi.com/journals/scientifica/2013/896297/