Infections in Surgery

Although most clinicians are aware of the problem of antimicrobial resistance, most also underestimate its significance in their own hospital. The incorrect and inappropriate use of antibiotics and other antimicrobials, as well as poor prevention and poor control of infections, are contributing to the development of such resistance.Appropriate use of antibiotics and compliance with infection prevention and control measures should be integral aspects of good clinical practice and standards of care. However, these activities are often inadequate among clinicians, and there is a considerable gap between the best evidence and actual clinical practice.

In hospitals, cultural determinants influence clinical practice, and improving behaviour in terms of infection prevention and antibiotics-prescribing practice remains a challenge. Despite evidence supporting the effectiveness of best practices, many clinicians fail to implement them, and evidence-based processes and practices that are known to optimize both the prevention and the treatment of infections tend to be underused. Addressing precisely this problem, this volume offers an essential toolkit for all surgeons and intensivists interested in improving their clinical practices.

Auteur

Massimo Sartelli is a consultant surgeon at the Department of General and Emergency Surgery, Macerata Hospital, Italy, where he is also Coordinator of Scientific Activities and a Member of the Hospital Infection Control Committee.

In recent years he focused on the study of surgical infections and sepsis, and coordinated the WSES Guidelines for the Management of Intra-abdominal Infections, WSES Guidelines for the Management of Skin and Soft Tissue Infections, and WSES Guidelines for the Management of Clostridium Difficile Infection in Surgical Patients. He is also the Founder and Acting Director of the Global Alliance for Infections in Surgery.

Raul Coimbra is the Surgeon in Chief of the Riverside University Health System Medical Centre, Director of the Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Professor of Surgery at Loma Linda University School of Medicine, and Emeritus Professor of the University of California San Diego School of Medicine. He is President of the Board of Directors for the World Coalition for Trauma Care, as well as a member of the Global Alliance for the Care of the Injured, part of the World Health Organization's Trauma and Injury Prevention Division. He has authored more than 630 scientific publications on various clinical and experimental aspects of Trauma, Emergency General Surgery, and Surgical Critical Care.

Leonardo Pagani works in the Infectious Diseases Unit at Bolzano Central Hospital (Italy), where he was the founder and Head of the Unit for Hospital Antimicrobial Chemotherapy (UHAC) and is currently the Director of the Antimicrobial Stewardship Program. He is a member of the International Scientific Committee of the World Alliance Against Antimicrobial Resistance, and serves on the Executive Board of the Global Alliance for Infections in Surgery. He is also a member of the American Society for Microbiology, the European Society for Clinical Microbiology and Infectious Diseases; he was member of the Executive Committees of the Study Group for Antibiotic Stewardship, for Infections in the Elderly, and PK/PD. He was member of the Guidelines Developer Group (GDG) of the World Health Organization for the WHO Global Guidelines for the prevention of surgical site infections. Currently involved in many international study groups and expert panels, he has authored or co-authored over 100 papers in peer-reviewed international journals.

Kemal Rasa works at the Department of Surgery, Anadolu Medical Centre, Turkey. Throughout his career he was involved in many national and international studies, researches and projects on surgical infections. He is now the President of Surgical Infection Society Europe and the Secretary of the Turkish Surgical Infection Society. He is also a founding member of the World Surgical Infection Society and currently a Board member (Secretary). He is also the Turkish national delegate to the World Society of Emergency Surgery. He has authored or co-authored a vast number of papers in peer-reviewed national and international journals and now at the Editorial Board of the Surgical Infections Journal.

Contenu

1 Impact of hospital-acquired infections in Surgery.- 2 The burden of surgical site infections. Pathophysiology and risk factors. Pre-operative measures to prevent surgical site infections.- 3 Antibiotic prophylaxis. When, how and how long.- 4 Intra-operative measures to prevent surgical site infections.- 5 How to manage the surgical wound.- 6 How to classify and treat surgical site infections.- 7 Guidelines for the prevention of surgical site infections. How to implement them.- 8 The infected mesh. How to treat it.- 9 How to prevent and treat hospital/ventilator-acquired pneumonia.- 10 How to prevent and treat hospital/ventilator-acquired pneumonia.- 11 How to prevent and treat catheter-associated urinary Tract Infections.- 12 How to prevent and treat Catheter-related bloodstream infections.- 13 Clostridium difficile infection in surgical patients.- 14 Source control in intra-abdominal infections.- 15 Ongoing (tertiary peritonitis) peritonitis.- 16 Damage Control Surgery in patients with acute peritonitis. When and how.- 17 The challenge of post-operative peritonitis by anastomotic leak.- 18 Antibiotics in intra-abdominal infections. When, how and which ones.- 19 Necrotizing soft tissue infections.- 20 Infections in elderly patients.- 21 How to use antibiotics in critically ill patients with sepsis and septic shock.- 22 Infections in trauma patients.- 23 The value of microbiological cultures. When to perform them and how to read them.- 24 Invasive candidiasis in surgical patients.- 25 The role of antimicrobial stewardship programs to optimize antibiotics use in the surgical departments.- 26 The impact of antimicrobial resistance. How can healthcare workers can contribute in the context of one health approach