Surgical and Hospital-Acquired Infections

Abstract

Surgical and hospital-acquired infections are common clinical problem. Surgical infections are either treated by an operation or caused by a surgical intervention. On the body surface they present with one or more of the five cardinal symptoms of infection. Deep infection are often more difficult to identify and may only present with systemic symptoms. The body has several physiological protective mechanisms, which prevent the invasion of pathogens. If these are compromised or if the congenital unspecific and the acquired specific immune system fails, infection occur. Surgical therapy of infections consists of operative treatment, correction of the acquired immune defect and systemic antimicrobial therapy. Local factors like limited blood perfusion, necrosis and inadequate wound care should be corrected. Furthermore, surgical and nosocomial infection can be prevented by strict hygiene measures with patient contact and in the operating room. This is particularly true for hospital-acquired infections with multiple drug resistant organisms, which require special surveillance. In clinical practice, infections are separated into aerobic and anaerobic infections. Typical aerobic infections are abscess, empyema, erysipelas, phlegmon and necrotizing fasciitis. Typical anaerobic infections are tetanus and gas gangrene. Depending on the type of infection, therapy may require immediate surgical intervention or systemic antimicrobial therapy.