Guideline for Prevention of Surgical Site Infection, 1999 ☆ ☆☆ ★ ★★

The “Guideline for Prevention of Surgical Site Infection, 1999” presents the Centers for Disease Control and Prevention (CDC)'s recommendations for the prevention of surgical site infections (SSIs), formerly called surgical wound infections. This two-part guideline updates and replaces previous guidelines.Part I, “Surgical Site Infection: An Overview,” describes the epidemiology, definitions, microbiology, pathogenesis, and surveillance of SSIs. Included is a detailed discussion of the pre-, intra-, and postoperative issues relevant to SSI genesis.

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Guideline for Prevention of Surgical Site Infection, 1999

These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the

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Clinical practice guidelines for antimicrobial prophylaxis in surgery

https://www.amjmed.com/article/0002-9343(91)90361-Z/pdf

Surgical wound infection rates by wound class, operative procedure, and patient risk index

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. In the absence of consensus definitions and treatment guidelines the diagnosis and management of IAH and ACS remains variable from institution to institution. An international consensus group of multidisciplinary critical care specialists convened at the second World Congress on Abdominal Compartment Syndrome to develop practice guidelines for the diagnosis, management, and prevention of IAH and ACS. Prior to the conference the authors developed a blueprint for consensus definitions and treatment guidelines which were refined both during and after the conference. The present article is the second installment of the final report from the 2004 International ACS Consensus Definitions Conference and is endorsed by the World Society of the Abdominal Compartment Syndrome. The prevalence and etiological factors for IAH and ACS are reviewed. Evidence-based medicine treatment guidelines are presented to facilitate the diagnosis and management of IAH and ACS. Recommendations to guide future studies are proposed. These definitions, guidelines, and recommendations, based upon current best evidence and expert opinion are proposed to assist clinicians in the management of IAH and ACS as well as serve as a reference for future clinical and basic science research.

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Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. II. Recommendations.

Traditional methods for prevention of large bowel cancer rely on surveillance of patients with known precursors of bowel cancer, namely ulcerative colitis and those genetically linked polyposis syndromes that have malignant potential. Identification of heritable bowel cancer families and solitary polyp--cancer families provide additional populations that merit intensive scrutiny. Persuasive, if circumstantial, evidence suggests that maintaining patients free of large bowel polyps reduces the risk of developing large bowel cancer. Prospects for prevention of large bowel cancer are extended by recognition that a diet low in fat may reduce the risk of large bowel cancer. Furthermore, there is considerable evidence in animals that a variety of antioxidants limit large bowel carcinogenesis and preliminary evidence in man that these agents may control large bowel neoplasia.

Surgical and medical measures in prevention of large bowel cancer.

We investigated the role of central nitric oxide (NO) synthase inhibition in the modulation of fasting gastrointestinal motor activity and gastric emptying rate of solid nutrient meals in conscious dogs. N(omega)-nitro-L-arginine methyl ester and N(omega)-nitro-L-arginine were infused intracerebroventricularly. Circular muscle contractions were recorded with surgically implanted strain gauge transducers. Gastric emptying was measured by a radiolabeled meal. The inhibition of NO synthase in the brain suppressed phase III activity in the stomach and the duodenum but not in the jejunum or the ileum. However, the central inhibition of NO synthase had no significant effect on the rate of gastric emptying of solid nutrient meals or the duration of postprandial disruption of migrating motor complex cycling. The central actions of NO synthase inhibition were blocked by bilateral truncal vagotomy but not by intravenous administration of propranolol or phentolamine. We conclude that the inhibition of NO synthase in the brain generates a stimulus that selectively inhibits gastric and duodenal phase III activities. This stimulus, however, may not affect the postprandial gastroduodenal motor activity or the rate of gastric emptying of solid nutrient meals.

Central inhibition of nitric oxide synthase modulates upper gastrointestinal motor activity.

Oral neomycin and erythromycin compared with single-dose systemic metronidazole and ceftriaxone prophylaxis in elective colorectal surgery.

Should antibiotics be administered to all patients undergoing a colon or rectal operation? During the past decade, a large body of information pertinent to this question has been acquired as controlled trials of antibiotic efficacy in colon operations have been reported. These studies show that antibiotics, or combinations of antibiotics, administered orally or parenterally, reduce the incidence of wound infections and other septic complications associated with operations on the colon and rectum. 1 The most pertinent evidence bearing on the question of whether or not antibiotics should be used in patients undergoing colorectal operations comes from those clinical studies that compared the risk of infection in a placebotreated group with that of a group receiving antibiotics. The conclusion from these studies is very clear. Among patients who did not receive antibiotics, the risks of wound infection and other septic complications following an operation on the colon or rectum were much

Robert E. Condon

Papers

Surgical and medical measures in prevention of large bowel cancer.

Central inhibition of nitric oxide synthase modulates upper gastrointestinal motor activity.

Oral neomycin and erythromycin compared with single-dose systemic metronidazole and ceftriaxone prophylaxis in elective colorectal surgery.

Bowel Preparation for Colorectal Operations

Cochrane review and meta-analysis.