Title: SURGICAL INFECTIONS: BONE
1SURGICAL INFECTIONS BONE SOFT TISSUES,
INCLUDING MICROBIOLOGY
- Dr. ADEFEMI O. AFOLABI
- DIVISION OF HEPATOBILIARY
- ENDOCRINE SURGERY
- DEPARTMENT OF SURGERY
- COLLEGE OF MEDICINE
- UNIVERSITY OF IBADAN
- IBADAN, NIGERIA.
2HISTORICAL BACKGROUND
- PRE-ANAESTHESIA ERA
- PRE-ANTIBIOTIC ERA
- WAR-TIME SURGERY
- SEMMELWEIS- HAND WASHING PUERPERAL SEPSIS (1847)
3HISTORICAL BACKGROUND
- LOUIS PASTEUR- GERM THEORY(1861)
- JOSEPH LISTER-ANTISEPTIC SURGERY (CARBOLIC ACID
1865) - GUSTAV NEUBER- THEATRE AND CAP GOWN (1882)
- BERGMANN SCHIMMELBUSH- STEAM STERILISATION(1886)
4HISTORICAL BACKGROUND
- HALSTEAD- GLOVES, BLOODGOOD-GENERAL USE (1898)
- MICKULICZ RADECKI- FACE MASKS
- ANAESTHESIA, BLOOD TRANSFUSION, ANTIBIOTICS
- DISINFECTION STERILISATION
5GENERAL CONSIDERATIONS
- DEFINITION
- PRINCIPLE OF THERAPY
- DETERMINANTS OF INFECTION
6DETERMINANTS OF INFECTION
- MICROBIAL PATHOGENICITY
- HOST DEFENCES
- LOCAL ENVIRONMENT
- SURGICAL TECHNIQUE
7TYPES OF SURGICAL INFECTION
- SKIN AND SOFT TISSUE
- CELLULITIS LYMPHANGITIS
- ABSCESS
- NECROTIZING SOFT TISSUE INFECTIONS
- TETANUS
8TYPES OF SURGICAL INFECTION
- BODY CAVITY
-
- PERITONITIS
- INTRA-ABDOMINAL ABSCESSES
- EMPYEMA- THORACIS
- GALL BLADDER
- OTHER CLOSED-SPACE INFECTIONS
9IATROGENIC INFECTIONS
- PROSTHETIC DEVICE ASSOCIATED
- JOINT PROSTHESES,
- VENTRICULO-PERITONEAL
- SHUNTS
- e.t.c.
- VASCULAR CATHETER-RELATED INFECTIONS
-
10HOSPITAL-ACQUIRED(NOSOCOMIAL)INFECTIONS
- WOUND (SURGICAL SITE)
-
- URINARY TRACT
- RESPIRATORY TRACT
- CATHETER RELATED
11WOUND (SURGICAL SITE) INFECTION
- CLASSIFICATION OF SURGICAL WOUNDS- INFECTION
RATES - CLEAN- 1.5-3.9
- CLEAN-CONTAMINATED- 3-4
- CONTAMINATED- 8.5
- DIRTY- 2-40
-
12WOUND (SURGICAL SITE) INFECTION
- PREVENTION
- OPERATION ROOM ENVIRONMENT
- INSTRUMENTS DRAPES
- HAND-WASHING
- GLOVES, CAPS, MASKS
- PRE-OP. HOSPITALISATION-SHORT
- PRE-OP. SHOWER
13PREVENTION OF WOUND INFECTION
- SHAVING
- TREAT REMOTE INFECTION
- SKIN PREPARATION
- BOWEL PREPARATION
- ADEQUATE GOOD NUTRITION
- GOOD SURGICAL TECHNIQUE
- PROPHYLACTIC ANTIBIOTICS
14SURGICAL MICROBIOLOGY
- BACTERIA
- GRAM VE COCCI
- AEROBIC FACULTATIVELY ANAEROBIC GRAM VE
BACILLI - ANAEROBIC BACTERIA
- FUNGI
- VIRUSES- HEPATITIS, H.I.V.
15UCH MICROBIOLOGY LAB SURVEILLANCE REPORT(MAR-DEC
2003)
- PREDOMINANT NOSOCOMIAL ORGANISMS
- Klebsiella spp- 25.3
- S.aureus- 22.7
- E.coli- 21.7
- P. aeruginosa- 13.6
- Pseudo spp- 5.6
16PREDOMINANT NOSOCOMIAL ORGANISMS
- Proteus mirabilis- 4
- Proteus spp- 3.5
- Enterococcus faecalis- 1.5
- Streptococcus pneumoniae- 1
- Non-haemolytic strept- 0.5
17ANTIMICROBIALTHERAPY
- DISTRIBUTION OF ANTIMICROBIAL AGENTS
- USE OF ANTIBIOTICS IN SURGERY
- DRUG ADMINISTRATION
- IMMUNOTHERAPY OF INFECTIONS
- MONOCLONAL ANTIBODIES, e.t.c.
18ACUTE BONE JOINT INFECTIONS
- ACUTE HAEMATOGENOUS OSTEOMYELITIS
- ACUTE SEPTIC ARTHRITIS
19CHRONIC BONE JOINT INFECTIONS
- CHRONIC PYOGENIC OSTEOMYELITIS
- TUBERCULOSIS
- BONES
- JOINTS