surgicalinfection(外科感染

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1、SurgicalInfectionDingYuedingyue36@126.comDepartmentofOrthopaedicSurgerySecondAffiliatedHospitalofSunYat-senUniversityParonychiaErysipelasGasgangreneDefinitionPresenceofinfectionthatmustberesolvedbysurgicalprocedureincludingtheinfectioncomplicatedwithtrauma,operation,burnoretal.Th

2、epathogenscausingsurgicalinfectionsarefrequentlymixed,andusuallyoriginatefromthepatient'sownendogenousflora.Thesepathogensareopportunistic,oftendependingonanacquiredepithelialdefecttocauseinfection.ClassificationAccordingtopathogensNonspecificinfectionSpecificinfectionAccordingto

3、courseAcuteinfection<3WSubacuteinfectionChronicinfection>2MAccordingtooriginationofpathogensEndogenousinfection(viscus)ExogenousinfectionOtherclassificationPrimaryinfectionSecondaryinfectionOpportunisticinfectionSurperinfectionNosocomialinfection(fromhospital)BacterialFactors:The

4、depositionandgrowthofbacteriawithinwoundsareaprerequisiteforthedevelopmentofinfection.Thekindandnumberofbacteriacontributetotheestablishmentofinfection.Studiesoftraumaticwoundsinhealthysubjectshaveshownthatbacterialcontaminationwithmorethan105organismsfrequentlycausesinfection.Th

5、edevelopmentofinfectionisalsoaffectedbythetoxinsproducedbytheorganismandtheorganismsabilitytoresistphagocytosisandintracellulardestruction.Gram-negativebacteriahavesurfacecomponents(endotoxinorlipopolysaccharide)thataretoxic.Gram-positivebacteriaproducepowerfulexotoxins.Syndromes

6、oftheinflammatoryresponseSystemicinflammatoryresponsesyndrome(SIRS)SepticaemiaSepsisSepticshockSIRS:Theessentialclinicalfindingswereanabnormalbodytemperature,tachycardia,tachypnea,andanaberrantwhitebloodcellcount.Sepsis:isthecircumstanceofapatientwithfindingsconsistentofSIRSandad

7、ocumentedinfection..Severesepsis:isdefinedasoccurringwhenapatientwithsepsishascriticalorgandysfunctionandhypo-perfusionincludinghypotension..Septicshock:isthemostseriousclinicalproblemandexistsifapatienthasseveresepsis,isresuscitatedappropriatelywithintravenousfluidinfusion,andre

8、mainsinshock..Deathrate:SIRS7%Sepsis16%S