Postoperative wounds

Description:

The factors promoting infection of postoperative wounds. Frequency of emergence of infectious complications at surgical patients is caused by various internal and exogenous causes. Carry a condition of immunity of the patient and his auto-flora to internal causes, to exogenous — physical, chemical characteristics of the environment, an obseme-nyonnost of its objects and the hygienic mode supported in a hospital.

Barriers of a postoperative wound. The first barrier almost completely blocking penetration of pathogens — skin and mucous membranes. The surgical section breaks integrity of integuments, damages the chemical barriers limiting colonization of skin with microorganisms and also changes characteristics of normal microflora of skin. Blood circulation disturbance sharply reduces ability of fabrics to answer with development of proper inflammatory and immune responses. At an intubation mucifying in pneumatic ways (immobilizing microorganisms) and mukotsiliarny transport is inhibited. The accompanying pathology (especially metabolic frustration, for example a diabetes mellitus, obesity, and also disturbances of food) considerably increases risk of development of postoperative infections. Especially significant group is made by patients with various defects of immune reaction.
Foreign bodys of a postoperative wound. The role of various implanted agents as the contributing factor is in detail not studied. It is obvious that foreign bodys — substrate for reproduction of the microorganisms not capable it is normal to develop in body tissues. Artificial implants from synthetic materials or animal fabrics quite often become the environment for growth of microorganisms. Total absence of vascularization interferes with penetration in them of AT, phagocytes, immunocompetent cells and chemotherapeutic means. The intravenous and uric catheters, gastric tubes, drainage tubes, a suture material and other foreign bodys which are temporarily entered to patients can be initially inseminated by pathogenic microorganisms. An obligatory consequence of each operation — damage of the fabrics surrounding the place of surgical intervention; for example, disturbance of integrity of protective barriers facilitates survival and penetration of microorganisms into the subject fabrics.

Antimicrobic means of a postoperative wound. Use of various antiseptic agents for processing of a surgery field and antibiotics of a broad spectrum of activity for treatment and prevention of bacterial complications creates premises for penetration into the wound field of the microorganisms causing opportunistic infections. On the one hand, suppression of optional microflora facilitates colonization of fabrics pathogenic microorganisms, with another — long stay in a hospital leads to substitution of an optional automikroflora is multiple steady microorganisms.