학술논문

Surgical site infection prevention and management in immunocompromised patients: a systematic review of the literature.
Document Type
Article
Source
World Journal of Emergency Surgery. 6/10/2021, Vol. 16 Issue 1, p1-13. 13p.
Subject
*ABDOMINAL surgery
*ONLINE information services
*MEDICAL databases
*INFORMATION storage & retrieval systems
*RAPAMYCIN
*IMMUNOCOMPROMISED patients
*SYSTEMATIC reviews
*POSTOPERATIVE care
*SURGERY
*PATIENTS
*SURGICAL complications
*ANTIBIOTIC prophylaxis
*SURGICAL site infections
*SURGICAL site
*HEALTH care teams
*MEDLINE
*DECISION making in clinical medicine
*TRANSPLANTATION of organs, tissues, etc.
*ENZYME inhibitors
Language
ISSN
1749-7922
Abstract
Background: Immunocompromised patients are at higher risk of surgical site infection and wound complications. However, optimal management in the perioperative period is not well established. Present systematic review aims to analyse existing strategies and interventions to prevent and manage surgical site infections and other wound complications in immunocompromised patients. Methods: A systematic review of the literature was conducted. Results: Literature review shows that partial skin closure is effective to reduce SSI in this population. There is not sufficient evidence to definitively suggest in favour of prophylactic negative pressure wound therapy. The use of mammalian target of rapamycin (mTOR) and calcineurin inhibitors (CNI) in transplanted patient needing ad emergent or undeferrable abdominal surgical procedure must be carefully and multidisciplinary evaluated. The role of antibiotic prophylaxis in transplanted patients needs to be assessed. Conclusion: Strict adherence to SSI infection preventing bundles must be implemented worldwide especially in immunocompromised patients. Lastly, it is necessary to elaborate a more widely approved definition of immunocompromised state. Without such shared definition, it will be hard to elaborate the needed methodologically correct studies for this fragile population. [ABSTRACT FROM AUTHOR]