การดูแลบาดแผลก่อนและหลังการทำหัตถการ
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Mar 31, 2022
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Abstract
Pre-Postoperative wound care to prevent infection is essential in clinical practices. All of these procedures comprise preoperative preparation of the skin, hand washing, scrubbing, disinfection, decontamination of surgical equipment include autoclaving, preoperative skin antiseptic such as alcohol, iodinated preparations and chlorhexidine. Whether to prescribe antibiotic prophylaxis is still a topic of controversial in postoperative wound care, however antimicrobial prophylaxis is usually unnecessary in dermatosurgical procedures. If the decision of using antimicrobials has been made, the next step is using it optimally in order to maintain the high blood level and tissue level of antimicrobials at the time of certain bacteremia. Antibiotic of choice to prevent infection needs discussion of wound types. Both patient risk factors and environmental risk factors contribute to wound infection are low immune status, diabetes mellitus, smoking, obesity, malignancy, advanced age, concomitant infections, etc.
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บทความฟื้นวิชา (Subject Review)
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References
เอกสารอ้างอิง
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2. Aasi SZ, Leffell DJ. Complications in dermatologic surgery: how safe is safe? Arch Dermatol. 2003;139:213-4.
3. Salopek TG, Slade JM, Marghoob AA, Rigel DS, Kopf AW, Bart RS, et al. Management of cutaneous malignant melanoma by dermatologists of the American Academy of Dermatology. II. Definitive surgery for malignant melanoma. J Am Acad Dermatol. 1995;33:451-61.
4. Haas AF, Grekin RC. Practical thoughts on antibiotic prophylaxis. Arch Dermatol. 1998;134:872-3.
5. Babcock MD, Grekin RC. Antibiotic use in dermatologic surgery. Dermatol Clin. 2003;21:337-48.
6. Amici JM, Rogues AM, Lasheras A, Gachie JP, Guillot P, Beylot C, et al. A prospective study of the incidence of complications associated with dermatological surgery. Br J Dermatol. 2005;153:967-71.
7. Futoryan T, Grande D. Postoperative wound infection rates in dermatologic surgery. Dermatol Surg.1995;21:509-14.
8. Levin EC, Chow C, Makhzoumi Z, Jin C, Shiboski SC, Arron ST. Association of postoperative antibiotics with surgical site infection in Mohs micrographic surgery. Dermatol Surg. 2019;45:52-7.
9. Wahie S, Lawrence CM. Wound complications following diagnostic skin biopsies in dermatology inpatients. Arch Dermatol. 2007;143:1267-71.
10. Helbling I, Muston HL, Ferguson JE, Mc Kenna M. Audit of admissions to dermatology beds in Greater Manchester. Clin Exp Dermatol. 2002;27:519-22.
11. Cantlon CA, Stemper ME, Schwan WR, Hoffman MA, Qutaishat SS. Significant pathogens isolated from surgical site infections at a community hospital in the Midwest. Am J infect Control. 2006;34:526-9.
12. Finn L, Crook S. Minor surgery in general practice--setting the standards. J Public Health Med. 1998;20:169-74.
13. Maragh SL, Otley CC, Roenigk RK, Phillips PK. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005;31:83-91.
14. Davis CP. Normal flora. In: Baron S, editor. Medical microbiology. 4th ed. Galveston, TX: The University of Texas Medical Branch at Galveston; 1996.
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16. Hurst EA, Grekin RC, Yu SS, Neuhaus IM. Infectious complications and antibiotic use in dermatologic surgery. Semin Cutan Med Surg. 2007;26:47-53.
17. Johnson-Jahangir H, Agrawal N. Perioperative antibiotic use in cutaneous surgery. Dermatol Clin. 2019;37:329-40.
18. Dixon AJ, Dixon MP, Askew DA, Wilkinson D. Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics. Dermatol Surg. 2006;32:819-26; discussion 826-7.
19. Olsen MA, Lock-Buckley P, Hopskins D, Polish LB, Sundt TM, Fraser VJ. The risk factors for deep and superficial chest surgical-site infections after coronary artery bypass graft surgery are different. J Thorac Cardiovasc Surg. 2002;124:136-45.
20. Garland R, Frizelle FA, Dobbs BR, Singh H. A retrospective audit of long-term lower limb complications following leg vein harvesting for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2003;23:950-5.
21. Hart S. Using an aseptic technique to reduce the risk of infection. Nurs Stand. 2007;21:43-8.
22. NHS Estates. A guide to decontamination of reusable surgical instruments. London: Department of Health; 2003.
23. Rutala WA, Weber DJ. Disinfection and sterilization in health care facilities: what clinicians need to know. Clin Infect Dis. 2004;39:702-9.
24. Spencer RC, Perry C. Decontamination of reusable surgical instruments. Hosp Med. 2001;62:662-3.
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26. Darouiche RO, Wall MJ Jr, Itani KM, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18-26.
27. Perez R, Freeman S, Sohmer H, Sichel JY. Vestibular and cochlear ototoxicity of topical antiseptics assessed by evoked potentials. Laryngoscope. 2000;110:1522-7.
28. Murthy S, Hawksworth NR, Cree I. Progressive ulcerative keratitis related to the use of topical chlorhexidine gluconate (0.02%). Cornea .2002;21:237-9.
29. Tanner J, Swarbrook S, Stuart J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev. 2008;1:CD004288.
30. Gould D, Ream E. Assessing nurses’ hand decontamination performance. Nurs Times. 1993;89:47-50.
31. Gould DJ, Chudleigh J, Drey NS, Moralejo D. Measuring handwashing performance in health service audits and research studies. J Hosp Infect. 2007;66:109-15.
32. Taylor LJ. An evaluation of handwashing techniques-1. Nurs Times. 1978;74:54-5.
33. Boyce JM, Pittet D. Guideline for hand hygiene in healthcare settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep. 2002;51:1-45, quiz CE41-44.
34. Grinbaum RS, de Mendonça JS, Cardo DM. An outbreak of handscrubbing-related surgical site infections in vascular surgical procedures. Infect Control Hosp Epidemiol. 1995;16:198-202.
35. Winnefeld M, Richard MA, Drancourt M, Grob JJ. Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use. Br J Dermatol. 2000;143:546-50.
36. Sartor C, Jacomo V, Duvivier C, Tissot-Dupont H, Sambuc R, Drancourt M. Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap. Infect Control Hosp Epidermiol. 2000;21:196-9.
37. Archibald LK, Corl A, Shah B, Schulte M, Arduino MJ, Aguero S, et al. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol. 1997;18:704-9.
38. Centers for Disease Control and Prevention. Reopening guidance for cleaning and disinfecting public spaces, Workplaces, Businesses, Schools, and homes. [update 2020 May 7; cited: 2020 Sep 21. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html
39. Bell RM. Surgical procedures, techniques, and skills. In: Lawrence PF, Beel RM, Dayton MT, editors. Essentials of general surgery. 3rd ed. Philadephia: Lippincott Williams & Williams: 1999. p. 519-62.
40. Lamberg L. Dermatologists debate sentinel node biopsy, safety of liposuction, and antibiotic prophylaxis. JAMA. 2000;283:2223-4.
41. George PM. Dermatologists and antibiotic prophylaxis: a survey. J Am Acad Dermatol. 1995;33:418-21.
42. Carmichael AJ, Flanagan PG, Holt PJ, Duerden BI. The occurrence of bacteraemia with skin surgery. Br J Dermatol. 1996;134:120-2.
43. Saleh K, Schmidtchen A. Postoperativa sårinfektioner inom hudkirurgi-en evidensöversikt-orsakar onödigt lidande och ökade vårdkostnader, bästa förebyggande åtgärd ännu inte klarlagd [Superficial surgical site infections in dermatologic surgery]. Lakartidningen. 2019;116:FHM6.
44. Scheinfeld N, Struach S, Ross B. Antibiotic prophylaxis guideline awareness and antibiotic prophylaxis use among New York State dermatologic surgeons. Dermatol Surg. 2002;28:841-4.
45. Huether MJ, Griego RD, Brodland DG, Zitelli JA. Clindamycin for intraincisional antibiotic prophylaxis in dermatologic surgery. Arch Dermatol. 2002;138:1145-8.
46. Patil AN, Uppin VM. Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial. Int Surg J. 2018;5:1438-42.
1. Kothapalli A. Postoperative wound infection rates following diagnostic skin biopsies in dermatology patients at an Australian tertiary hospital. Australas J Dermatol. 2019;60:77-8.
2. Aasi SZ, Leffell DJ. Complications in dermatologic surgery: how safe is safe? Arch Dermatol. 2003;139:213-4.
3. Salopek TG, Slade JM, Marghoob AA, Rigel DS, Kopf AW, Bart RS, et al. Management of cutaneous malignant melanoma by dermatologists of the American Academy of Dermatology. II. Definitive surgery for malignant melanoma. J Am Acad Dermatol. 1995;33:451-61.
4. Haas AF, Grekin RC. Practical thoughts on antibiotic prophylaxis. Arch Dermatol. 1998;134:872-3.
5. Babcock MD, Grekin RC. Antibiotic use in dermatologic surgery. Dermatol Clin. 2003;21:337-48.
6. Amici JM, Rogues AM, Lasheras A, Gachie JP, Guillot P, Beylot C, et al. A prospective study of the incidence of complications associated with dermatological surgery. Br J Dermatol. 2005;153:967-71.
7. Futoryan T, Grande D. Postoperative wound infection rates in dermatologic surgery. Dermatol Surg.1995;21:509-14.
8. Levin EC, Chow C, Makhzoumi Z, Jin C, Shiboski SC, Arron ST. Association of postoperative antibiotics with surgical site infection in Mohs micrographic surgery. Dermatol Surg. 2019;45:52-7.
9. Wahie S, Lawrence CM. Wound complications following diagnostic skin biopsies in dermatology inpatients. Arch Dermatol. 2007;143:1267-71.
10. Helbling I, Muston HL, Ferguson JE, Mc Kenna M. Audit of admissions to dermatology beds in Greater Manchester. Clin Exp Dermatol. 2002;27:519-22.
11. Cantlon CA, Stemper ME, Schwan WR, Hoffman MA, Qutaishat SS. Significant pathogens isolated from surgical site infections at a community hospital in the Midwest. Am J infect Control. 2006;34:526-9.
12. Finn L, Crook S. Minor surgery in general practice--setting the standards. J Public Health Med. 1998;20:169-74.
13. Maragh SL, Otley CC, Roenigk RK, Phillips PK. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005;31:83-91.
14. Davis CP. Normal flora. In: Baron S, editor. Medical microbiology. 4th ed. Galveston, TX: The University of Texas Medical Branch at Galveston; 1996.
15. Hart S. Aseptic technique. In: Dougherty L, Lister SE, editors. The Royal Marsden Hospital manual of clinical nursing procedures. 6th ed. Oxford: Blackwell Publishing; 2004. p. 50-63.
16. Hurst EA, Grekin RC, Yu SS, Neuhaus IM. Infectious complications and antibiotic use in dermatologic surgery. Semin Cutan Med Surg. 2007;26:47-53.
17. Johnson-Jahangir H, Agrawal N. Perioperative antibiotic use in cutaneous surgery. Dermatol Clin. 2019;37:329-40.
18. Dixon AJ, Dixon MP, Askew DA, Wilkinson D. Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics. Dermatol Surg. 2006;32:819-26; discussion 826-7.
19. Olsen MA, Lock-Buckley P, Hopskins D, Polish LB, Sundt TM, Fraser VJ. The risk factors for deep and superficial chest surgical-site infections after coronary artery bypass graft surgery are different. J Thorac Cardiovasc Surg. 2002;124:136-45.
20. Garland R, Frizelle FA, Dobbs BR, Singh H. A retrospective audit of long-term lower limb complications following leg vein harvesting for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2003;23:950-5.
21. Hart S. Using an aseptic technique to reduce the risk of infection. Nurs Stand. 2007;21:43-8.
22. NHS Estates. A guide to decontamination of reusable surgical instruments. London: Department of Health; 2003.
23. Rutala WA, Weber DJ. Disinfection and sterilization in health care facilities: what clinicians need to know. Clin Infect Dis. 2004;39:702-9.
24. Spencer RC, Perry C. Decontamination of reusable surgical instruments. Hosp Med. 2001;62:662-3.
25. Danziger L, Hassan E. Antimicrobial prophylaxis of gastrointestinal surgical procedures and treatment of intraabdominal infections. Drug Intell Clin Pharm. 1987;21:406-16.
26. Darouiche RO, Wall MJ Jr, Itani KM, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med. 2010;362:18-26.
27. Perez R, Freeman S, Sohmer H, Sichel JY. Vestibular and cochlear ototoxicity of topical antiseptics assessed by evoked potentials. Laryngoscope. 2000;110:1522-7.
28. Murthy S, Hawksworth NR, Cree I. Progressive ulcerative keratitis related to the use of topical chlorhexidine gluconate (0.02%). Cornea .2002;21:237-9.
29. Tanner J, Swarbrook S, Stuart J. Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev. 2008;1:CD004288.
30. Gould D, Ream E. Assessing nurses’ hand decontamination performance. Nurs Times. 1993;89:47-50.
31. Gould DJ, Chudleigh J, Drey NS, Moralejo D. Measuring handwashing performance in health service audits and research studies. J Hosp Infect. 2007;66:109-15.
32. Taylor LJ. An evaluation of handwashing techniques-1. Nurs Times. 1978;74:54-5.
33. Boyce JM, Pittet D. Guideline for hand hygiene in healthcare settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep. 2002;51:1-45, quiz CE41-44.
34. Grinbaum RS, de Mendonça JS, Cardo DM. An outbreak of handscrubbing-related surgical site infections in vascular surgical procedures. Infect Control Hosp Epidemiol. 1995;16:198-202.
35. Winnefeld M, Richard MA, Drancourt M, Grob JJ. Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use. Br J Dermatol. 2000;143:546-50.
36. Sartor C, Jacomo V, Duvivier C, Tissot-Dupont H, Sambuc R, Drancourt M. Nosocomial Serratia marcescens infections associated with extrinsic contamination of a liquid nonmedicated soap. Infect Control Hosp Epidermiol. 2000;21:196-9.
37. Archibald LK, Corl A, Shah B, Schulte M, Arduino MJ, Aguero S, et al. Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap. Infect Control Hosp Epidemiol. 1997;18:704-9.
38. Centers for Disease Control and Prevention. Reopening guidance for cleaning and disinfecting public spaces, Workplaces, Businesses, Schools, and homes. [update 2020 May 7; cited: 2020 Sep 21. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html
39. Bell RM. Surgical procedures, techniques, and skills. In: Lawrence PF, Beel RM, Dayton MT, editors. Essentials of general surgery. 3rd ed. Philadephia: Lippincott Williams & Williams: 1999. p. 519-62.
40. Lamberg L. Dermatologists debate sentinel node biopsy, safety of liposuction, and antibiotic prophylaxis. JAMA. 2000;283:2223-4.
41. George PM. Dermatologists and antibiotic prophylaxis: a survey. J Am Acad Dermatol. 1995;33:418-21.
42. Carmichael AJ, Flanagan PG, Holt PJ, Duerden BI. The occurrence of bacteraemia with skin surgery. Br J Dermatol. 1996;134:120-2.
43. Saleh K, Schmidtchen A. Postoperativa sårinfektioner inom hudkirurgi-en evidensöversikt-orsakar onödigt lidande och ökade vårdkostnader, bästa förebyggande åtgärd ännu inte klarlagd [Superficial surgical site infections in dermatologic surgery]. Lakartidningen. 2019;116:FHM6.
44. Scheinfeld N, Struach S, Ross B. Antibiotic prophylaxis guideline awareness and antibiotic prophylaxis use among New York State dermatologic surgeons. Dermatol Surg. 2002;28:841-4.
45. Huether MJ, Griego RD, Brodland DG, Zitelli JA. Clindamycin for intraincisional antibiotic prophylaxis in dermatologic surgery. Arch Dermatol. 2002;138:1145-8.
46. Patil AN, Uppin VM. Intra-incisional versus intravenous route of antibiotic administration in preventing surgical site infections: a randomized controlled trial. Int Surg J. 2018;5:1438-42.