大阪市立総合医療センター 小児心臓血管外科Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital ◇ Osaka, Japan
手術部位感染（SSI）はこれを治療するための人的および経済的コストを増加させる．しかしSSIの約半数はエビデンスに基づく戦略により予防できると推定される1, 2)．本稿では，SSI予防策についてCDCを中心とした各種のガイドラインを中心に述べ，注意を喚起したい．おもにCDCガイドライン1999年版および2017年版に示される手術室の環境整備，術前の剃毛，消毒法，手洗い法，抗生剤予防投与，術中の注意点，術後創部の管理法などについて述べる．CDCをはじめとする各種ガイドラインに沿ってSSI予防に努め，手術の質を向上させることが求められる．
The human and financial costs of treating surgical site infections (SSIs) have been increasing. It has been estimated that approximately half of SSIs are preventable by using evidence-based strategies. The objective of this paper is to review the new and updated evidence-based recommendations for the prevention of SSIs, such as those of The Centers for Disease Control and Prevention (CDC, USA) guidelines for Prevention of SSIs published in 1999 and 2017. We mainly discuss the guidelines of 1999 and 2017 regarding preoperative preparation of patients, prophylactic antibiotics, intraoperative ventilation, aseptic and surgical technique, and postoperative incision care to identify differences between the older guideline and the new and updated recommendations to prevent unpleasant SSIs.
Key words: surgical site infections; CDC guideline 2017; CDC guideline 1999; pediatric cardiac surgery
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