surgical infections

Surgical infections
Definitio
• Surgical infections = infections that are surgically treatable (primary surgical
infection) or appear as consequence of medical procedures

• Surgical infection is an infection that:

(1) is unlikely to respond to nonsurgical treatment (it usually must be excised or
drained) and occupies an unvascularized space in tissue or

(2) occurs in an operated site



Classification (1)
Acute \ Subacute \ Chronic

Localised \ Systemic

Etiology:

•Bacterial •Viral •Fungal •Parasitic etc.



Single germ -Pluribacterial

Nonspecific -Specific (TB, actinomicosis etc.)



Etiology
Determinant factors:

•Microorganism

(1) microbial pathogenicity and number,

(2) host defenses,

(3) the local environment, and

(4) surgical technique(for postoperative infection).



1

, Pathogenesis - 1
-Primum movens – bacterial agression produces a local and systemic reaction

-Tissue necrosis is always present in localised infection

-Inflammation is the cornerstone: Inflammation is a protective response

-intended to eliminate the initial cause of cell injury as well as the necrotic
cells and tissues resulting from the original insult.


Pathogenesis - 2
For localised infection:

•an infectious agent

•a susceptible host

•a closed, unperfused space

Pathophysiology - 1
Inflammation:

• Local vasodilation

• Increased vascular permeability

• PMN migration

•Mediators (kinins, complement, clotting factors, inflammation factors)

Influencing factors:

• Virulence and germ species

• Germ inoculation quantity

• Microbial association

•The host

Infection course:

•Local:



2