SURGICAL INFECTION &

SURVIVING SEPSIS CAMPAIGN

Fasilitator : Dr. Reno Rudiman,dr.,M.Sc.,Sp.B(K)BD
Presentan :
Danny, dr
Yhoga, dr
Ferry, dr
Syakuran, drg
 PART I
SURGICAL INFECTION
 Patogenesis
Infection

Host
Agent
Defance
Agent
Mikroorganisme

Bakteri Fungi Viral

 AEROBIC PATHOGENS IN
SURGICAL INFECTIONS
STAPHYLOCOCCUS AUREUS (17%)
ENTEROCOCCI (13%)
COAGULASE-NEGATIVE STAPHYLOCOCCI (12%)
ESCHERICHIA COLI (10%)
PSEUDOMONAS AERUGINOSA (8%)
ENTEROBACTER SPECIES (8%)
PROTEUS MIRABILIS (4%)
KLEBSIELLA PNEUMONIAE (3%)
CANDIDA SPECIES (2%)

11
Fungi
Nosocomial infections  Candida albicans and related

species),
Rare causes of aggressive soft tissue infections  Mucor
Rhizopus, and Absidia spp (opportunistic pathogens)
Infection in the immunocompromised host  Aspergillus
fumigatus, niger, terreus, and other spp., Blastomyces
dermatitidis, Coccidioides immitis, and Cryptococcus
neoformans
Viral
Difficult identification  Small size and
necessity for growth within cellsdifficult to
culture
 Viral infection was identified by indirect
means  the host antibody response.
Host Defance
Interaction mikroba with resident and
recruited host defenses:
Eradication

Containment

Locoregional Infection
Interaction mikroba with resident and
recruited host defenses:
Systemic Infection

Sepsis
Surgical Wound Infection
Surgical wounds
are classified
• Dirty wounds (class IV)
based on the • Contaminated wounds (class III)
presumed wounds(class II)
magnitude of the • Clean contaminated
bacterial load at • Clean wound(Class1)
the time of
surgery :
Clean wounds (class I) include those in which no
infection is present; only skin microflora potentially
contaminate the wound, and no hollow viscus that
contains microbes is entered.
Clean/contaminated wounds (class II) include those
in which a hollow viscus such as the respiratory,
alimentary, or genitourinary tracts with
indigenousbacterial flora is opened under controlled
circumstances without significant spillage of contents.
Contaminated wounds (class III) include open
accidental wounds encountered early after injury,
those with extensive introduction of bacteria into
a normally sterile area of the body due to major
breaks in sterile technique (e.g., open cardiac
massage) ,gross spillage of viscus contents such as
from the intestine,or incision through inflamed,
nonpurulent tissue.
Dirty wounds (class IV) include traumatic
wounds in which a significant delay in
treatment has occurred and in which necrotic
tissue is present, those created in the presence
of overt infection as evidenced by the presence
of purulent material, and those created to
access a perforated viscus accompanied by a
high degree of contamination.
PREVENTION AND TREATMENT OF SURGICAL INFECTIONS

Treatment

Source
Antibiotik Komorbid
Control