asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2024-013asurgery-435Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCE | PRACTICEО методах профилактики инфекций области хирургического вмешательстваMethods of preventing surgical site infectionshttps://orcid.org/0000-0003-4213-5379МорозовА. М.MorozovA. M.

Морозов Артем Михайлович - к.м.н., доцент, доцент кафедры общей хирургии.

170100, Тверь, ул. Советская, д. 4

Artem M. Morozov - Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of General Surgery.

4, Sovetskaya St., Tver, 170100

ammorozovv@gmail.comhttps://orcid.org/0000-0002-9657-8063СергеевА. Н.SergeevA. N.

Сергеев Алексей Николаевич - д.м.н., доцент, заведующий кафедрой общей хирургии.

170100, Тверь, ул. Советская, д. 4

Alexey N. Sergeev - Dr. Sci. (Med.), Associate Professor, Head of the Department of General Surgery.

4, Sovetskaya St., Tver, 170100

dr.nikolaevich@mail.ruhttps://orcid.org/0000-0001-5304-1963ЧервинецВ. М.ChervinetsV. M.

Червинец Вячеслав Михайлович - д.м.н., профессор, профессор кафедры микробиологии и вирусологии с курсом иммунологии.

170100, Тверь, ул. Советская, д. 4

Vyacheslav M. Chervinets - Dr. Sci. (Med.), Professor, Professor of the Department of Microbiology and Virology with a course in Immunology.

4, Sovetskaya St., Tver, 170100

chervinets@mail.ruhttps://orcid.org/0000-0001-9209-7839ЧервинецЮ. В.ChervinetsJ. V.

Червинец Юлия Вячеславовна - д.м.н., профессор, заведующая кафедрой микробиологии и вирусологии с курсом иммунологии.

170100, Тверь, ул. Советская, д. 4

Julia V. Chervinets - Dr. Sci. (Med.), Professor, Head of the Department of Microbiology and Virology with a course in Immunology.

4, Sovetskaya St., Tver, 170100

julia_chervinec@mail.ruhttps://orcid.org/0000-0003-1635-7533ГуськоваО. Н.GuskovaO. N.

Гуськова Оксана Николаевна - к.м.н. доцент, заведующая кафедрой патологической анатомии.

170100, Тверь, ул. Советская, д. 4

Oksana N. Guskova - Cand. Sci. (Med.), Associate Professor, Head of the Department of Pathological Anatomy.

4, Sovetskaya St., Tver, 170100

СкарякинаО. Н.SkaryakinaO. N.

Скарякина Олеся Николаевна - ассистент кафедры патологической анатомии.

170100, Тверь, ул. Советская, д. 4

Olesya N. Skaryakina - Assistant of the Department of Pathological Anatomy.

4, Sovetskaya St., Tver, 170100

tvergma.patan@yandex.ruhttps://orcid.org/0000-0002-4323-5286ЕгороваЕ. Н.EgorovaE. N.

Егорова Елена Николаевна - д.м.н., доцент, заведующая кафедрой биохимии с курсом клинической лабораторной диагностики.

170100, Тверь, ул. Советская, д. 4

Elena N. Egorova - Dr. Sci. (Med.), Associate Professor, Head of the Department of Biochemistry with a course in Clinical Laboratory Diagnostics.

4, Sovetskaya St., Tver, 170100

enegor@mail.ruТверской государственный медицинский университетРоссияTver State Medical UniversityRussian Federation202417052024211168176Copyright © Морозов А.М., Сергеев А.Н., Червинец В.М., Червинец Ю.В., Гуськова О.Н., Скарякина О.Н., Егорова Е.Н., 20242024Морозов А.М., Сергеев А.Н., Червинец В.М., Червинец Ю.В., Гуськова О.Н., Скарякина О.Н., Егорова Е.Н.Morozov A.M., Sergeev A.N., Chervinets V.M., Chervinets J.V., Guskova O.N., Skaryakina O.N., Egorova E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/435

Инфекции, связанные с оказанием медицинской помощи, являются наиболее часто встречающимися и актуальными для всех учреждений здравоохранения любого профиля. Инфекции области хирургического вмешательства являются наиболее часто регистрируемыми типом инфекций, связанных с оказанием медицинской помощи. Инфекции области хирургического вмешательства также являются одной из основных причин длительного пребывания пациентов в больнице, пролонгированной антибактериальной терапии, незапланированных повторных госпитализаций, ухудшения отдаленных результатов лечения пациентов и назначения дополнительных оперативных вмешательств. В настоящее время именно профилактика была определена как единственная наиболее важная стратегия борьбы с инфекцией области хирургического вмешательства. Предложенная трехэтапная модель объединяет периоперационные мероприятия, а также междисциплинарное сотрудничество по непрерывному повышению качества оказания медицинской помощи. Данный подход включает в себя предоперационные, интраоперационные и послеоперационные методы профилактики. Предпринимаемые в настоящее время предоперационные стратегии по профилактике инфекций области хирургического вмешательства могут значительно снизить риск развития данной нозологии. К одному из значимых аспектов предоперационной профилактики относится выявление, устранение и/или коррекция модифицируемых, а также учет немодифицируемых факторов риска. Помимо этого, можно выделить интраоперационные факторы риска, принципиально важным из которых является длительность проведения оперативного вмешательства. Из послеоперационных факторов риска выделяют гипергликемию и сахарный диабет, уход за послеоперационной раной и переливание крови. Разработано множество эффективных способов профилактики инфекций области хирургического вмешательства, которые включают в себя отдельно методы предоперационной, интраоперационной и послеоперационной профилактики, однако только с помощью внедрения комплексной модели, которая объединит все периоперационные мероприятия, учреждения здравоохранения смогут эффективно снизить частоту развития инфекций области хирургического вмешательства и улучшить результаты лечения пациентов. Несмотря на то что в настоящее время ведется активная разработка новых методов профилактики инфекции области хирургического вмешательства, первостепенное значение имеет непосредственное внедрение данных технологий в практическую деятельность специалистов.

Healthcare-associated infections are the most common and relevant to all healthcare facilities of all types. Surgical site infections are the most frequently reported type of healthcare-associated infections. Surgical site infections are also one of the main causes of prolonged hospital stays, prolonged antibiotic therapy, unplanned re-hospitalizations, worsened long-term patient outcomes and the prescription of additional surgical interventions. At present, it is prevention that has been identified as the single most important strategy to combat surgical site infection. The proposed three-stage model combines perioperative interventions as well as interdisciplinary collaboration to continuously improve the quality of care. This approach includes preoperative, intraoperative, and postoperative prevention methods. Current preoperative strategies for the prevention of surgical site infections can significantly reduce the risk of developing this nosology; one important aspect of preoperative prophylaxis includes the identification, elimination, and/or correction of modifiable as well as non-modifiable risk factors. In addition, it is possible to identify intraoperative risk factors, of which the duration of surgical intervention is fundamentally important. Postoperative risk factors include hyperglycemia and diabetes mellitus, postoperative wound care and blood transfusion. Many effective ways of preventing surgical site infections have been developed, which include separate methods of preoperative, intraoperative and postoperative prophylaxis, however, only through the implementation of a comprehensive model that combines all perioperative measures, health care institutions will be able to effectively reduce the incidence of healthcare-associated infections and improve patient outcomes. Despite the fact that currently there is an active development of new methods of surgical site infections prophylaxis, the direct implementation of these technologies in the practical activity of specialists is of primary importance.

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The authors declare that there are no conflicts of interest present.