臨床外科62巻8号

2007年08月発行

特集 Surgical Site Infection（SSI）対策

新しいSSI対策―術中の体温管理

著者： 福島亮治¹

所属機関： ¹帝京大学医学部外科

ページ範囲：P.1041 - P.1046

文献概要

要旨：手術中は麻酔の影響などで36℃未満となる低体温が生じることが多い．低体温は出血を助長させたり，心筋虚血を招くとされているが，免疫能を低下させ，SSI（surgical site infection）発生の危険因子とも考えられている．大腸癌手術患者を対象とした検討では，術中に積極的に加温すると創感染率が約1/3に減少し，ヘルニアなどの短時間手術では，術前に局所や全身を温めておくと創感染率が低下するとの報告がある．低体温対策としては，室温をなるべく23℃以上にすることや，大量の冷たい輸液を避けること，保温装置を利用することなどが挙げられる．保温装置は，forced air warmingが最も有効であるといわれており，1時間以上の手術では使用が推奨される．

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