臨床外科63巻7号

2008年07月発行

特集 実践に必要な術後創の管理

SSI予防と感染創の全身管理

著者： 福島亮治¹ 岩崎晃太¹ 小出泰平¹ 山崎江里子¹ 飯沼久恵¹ 稲葉毅¹

所属機関： ¹帝京大学医学部外科

ページ範囲：P.935 - P.941

要旨：Surgical site infection（SSI）をはじめとする術後感染の成立は病原微生物（細菌）と，感染を起こす環境および宿主の防御能によって決定される．宿主側における全身管理はSSIの発生を予防するための重要な方策の1つである．具体的には（1）侵襲後の早い時期から経腸栄養を開始する早期経腸栄養法，（2）アルギニンやω-3系不飽和脂肪酸など，免疫を高めるとされる栄養素を豊富に含む免疫増強栄養剤の使用（特に術前から投与することが重要であるとされる），（3）術後48時間以内の厳密な血糖管理（150～160mg/dl以内），（4）手術中の体温低下の防止，（5）術中から術後早期にかけて80％程度の高濃度酸素を投与すること，などが注目されている．

参考文献

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