By Lawrence W. Way
College of California, San Francisco. Lange scientific booklet sequence. new version of a Brandon/Hill clinical checklist first-purchase choice. Reference on ailments controlled by means of surgeons, for clinical scholars, citizens, and practitioners. 88 participants, eighty five U.S.
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Extra info for Current Surgical Diagnosis and Treatment
The AIDS patient may also be severely immunocompromised and presents a risk to health care workers. Since preoperative AIDS testing is not required even for high-risk patient groups, universal precautions are practiced, especially when dealing with blood and body secretions. 3. Other factors leading to increased infection—Certain drugs may reduce the patient's resistance to infection by interfering with host defense mechanisms. Corticosteroids, immunosuppressive agents, cytotoxic drugs, and prolonged antibiotic therapy are associated with an increased incidence of invasion by fungi and other organisms not commonly encountered in infections.
1. Hand scrub routine—Although the duration of the hand scrub is not universally defined, a 5-minute scrub before the first case—provided a brush is used—appears to be sufficient. Greatest attention should be paid to the fingertips and nails, since these areas harbor the greatest numbers of bacteria. A 2-minute scrub is adequate between cases. Solutions containing chlorhexidine or one of the iodophors appear to be most effective. 2. Preparation of the operative field—Initial preparation of the skin is usually done the afternoon or evening before operation.
Preoperative evaluation consists of an overall assessment of the patient's general health in order to identify significant abnormalities that might increase operative risk or adversely influence recovery. Preoperative preparation includes interventions dictated by the findings on diagnostic workup and preoperative evaluation and by the nature of the expected operation. Postoperative Care The postanesthetic observation phase of management is the few hours immediately after operation during which the acute reaction to operation and the residual effects of anesthesia subside.
Current Surgical Diagnosis and Treatment by Lawrence W. Way