Intercurrent infections of any area of the body may complicate surgery. Infection is a type of inflammation where germs are the agent irritating the involved tissues. As an initial step in surgical therapy, search is made for any focus of germ invasion, and appropriate treatment is initiated. The primary surgical illness itself may be an infectious process, but also of concern are any other concurrent or incidental infections elsewhere in the body.
The defenses against infection are often involved in more than one inflammatory process in the body at one time; but, whenever operative intervention is contemplated, it is to great advantage to have all the body’s resources available for the one main inflammation and repair process. Whenever the body’s defense mechanisms are divided between two inflammation processes, either one or both may be denied their full powers of recovery.
Throughout all the stages of operative treatment every precaution is taken to protect the operative region against invasion by germs from without; care must also be taken to prevent such invasion from within, as might occur if infections exist in any area in the body. Infections may extend locally, or they may migrate to set up other sites of infection. And regardless of the tissues involved in an infectious process, the toxic products liberated by certain infections may be disseminated through the body to impair the function of other tissues. Of greatest concern, however, are those co-existing infections which may interfere directly with the operative procedure, such as an infection of the respiratory tract which could impair the normal recovery from anesthesia or a skin infection at the incision site.
The search for any co-existing infection is a part of the diagnostic phase of patient care, which actually never ends throughout the entire therapy program. Normal recovery depends on the efficient function of all the systems of the body. Infections must be eliminated before operation whenever possible. To this end certain diagnostic tests, such as a white blood count, chest x-ray and urine analysis, are routinely performed by some surgeons as diagnostic adjuncts in the preoperative evaluation. Emergency operations sometimes have to be performed in the face of concurrent infection, but elective surgery is postponed until such has been corrected. The commoner infections which may modify surgical therapy are those of the respiratory passages, kidneys, skin, teeth, and mouth.