Infections which complicates surgery

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.