Table Of ContentM. Schein· J.C. Marshall (Eds.)
Source Control
Springer-Verlag Berlin Heidelberg GmbH
M. Schein J.C. Marshall (Eds.)
Source Control
A Guide to the Management
of Surgical Infections
, Springer
MOSHE SCHEIN
Professor of Surgery
Weill Medical College
of Cornell University
Department of Surgery
Bronx Lebanon Hospital Center
1650 Selwyn Avenue
4th Floor, Suite 4F
Bronx, NY 10457, USA
(e-mail: [email protected])
lOHN C. MARSHALL
Professor of Surgery
Eaton North 9-234
Toronto General Hospital
University Health Network
200 Elizabeth Street
Toronto, Ontario M5G 2C4. Canada
(e-mail: [email protected])
ISBN 978-3-540-00408-0 ISBN 978-3-642-55914-3 (eBook)
DOI 10.1007/978-3-642-55914-3
Library of Congress Cataloging-in-Publication Data
Source control : A Guide to the management of surgical infections /
M. Schein, J.C. Marshall (eds.).
p.cm.
Inc1udes bibliographical references and indeL
I. Surgical wound infections--Treatment. I. Schein, Moshe.lI. MarshalI, J. (John),
1949-
RD98.3 .S67 2002
6Ii.OI--dc21
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Preface
Surgical infections are infections that develop in surgical patients.
They may develop before the operation or occur postoperatively.
In fact, many surgical infections arise in patients who have not
undergone an operation or who do not need one. Using such a
broad definition, surgical infections form an integral and signifi
cant part of any general, thoracic, and vascular surgery practice.
We believe that the best infectious disease specialist for the sur
gical patient is the educated surgeon.
The concept of source control encompasses all of those physical
interventions - surgical and otherwise - that are used to treat in
fection. Although source control is one of the most important
aspects of the treatment of serious infection, it is a topic that in
the past has received relatively little attention. Our goal, in this
book, is to correct this deficiency. This project grew out of an in
itiative of the Source Control Working Group of the Surgical In
fection Society (SIS) and almost all contributors are members of
SIS or SIS-Europe. Each of the individual chapters - which cover
general aspects of source control, as well as source control for
specific conditions and anatomical sites - is followed by a balancing
invited commentary by another expert. A certain amount of
overlap is inevitable in such a multi-authored book; however, the
many opinions expressed here reflect the dimensions of consensus
and controversy in the field.
This book is aimed principally at the practicing surgeon and
surgical trainee, but will also be useful to the non-surgeon who
takes part in the care of infected surgical patients in the intensive
care environment, as well as to the infectious disease specialist.
The most potent antibiotics, and the best supportive care, are
meaningless if principles ofs ource control are not adhered to with
obsessiveness.
Moshe Schein, Bronx, New York October 2002
John C. Marshall, Toronto, Ontario
Dedication
This book had its genesis in a project initiated by the Surgical In
fection Society to develop greater structure for the description
and evaluation of the surgical management of infection. We are
deeply grateful to the membership of the Surgical Infection
Societies of North America and Europe, who not only supported
this ambitious project, but also provided their experience and in
sights as authors. We are immeasurably indebted to our families
- the Schein family, my wife Heidi and sons Omri, Yariv, and Dan;
and the Marshall clan, my wife and partner Mary Morison and
our daughter Kate - for their love and tolerance of yet another in
trusion into family life as the project took shape. We owe a huge
vote of thanks to Mrs. Stephanie Benko from Springer-Verlag
in Heidelberg, for shepherding the undertaking through to com
pletion. And we dedicate our book to those who have experienced
the ravages of infection, either themselves or through the tribu
lations of a loved one, in the hope that it may contribute to im
proving the care of future victims.
Moshe Schein, New York May 2002
John C. Marshall, Toronto May 2002
Contents
1 Introduction
JOHN C. MARSHALL, MOSHE SCHEIN •••••••.••••.•.••••••
Part I: Principles of Source Control
2 The Biological Rationale
DAVID L. DUNN. • • • . • • . • • • • • . • • . • . • • . . • • • • • . • . • • • . • . 9
Invited Commentary
RONALD V. MAIER. • . • . . • • • • • • • • • • • • . • • • . • . • . • • • • • • •• 13
Editorial Comment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 15
3 Experimental Models of Source Control
PING WANG, IRSHAD H. CHAUDRy...................... 17
Invited Commentary
MALCOLM R. KELL, H. PAUL REDMOND • • • • • • • . • • • . • • • • •• 22
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 23
4 Drainage
GyU I. GANG, JONATHAN F. MOULTON, JOSEPH S. SOLOMKIN •• 25
Invited Commentary
ROBERT E. CONDON................................. 31
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 33
5 Debridement and "Peritoneal Toilet"
JOHN BOHNEN...................................... 36
Invited Commentary
HIRAM C. POLK JR., DAVID A. SPAIN. • • • • . • • • • • • • • • • • • • •• 43
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 45
6 Device Removal
VICTOR LAZARON, GREGORY J. BEILMAN. • . • . • • • • • • • • • • . •• 47
Invited Commentary
LORI L. BURROWS. • • . • • . • • • • • • •• • . • • . • • • • • • . • • • . • • •• 51
x
Contents
7 Definitive Versus Temporizing Therapy
DONALD E. FRY. • • • • • • • • • . • • • • • • • • . • . • • • • • • • • • • • • • •• 54
Invited Commentary
EDWIN A. DEITCH. . • • • • • • • • • • • • • • • • • • • • • . • • • • • • • • • •• 59
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 60
8 Deciding on the Extent of Surgical Therapy
GIUSEPPE PAPIA, JOHN C. MARSHALL. • • • • • • • • • • • • • • • • • .• 62
Invited Commentary
RHONDA S. FISHEL, ADRIAN BARBUL. • • • • • • • • • • • • • • • • • • •• 67
9 Consequences of Failed Source Control
PHILIP S. BARIE, SOUMITRA R. EACHEMPATI • • • • • • • • • • • • • •• 71
Invited Commentary
ARTHUR E. BAUE. • • • • • • • • • • • • • • • • • • • • • . • • . • • . • • . • • •. 81
Editorial Comment ............................... , 83
Part II: Source Control in Specific Locations
10 Diffuse Peritonitis
BEAT GLOOR, MATHIAS WORNI, MARKUS W. BOCHLER •••••• 87
Invited Commentary
WILLIAM G. CHEADLE •••••••••••••••.••••••••••••••• , 91
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 92
11 Gastric and Proximal Small Bowel
DAREN DANIELSON, MICHAEL A. WEST. • • • • • • • • • • • • • • • • •• 93
Invited Commentary
DAVID LEAPER •••.•••••••••••••••••••••••••••••••••• 100
Editorial Comment ............................... , 101
12. The Colon
DIETMAR H. WITTMANN •••••••••••••••.•••••••••••••• 103
Invited Commentary
LEWIS FLINT • • • • • • • • • • • • • • • • • • • . • • • • • • • • • • • • • • • • • •• 109
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. III
13 Infection and Trauma of the Rectum and Anus
PER-OLOF NYSTROM •••••••••••••••.••••••••••••••••• 114
Invited Commentary
LUIS A. CARRIQUIRY ................................. 121
Contents XI
14 Acute Appendicitis
JAMES M. WATTERS ••••.••••••••••••••••••••••••••••• 124
Invited Commentary
ROLAND E.B. ANDERSSON ••••••••••••••••••••••••••••• 130
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 133
15 Bariatric Operations
ROBERT E. BROLIN. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• 134
Invited Commentary
NICOLAS V. CHRISTOU •••••••••••••••••••••••••••••••• 139
Editorial Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 140
16 The Gallbladder and Biliary Tree
PETER GOTZINGER, REINHOLD FOGGER. • • • • • • • • • • • • • • • • •• 142
Invited Commentary
JACK PICKLEMAN • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• 149
Editorial Comment ................................ 150
17 Pancreatic Infection
PATCHEN DELLINGER .•••••••••••••••••••••••••••••••• 154
Invited Commentary
BEAT GLOOR, MARKUS W. BOCHLER ••••••••••••••••••••• 162
Editorial Comment ................................ 165
18 Liver Abscesses
ISKENDER SAYEK, DEMIRALI DNAT •••••••••••••••••.••••• 167
Invited Commentary
ABE FINGERHUT •••• • • • • • • • • • • • • • • • • • • • • • • • • . • • • • • •• 175
Editorial Comment . .. . . .. .. . .. . .. .. . .. . .. . . .. . .. .. 177
19 Acute Mesenteric Ischemia
DANIEL P. RAYMOND, ADDISON K. MAY •••••••••••••••••• 178
Invited Commentary
ASHER HIRSHBERG •••••••••••••••••••••••••••••••••• 186
Editorial Comment ................................ 189
20 The Esophagus
JAIME ESCALLON, MARIA FERNANDA JIMENEZ •••••••••.••.• 191
Invited Commentary
J. DAVID RICHARDSON ••••••••••••••••••••••.••••••••• 197
Editorial Comment ................................ 200
