Curs3.INFECŢIILE CHIRURGICALE

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class="pageNum">1 / 3</div><div id="p1" name="p1"><div style="direction:ltr;margin-
top:5px"><b><span style="direction:ltr;">INFECŢIILE CHIRURGICALE
<br></span></b></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;">DEFINIŢIA - INFECŢIEI<b><span style="direction:ltr;">
<br></span></b></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;">
- INFECŢIEI CHIRURGICALE <br></span></div><div
style="direction:ltr;margin-top:5px"><span style="direction:ltr;">FACTORII DE
CONDIŢIONARE <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - germenii <br></span></div><div
style="direction:ltr;margin-top:5px"><span style="direction:ltr;">
- terenul local <br></span></div><div
- macroorganismul <br></span></div><div
style="direction:ltr;margin-top:5px"><span style="direction:ltr;">Germenii -
Virulenţa microbiană <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;">
- Agresiune
<br></span></div><div style="direction:ltr;margin-top:5px"><span
- Toxine
- Asocierea microbiană <br></span></div><div
- Patogenitatea
- Cantitate de germeni <br></span></div><div
- Timpul de contact
<br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;">Terenul local <br></span></div><div
- Poarta de intrare <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Insuficienţa
irigaţiei <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - Corpi străini
style="direction:ltr;">Macroorganismul (terenul sistemic) <br></span></div><div
- Vârsta <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Sexul
style="direction:ltr;"> - Rasa
style="direction:ltr;"> - Stări patologice
style="direction:ltr;"> <br></span></div><div
<br></span></div><div style="direction:ltr;margin-top:5px"><b><i><span
style="direction:ltr;">Patogenia infecţiilor <br></span></i></b></div><ul
style="margin-left:35px;"><li><div style="direction:ltr;"><span
style="direction:ltr;">• REACŢII LOCALE DE APĂRARE <br></span></div></li></ul><div
- Modificări vasomotorii <br></span></div><div
- Exudaţie <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Leucodiapedeză
style="direction:ltr;"> - Reconstrucţie (granulare –
fibroză) <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - Fagocitoză
style="direction:ltr;"> - Distrucţie celulară
<br></span></div><ul style="margin-left:35px;"><li><div
style="direction:ltr;"><span style="direction:ltr;">• REACŢII GENERALE DE APĂRARE
<br></span></div></li></ul><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - Factori umorali şi celulari
style="direction:ltr;"> - Proces imunobiologic secundar
- Celule imunocompetente <br></span></div><div style="direction:ltr;margin-
- Complement <br></span></div><div
style="direction:ltr;margin-top:5px"><b><i><span style="direction:ltr;">Etape în
evoluţia clinică a infecţiilor <br></span></i></b></div><ul style="margin-
left:35px;"><li><div style="direction:ltr;"><span style="direction:ltr;">•
CONTAMINAREA <br></span></div></li></ul><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Primitivă
style="direction:ltr;"> - Secundară
style="direction:ltr;"> - Intercontaminarea
style="direction:ltr;"><span style="direction:ltr;">• INCUBAŢIA
style="direction:ltr;"> - Dinamica microbiană
- Stafilococ <br></span></div><div style="direction:ltr;margin-
- Coli <br></span></div><div style="direction:ltr;margin-
- Proteus <br></span></div><div
<br></span></div></div><hr class="pageHr"></div><div id="pc2"><div
class="pageNum">2 / 3</div><div id="p2" name="p2"><div style="direction:ltr;margin-
top:5px"><b><i><span style="direction:ltr;">Tabloul anatomoclinic
<br></span></i></b></div><ul style="margin-left:35px;"><li><div
style="direction:ltr;"><span style="direction:ltr;">• SEMNE LOCALE (CELSUS +
HUNTER) <br></span></div></li></ul><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Durerea
(dolor) <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - Roşeaţa (rubor)
style="direction:ltr;"> - Tumefacţia (tumor)
style="direction:ltr;"> - Impotenţa funcţională
style="direction:ltr;"> - Fluctuenţa
<br></span></div><ul
style="margin-left:35px;"><li><div style="direction:ltr;"><span
style="direction:ltr;">• SEMNE GENERALE <br></span></div></li></ul><div
- Febră <br></span></div><div
- Frison <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Pulsul
style="direction:ltr;"> - Astenia <br></span></div><div
- Cefaleea <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Curbatura
style="direction:ltr;"> - Vărsături
style="direction:ltr;"> - Tulburări dispeptice
style="direction:ltr;"><span style="direction:ltr;">• SEMNE DE LABORATOR
style="direction:ltr;"> - Leucocitoza
style="direction:ltr;"> - Leucopenia
style="direction:ltr;"> - VSH crescut
style="direction:ltr;"> - Fibrinogen
crescut <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - Gama globuline
crescute
style="direction:ltr;"> - Examen
macroscopic puroi <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> -
Frotiu pe lamă <br></span></div><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> -
Cultura + antibiogramă <br></span></div><div
- Hemocultură <br></span></div><div
style="direction:ltr;"> <br></span></div><div style="direction:ltr;margin-
top:5px"><b><i><span style="direction:ltr;">Evoluţia clinică a infecţiilor
<br></span></i></b></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;">CONTAMINARE → REACŢIE LOCALĂ → <span
style="direction:ltr;">RETROCEDARE → INFECŢIE LOCALIZATĂ (ABCES) <span
style="direction:ltr;">→ FISTULIZARE → LIMFANGITĂ + <span
style="direction:ltr;">LIMFADENITĂ → GENERALIZAREA INFECŢIEI
<br></span></span></span></span></div><div style="direction:ltr;margin-
top:5px"><b><i><span style="direction:ltr;">Tratamentul infecţiilor
chirurgicale <br></span></i></b></div><ul style="margin-left:35px;"><li><div
style="direction:ltr;"><span style="direction:ltr;">• PROFILAXIA
style="direction:ltr;"> - Asepsie – antisepsie
style="direction:ltr;"> - Stimulare imunologică
style="direction:ltr;"> - Tratament corect chirurgical
style="direction:ltr;"> - Antibioterapie
<br></span></div><div style="direction:ltr;margin-top:5px"><b><i><span
style="direction:ltr;">Tratamentul etiologic - antibioterapia
style="direction:ltr;"><span style="direction:ltr;">• PRINCIPII
style="direction:ltr;"> - Alegerea
style="direction:ltr;"> - Contact antibiotic - germeni
- Absenţa toxicităţii <br></span></div><div
- Stimularea apărării <br></span></div><div
- Prezenţa rezistenţelor <br></span></div><ul style="margin-
left:35px;"><li><div style="direction:ltr;"><span style="direction:ltr;">• ACŢIUNEA
ANTIBIOTICULUI – SPECIFICĂ <span style="direction:ltr;">– SELECTIVĂ
<br></span></span></div></li><li><div style="direction:ltr;"><span
style="direction:ltr;">• INDICAŢIILE ANTIBIOTERAPIEI
style="direction:ltr;"> - infecţii cu germeni
cunoscuţi <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - infecţii cu germeni
necunoscuţi <br></span></div><div style="direction:ltr;margin-top:5px"><span
style="direction:ltr;"> - profilactic
style="direction:ltr;"><span style="direction:ltr;">• CALEA DE ADMINISTRARE
style="direction:ltr;"> - orală
style="direction:ltr;"> - parenterală -
I.M. <br></span></div><div style="direction:ltr;margin-top:5px"><span
- I.V.
style="direction:ltr;"> <br></span></div></div><hr class="pageHr"></div><div
id="pc3"><div class="pageNum">3 / 3</div><div id="p3" name="p3"><div
style="direction:ltr;margin-top:5px"><b><i><span style="direction:ltr;">Stabilirea
schemei de tratament <br></span></i></b></div><ul style="margin-
left:35px;"><li><div style="direction:ltr;"><span style="direction:ltr;">• Locală
<br></span></div></li><li><div style="direction:ltr;"><span
style="direction:ltr;">• Fixarea dozei <br></span></div></li><li><div
style="direction:ltr;"><span style="direction:ltr;">• Ritmul de administrare
style="direction:ltr;">• Durata tratamentului <br></span></div></li><li><div
style="direction:ltr;"><span style="direction:ltr;">• Cauzele de insucces
style="direction:ltr;">• Germenii <br></span></div></li><li><div
style="direction:ltr;"><span style="direction:ltr;">• Bolnavul
style="direction:ltr;">• Tratamentul <br></span></div></li></ul><div
style="direction:ltr;margin-top:5px"><b><i><span style="direction:ltr;">Tratamentul
infecţiilor chirurgicale <br></span></i></b></div><ul style="margin-
left:35px;"><li><div style="direction:ltr;"><span style="direction:ltr;">•
TRATAMENTUL IMUNOLOGIC <br></span></div></li><li><div style="direction:ltr;"><span
style="direction:ltr;">• TRATAMENTUL SIMPTOMATIC <br></span></div></li><li><div
style="direction:ltr;"><span style="direction:ltr;">• REECHILIBRAREA FUNCŢIILOR
style="direction:ltr;">• TRATAMENTUL LOCAL <br></span></div></li></ul><div
- FAZA DE CRUDITATE - Conservator <br></span></div><div

- Favorizare
<span style="direction:ltr;">colectare <br></span></span></div><div
- FAZA DE COLECŢIE - Incizie <br></span></div><div

- Evacuare

- Toaletă <br></span></div><div

- Drenaj
<br></span></div><div
style="direction:ltr;margin-top:5px"><b><i><span
style="direction:ltr;">Clasificarea infecţiilor chirurgicale
style="direction:ltr;"><span style="direction:ltr;">• DUPĂ EVOLUŢIE
style="direction:ltr;"> - Acute <br></span></div><div
- Cronice <br></span></div><ul style="margin-
left:35px;"><li><div style="direction:ltr;"><span style="direction:ltr;">• DUPĂ
LOCALIZARE <br></span></div></li></ul><div style="direction:ltr;margin-
top:5px"><span style="direction:ltr;"> - Localizate
style="direction:ltr;"> - Generalizate
style="direction:ltr;"> - Localizate cu manifestări
generale severe <br></span></div><div
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