Global Health
4 elements of source control in sepsis
Sepsis and septic shock affect thousands and thousands of patients worldwide (Evans et al., 2021). Sepsis is defined as life-threatening end-organ dysfunction attributable to a dysregulated host response to infection. Sepsis is the leading reason for death in critically ailing patients; early identification and appropriate treatment significantly improve morbidity and mortality. Management includes rapid diagnosis, timely administration of appropriate antibiotics, fluid resuscitation, hemodynamic support, and control of the source of infection (Forrester, 2021).
Source control is defined as surgical and non-surgical interventions used to treat infections (Marshall, 2010). Rapid identification and establishment of source control is a vital element of sepsis diagnosis and treatment. It involves an examination that features a history and physical examination, laboratory tests, and appropriate imaging (Marshall, 2010).
When first diagnosed, the means of identifying the source of infection may be difficult since the source is probably not immediately visible. Although chest X-ray, urinalysis, and blood culture are standard tests to discover potential sources of infection, in lots of cases, further testing and computed tomography (CT) are warranted to rule out a surgical source of primary infection (Kim and Park, 2019). ).
The 4 elements of source control
refers back to the evacuation of infected fluid by opening an infected abscess. This is finished by incision and drainage or by inserting a drain. The drainage process transforms a closed, infected abscess right into a controlled sinus or fistula, which promotes drainage (Marshall, 2010). Examples include incision and drainage of an infected Bartholin’s cyst with insertion of a tampon or insertion of a percutaneous cholecystectomy tube for cholecystitis.
involves the removal of necrotic, dead or infected tissue by surgical or non-surgical procedures. Local wound treatment is an example of non-surgical debridement. Surgical debridement involves excision of gangrenous soft tissue equivalent to necrotizing fasciitis or debridement of infected bowel.
involves the removal of a prosthesis that has been colonized by organisms. This may include removal of a central line or urinary catheter, removal of an infected vascular graft, or removal of infected orthopedic hardware.
are other interventions, often surgical, performed to remove the main focus of infection and restore optimal function and quality of life. This may include surgical resection of diverticular disease and restoration of bowel continuity, lung desquamation after drainage of empyema, or repair of an abnormal mural hernia after treatment of peritonitis.
Sepsis and septic shock carry a high mortality rate. Early identification, resuscitation, initiation of antibiotics, and prompt identification and treatment of the source and reason for sepsis are essential to improving patient outcomes.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C.M., French, C., Machado, F.R., Mcintyre, L., Ostermann, M., Prescott, H.C., Schorr, C. ., Simpson, S., Wiersinga, W.J., Alshamsi, F., Angus, D.C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., Belley-Cote, E., … Levy, M. (2021). Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock 2021. , (11), 1181–1247. https://doi.org/10.1007/s00134-021-06506-y
Forrester, J. (2021, September). Sepsis and septic shock.
Kim, H. and Park, S. (2019). Sepsis: early recognition and optimized treatment. (1), 6–14. https://doi.org/10.4046/trd.2018.0041
Lagunes, L., Encina, B., and Ramirez-Estrada, S. (2016). Current understanding of source control management in patients with septic shock: a review. , (17), 330. https://doi.org/10.21037/atm.2016.09.02
Marshall JC (2010). Principles of source control within the early treatment of sepsis. , (5), 345–353. https://doi.org/10.1007/s11908-010-0126-z
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