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Principles of Adult Surgical Critical Care pp 267–279Cite as

Source Control and Supporting Therapeutics: Integrating Bacterial Invasion, Host Defense, and Clinical Interventions with Source Control Procedures

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Abstract

While the concept of source control is not new and is in widespread practice, some of the underpinning that defines the practice has evolved. While source control is commonly interpreted as the drainage of purulent material, removal of infected medical devices, control of GI tract perforation, and debridement of devitalized tissue, all of those elements are reactionary in nature and are accompanied by adjunctive antibiotics for variable courses. Over the last decade, major advances have occurred in understanding the molecular basis of disease pathogenesis as well as the host response to injury, inflammation, and infection. These advances may enable proactive measures to be undertaken that target specific elements of host defense to optimize patient outcome in the emergency department (ED), operating room (OR), intensive care unit (ICU), or general ward. This chapter will address how one may integrate standard source control practices with recent data on potentially controllable elements that may enable host defense success.

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Authors and Affiliations

  1. Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA

    Lewis J. Kaplan MD, FACS, FCCM, FCCP

  2. Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37212, USA

    Addison K. May MD

  3. Department of Surgery, University of Michigan Health System, Ann Arbor, MI, 48109, USA

    Lena M. Napolitano MD

Authors
  1. Lewis J. Kaplan MD, FACS, FCCM, FCCP
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  2. Addison K. May MD
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  3. Lena M. Napolitano MD
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Correspondence to Addison K. May MD .

Editor information

Editors and Affiliations

  1. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Niels D. Martin

  2. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Lewis J. Kaplan

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Kaplan, L.J., May, A.K., Napolitano, L.M. (2016). Source Control and Supporting Therapeutics: Integrating Bacterial Invasion, Host Defense, and Clinical Interventions with Source Control Procedures. In: Martin, N.D., Kaplan, L.J. (eds) Principles of Adult Surgical Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-33341-0_23

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  • DOI: https://doi.org/10.1007/978-3-319-33341-0_23

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