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

  • Lewis J. Kaplan
  • Addison K. May
  • Lena M. Napolitano
Chapter

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.

Keywords

Infectious diseases Antibiotic stewardship Multidrug-resistant organisms Biofilm Host defenses 

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Copyright information

© Springer International Publishing Switzerland 2016

Open Access This chapter is distributed under the terms of the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Lewis J. Kaplan
    • 1
  • Addison K. May
    • 2
  • Lena M. Napolitano
    • 3
  1. 1.Department of Surgery, Perelman School of MedicineUniversity of Pennsylvania, Corporal Michael J. Crescenz VA Medical CenterPhiladelphiaUSA
  2. 2.Division of Trauma and Surgical Critical Care, Department of SurgeryVanderbilt University Medical CenterNashvilleUSA
  3. 3.Department of SurgeryUniversity of Michigan Health SystemAnn ArborUSA

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