title: Perioperative infection in the patient with rheumatic disease.
abstract: The risk of infection accompanies the benefits of surgery. Immunomodulatory chronic illnesses may increase the risk of surgical infections. Surgical patients with rheumatologic illness need close preoperative assessment regarding their infection risks (fixed and modifiable), which vary on the basis of the proposed procedure, specific rheumatologic illness, and underlying comorbidities. Modification of the medication regimens in the preoperative period may decrease risk and enhance healing. Intraoperative antisepsis and antibiotic prophylaxis remain critical in this patient population. Postoperative fevers within 3 days of surgery are usually noninfectious but require vigilance and attention. The principles of surgical infection reduction are not different in the rheumatologic and general patient populations, but best practice depends on expertise in caring for patients with these illnesses.
authors.affiliation: The Hospital for Special Surgery, Affiliated with The New York Presbyterian Hospital and Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA, milleran@hss.edu.
authors.forename: Andy O
authors.initials: AO
authors.lastname: Miller
authors.forename: Barry D
authors.initials: BD
authors.lastname: Brause
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D019072:Antibiotic Prophylaxis; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects; D009894:Opportunistic Infections / Q000150:complications* / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods; D012216:Rheumatic Diseases / Q000150:complications* / Q000188:drug therapy; D013530:Surgical Wound Infection / Q000150:complications* / Q000517:prevention & control
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007155:Immunologic Factors