[Surgical infection and its backgrounds]

The backgrounds of surgical infection of esophageal cancer patients are studied for host factors (relation of nutrition and immune response) and parasite factors surgical parts which are easily contaminated, the differences of serum concentration with 3 methods of antibiotics administration, and the relations about the bacteria in mouth and upper esophagus in operation and bacteria which were found in the respiratory system after operation). The results are as follows. The preoperative nutritional support was effective to rapid recovery of cytological immune functions. But in the post-operative infected cases, immunological recovery delayed and they nutritionally needed BCAA, glutamine, and essential fatty acids. For the study of parasite factors, surgical wounds (neck, chest wall, abdominal wall) were more easily contaminated than other parts except digestive tract. Continuous administration of antibiotics, 1g/hr x 4 was most excessive in three methods. The bacteria in the mouth and upper esophagus in operation and those in airway after operation, were not correlated. Furthermore, antibiotics-resistant bacteria which were Pseudomonas, MRSA were found in the airway. These results indicate that nutritional support is important for the host defense system and antibiotics should be administered considering each operative process. And about the postoperative respiratory infection, protection of hospital infection is important.