10 Flashcards
describe the CDC classification of surgical infections
SSI = one that occurs anywhere within operative field after surgery1. incisional (superficial vs deep)2. organ/space
Wound/operative procedure classification guidelines by the national research council
cleanclean-contaminatedcontaminateddirty
percentage of clean elective ortho procedures that get infected
15%(generally higher than reported for a clean wound—2-4.8%)
risk factor for SSI and clipping surgical site
clip immediately prior to procedureanimals clipped within 4 hours of induction had an equally significant risk for SSI as those clipped >4 hr prior to inductioncolonizing “nicks”
risk factor for SSI and duration of sx
risk of SSI approximately doubles for every 60 minutes of surgery timesuppression of cell mediated immunity, exposure incr, more tissue handling
risk factor for SSI and duration of ax
30% increase in risk SSI for every 60 min of axpropofol use (lipid base)
risk factor for SSI and endocrinopathies
DM has not been incr risk for SSIDM has been incr risk for UTI and dermatologic dzSSI risk with Cushings, hypoT
risk factor for SSI and # people in OR
for ea additional person in OR, risk of SSI increases as much as 30%(1.3 x)
risk factor for SSI and sex/neuter status
intact male cats/dogs incr risk SSI
other misc. risk factors for SSI
immunosuppressive drugs (GCC, chemo)infxn elsewhere in bodyperiop hypotension, hypothermiapoor BCSsuture typeblood lossASA statushospital stay
range of reported SSI in veterinary patients
clean 2-4.8%clean contaminated 3.5-5.0%contaminated 4.6-12%dirty 6.7-18.1%
recommendations for period Ab prophylactic use
- when risk of infxn is high (clean-contamin, contaminated, dirty)2. SSI would have disastrous consequences
Ab of choice for clean contaminated procedures of the skin and/or GI tract
cefazolincovers gm + and gm – Enterococciminimal side effectscheap
timing of Ab administration
Ab should be in the tissue operative site at effective concentrations at start of surgeryconcentrations should be maintained. recommend at induction or within 1 hr of surgical incision and repeated every 2 hours (per TJ)
disadvantage of using perioperative Ab in cases where no significant benefit occurs
may contribute to colonization with resistant bacterial species and nosocomial infection
