19. Classification of surgical infections

Question 1

19. Classifications of surgical infections

Answer 1

Classifications of surgical infections
-surgical infections can occur:
1)with primary surgical disease
2)as complication of a surgical procedure not commonly associated with
infection
3)as a complication of a support procedure
4)with prosthetic implants

Primary surgical disease(ensisijainen kirurginen sairaus)
-nonsterile source(skin,GI tract,urinary tract)
-subject only to surgical treatment not surgical prevention
-AB based on expected bacterial flora– then modified if necessary
-(osteomyelitis secondary to open fracture, pyometra, prostatic
abscessation)

Complication of a surgical procedure not
commonly associated with infection(kirurgisen toimenpiteen komplikaatio,joihin ei liity yleisesti infektioon)
-all surgical procedures cause some bacterial contamination!
-development of infection?
>number and virulence of the bacteria
>competence of host defenses
>amount of tissue damage
>amount of dead space resulting from the procedure
-infections can be minimized!

Complication of a support procedure
-debilitated,traumatized,immunocompromised patients
-intravenous catheters
>cephalic catheters changed every 48 to 72 hours
>jugular catheters changed every 7 to 10 days
-urinary catheters
>common source of infection after 2-3 days
-prolonged endotracheal intubation(foreign body,disrupted cough
reflex)

Prosthetic implants
-implants–foreign substances used to support, rebuild or mimic function of
an anatomic structure
-foreign material in contaminated/infected wounds increases chance for
chronic infection
-biofilm–colony of microorganisms,within a matrix of extracellular
polymeric substance that they produce(biofilm microorganisms usually
resistant to AB)
-AB treatment seldom successful until implant removed
-aseptic technique,AB prophylaxis– infection,implant
rejection rare
-(nonabsorbable suture, polypropylene mesh, TTA)