27-10-21 - Surgical Site Infections Flashcards
What are surgical site infections?
What % of HCAIs are they responsible for?
How long can it take to occur in incisions and prosthetics?
What are SSIs associated with? => 2 things
- SSIs are infections occurring in an incision made by an invasive surgical procedure
- They account for 20% of HCAIs
- SSIs can appear within 30 days of an incision
- Can appear up to a year after a prosthetic joint is put in
- SSIs are associated with high morbidity (condition of suffering from a disease or medical condition)
- They are also associated with longer hospital stays.
What are the differences between primary and secondary wound closure?
- Primary wound closure used sutures and heals from the top to bottom
- Secondary wound closure heals from the bottom up, so leaves a hole where fluid can collect and cause infection
- There is minimal scarring in primary closure and more visible scarring in secondary closure
What are the 6 clinical signs of infection?
IDC FPS
- Inflammation
- Discharge
- Collection – can be known as abscess, collection of blood isa haematoma, seroma is a collection of serous fluid
- Failure to heal
- Pain
- Systemic symptoms – sepsis – body’s extreme response to infection
What are the 5 pillars of infection?
- Rubor (erythema/redness)
- Calor (increased temperature)
- Tumor (swelling)
- Dolor (pain)
- Loss of function
What are 8 ways a mild to severe wound may present?
W D A N N G S S
- Wound discharge – fluid, pus, blood
- Dehiscence – wound opening caused by weak sutures or sutures untying
- Abscess – collection of pus
- Necrosis – death of tissues in wound
- Necrotising fasciitis – skin infection that burrows into deeper layers of skin, causes infection, and causes tissue to rot
- Gangrene – cell death and rot
- Spread to deeper tissues
- Sepsis
What are the risk factors for SSI?
patient factors = 5
operatio - 5
How do SSIs occur?
What do they cause?
When can they occur?
- Contamination of incision by normal microbiota
- Presence of foreign bodies e.g sutures, implants
- Damage to tissues
- Damage to blood vessels
- Reduces efficacy in inflammatory response
- Can occur before, during, or after surgery
What are skin and bowel causes of SSIS?
skin = spp
What are 3 consequences of SSIS?
=> spread
What are 4 pre-operative precautions taken to avoid SSIs? => done on patient
what type of surgery do u give prophylaxis before?
- Prophylaxis – treatment given or action taken to prevent disease
How does disinfection of hospital staff, surgical team, and patients skin occur?
NAS
ABHR
AASS
ABHR
AC
PI
What are 5 intraoperative factors that aim to prevent SSIs
What are the 4 classifications of surgical wounds?
What are the microbial load at the time of surgery for ach class?
- Cfl/ml – colony forming unit/ml
What are the incidences of SSIs of each class with and without prophylaxis?
What are the 2 different kinds of wound closure?
What are examples?
• Continuous suture/subcuticular – sutures without any gaps
• Interrupted suture – closes wound at intervals and leaves gaps in between
• Interrupted mattress suture
• Staples (shown in picture)
What are 8 post-operative factors that aim to prevent SSIs?
What are the 3 different types of dressing used to prevent infection?
- some fluid passes = GTN
- no fluid escapes = HPF
- fluid sucked away
What are 3 devices associate with infection?
What are the 4 risk factors of prosthetic joint infections?
What are 6 diagnostics of prosthetic joint infection?
Joint aspiration for culture and microscopy is a diagnostic procedure used to identify infections in a prosthetic joint (such as a hip or knee replacement). It involves withdrawing a sample of synovial fluid (the lubricating fluid in the joint) from the space around the artificial joint using a needle and syringe. This procedure is commonly performed when an infection is suspected in a prosthetic joint.
