6.11. Skin and Soft Tissue Infection - Surgical Site Infection Flashcards
How many Classes of Surgical Wounds are there?
4
What does Class 1 Surgical Wounds involve?
Clean Wound:
This means the Respiratory, Alimentary, Genital or Urinary System have not been entered
What does Class 2 Surgical Wounds involve?
Clean-Contaminated Wound:
This means the Respiratory, Alimentary, Genital or Urinary System have been entered but there is no unusual contamination
What does Class 3 Surgical Wounds involve?
Contaminated Wound:
This means there is open, fresh accidental wounds (or gross spillage) from the Gastrointestinal Tract
What does Class 4 Surgical Wounds involve?
Infected Wound:
This means there is existing clinical infection (infection present before the operation)
What are the main causes of Surgical Site Infections?
- Staphylococcus Aureus (MSSA and MRSA)
- Coagulase Negative Staphylococci
- Enterococcus
- Escherichia Coli
- Pseudomonas Aeruginosa
- Enterobacter
- Streptococci
- Fungi
- Anaerobes
What are the patient risk factors for a Surgical Site Infection?
- Diabetes Mellitus
- Smoking
- Obesity
- Malnutrition
- Concurrent Steroid Use
- Colonisation with Staphylococcus Aureus
What are the procedural risk factors for a Surgical Site Infection?
- Shaving of the site the night prior to the procedure
- Improper pre-operative skin preparation
- Improper antimicrobial prophylaxis
- Break in the Sterile Technique
- Inadequate Theatre Ventilation
- Peri-operative Hypoxia
How is a Surgical Site Infection diagnosed?
- Sending pus/infected tissue for cultures
- Avoid Superficial Swabs (aim for deep structures)
- Consider unlikely pathogen as a cause if obtained from a sterile site
- Antibiotics to target the likely organisms