Exam 3 Wound Infection

Question 1

Surgical Site Infections (SSI) primary source of pathogen?

Answer 1

The patient

Question 2

What local factors combat SSI? (7)

Answer 2

Intact epithelium
↓ moisture
Flushing via tears/urine
Cilia
Mucus
pH
Local immunity

Question 3

What systemic factors combat SSI? (2)

Answer 3

Phagocytes

Immune system

Question 4

What % of pts w/ SSI die?

Answer 4

> 75%

Question 5

SCIP quality performance measures include? (6)

Answer 5

Prophy ABX
Hair removal
Urinary catheters
Periop temp
VTE prophy
β-block therapy

Question 6

What systemic factors ↑ risk of SSI? (9)

Answer 6

Age
Chronic illness
Steroids
Malnutrition
Chemo/Radiation
Obesity (poor vascularization)
DM
Hyperglycemia
Immunosuppression

Question 7

Sites of entry for infection? (4)

Answer 7

Injured tissue
Incision
Puncture for vascular access
Catheters

Question 8

Causes of Hypothermia? (3)

Answer 8

Exposure
Large vol infusion of cold liquid
Evaporative loss during intracavitary surgery

Question 9

Hypothermia ↑ risk for infection, how?

Answer 9

Vasoconstriction ↓ blood flow and immune response

Question 10

Causes of Hyperglycemia?

Answer 10

Catabolism and insulin resistance from surgical stress

Question 11

Hyperglycemia ↑ risk for infection, how?

Answer 11

Impairs immune fxn in DM and non-DM pts

Question 12

Prophy ABX for surgery?

Answer 12

1st or 2nd gen Cephalosporins

Question 13

Contact isolation necessary for what microbes? (4)

Answer 13

MRSA (Methicillin Resistant Staph Aureus)
VRE (Vancomycin-Resistant Enterococci)
MDR (Multi-resistant G- bacilli)
C Diff

Question 14

C Diff requires what particular precaution?

Answer 14

Handwashing w/ soap/H2O

Alcohol gels don’t kill spores