Introduction Flashcards
what does “clean” mean?
non-traumatic, non-inflamed operative wounds in which the respiratory, gastrointestinal, genitourinary, and oropharyngeal tracts are not entered
what does “dirty” mean?
wounds with purulent discharge, devitalized tissues, or foreign bodies
preoperative perforation of a viscera has occured, or fecal contamination occurs
what is the biggest risk factor of infection?
amount of contamination
what does “clean-contaminated” mean?
non-traumatic, non-inflamed operative wounds in which the respiratory, gastrointestinal, genitourinary, and/or oropharyngeal tracts are entered under controlled conditions
what is prophylactic antibiotic use?
antibiotic use in the absence of infection or gross contamination at the surgery site
what do you need to achieve maximum benefit with antibiotic prophylaxis?
avoid contamination
operate efficiently
recognize high risk patient
knowledge of bacterial contaminants
what are Halsted’s principles?
strict asepsis
gentle tissue handling
accurate hemostasis
preservation of blood supply
careful approximation of tissues
no tension on tissues
obliterate dead space
what is the leading systemic risk factor for wound infection?
shock
what are the principles of prophylactic antibiotic use?
clean, clean contaminated procedures
patients at high risk for developing infection or when outcome is dependent on absence of infection
achieve highest concentration in tissue at time of contamination
administer until risk of contamination is over
when do we use empirical antibiotic therapy?
subcutaneous wound infection
intra-abdominal sepsis
cat bites
before culture and sensitivity results
when do we use aggressive antibiotic therapy?
critical patients
infections with serious consequences
when scrubbing, how long should each side of the fingers and hands, and each side of the arms, be scrubbed?
2-3 minutes
when scrubbing, how many strokes should the tips of the fingers and thumbs, and each surface of the fingers and arms, be given?
30 strokes on tips of fingers and thumbs
20 strokes on each of 4 surfaces of arms/fingers
what are the three infection risk factors?
time
trauma
trash
what does “contaminated” mean?
traumatic wounds, no purulent discharge
gastrointestinal contents or infected urine spilled
major break in aseptic technique
