Perioperative Antibiotics And Surgical Site Infections Flashcards
(21 cards)
Inflammation
Immune response to infection that causes heat, swelling, redness, pain or loss of function
___ infections can be classified as incisional or organ space
Surgical site
What is the overall risk for SSI for all NRC classifications?
5% risk for all classifications
Clean: 2-4%
CC: 3-5%
Contaminated: 4-12%
Dirty: 7-18%
What are some risk factors in surgery?
Duration of surgery can double the risk of infection for every extra hour spent in surgery. Adding an hour to anesthesia and adding a person to the OR increases the risk by 30%. Propofol sitting out at room temp also increases risk since it’s lipid based and a good medium for bacterial growth.
Aseptic technique
A collection of medical practices procedures that helps protect patients from potential infection
__ is the go to antibiotics for surgery while __ and __ are also used regularly. The __ of the antibiotics determines when you give the second dose of perioperative prophylaxis
Cefazolin is the go to antibiotics for surgery while Ampicillin and cefoxitin are also used regularly. The half life of the antibiotics determines when you give the second dose of perioperative prophylaxis
What percent of resident flora remain after aseptic technique?
20%
In what 2 scenarios should post operative antibiotics be used?
Sepsis and dirty surgery OR some orthopedic surgeries have disastrous consequences so you should give post operative antibiotics
T/F: post operative antibiotics are a common prophylactic treatment for a patient with an infection
F, this describes therapeutic use of antibiotics. If you’re giving post operative antibiotics then you’re treating sepsis or a dirty sx which would be therapeutic treatment
T/F: antibiotics preferentially target pathogenic bacteria
F
Therapeutic antibiotic protocol
Give a full course until sometime after infection looks resolved
Prophylactic antibiotic protocol
Start 30-50 minutes before incision and stop within 24 hours of surgery
CLEAN wound
Surgical wound
Aseptic conditions
Non- traumatic
Non- inflamed
No luminal structures entered
CONTAMINATED Wound
- Any traumatic wound
- Surgical wound with gross spillage of contaminating contents
- Surgical wound with major break in asepsis
CLEAN CONTAMINATED wound
Surgical wound where luminal structure is entered in a controlled manner, otherwise clean with drain
DIRTY wound
Infection, abscess, purulent discharge, necrotic tissue
What are some ways to reduce SSI’s other than antibiotics?
Practicing aseptic technique and following halsteads principles. For clean contaminated surgeries you should perform the clean procedures first and then have a plan for entering luminal organs. Isolate the organ, take it out of the abdomen and pack it off with lap sponges. Then use separate instruments for different levels of contamination and have your suction ready. After closing the organ, you can lessen contamination buy changing gloves and instruments and lavage the organ/abdomen
How long after surgery is infection considered a surgical site infection?
30 days
In what procedures are prophylactic antibiotics indicated?
Clean contaminated, contaminated and dirty
Halsteads Principles
- Aseptic technique
- Gentle tissue handling
- Control hemorrhage
- Eliminate dead space
- Accurate apposition of tissue with minimal tension
- Preservation of blood supply
What defines infection?
Presence of both tissue inflammation and 10(5) bacterial organisms present per gram
