Post-Op Infections Flashcards
Furuncle/ carbuncle- Eti
- Primary cutaneous abscess originating from glands and hair follicles
- Furuncles most common surgical infection
- Immunodeficient pts
- Staph and anaerobes
Furuncle/ carbuncle- Sx
- Red to white to necrosis
- Boils
- Itch
- Regional lymphadenopathy
- Funruncles to carbuncles
- Carbuncles- Deep seated mass of fistulous tracts
Furuncle/ carbuncle- Tx
- Furncle- Drainage
- Carbuncle- Excision and abx
Cellulitis- Eti
Connective tissue infection
- PMNs
- Strept or staph
Cellulitis- Sx
- Brawny reddish brown skin
- Edematous
- Surgical wound site as portal of entry
- High fever
- Lymphangitis
Cellulitis- Tx
- Rest, elevation
- Abx
- Warm packs
Pyomyositis- Eti
- Skeletal muscle infection
- S. aureus and GAS
Gas gangrene- Eti
- Clostridium species
Wound infection- Eti
- Staph or strept infection during procedure
- 3rd most common infection
Wound infection- Timeline
5-10 days post op
Wound infection- Sx
- Fever
- Erythema, pain, warmth at surgical site
Wound infection- Tx
- Open wound and drain
- Abx if invasive
Pyomyositis- Sx
- Severe muscle edema
- Compartment syndrome
- Necrosis
- Skin change
Pyomyositis- Dx
CT
Pyomyositis- Tx
- Drainage
- Abx
Gas gangrene- Sx
- Red-brown skin sloughing off
- Rapid progression
- Foul smell
- Discharge and gas bubbles
Gas gangrene- Timeline
6 hrs - 4 days
Gas gangrene- Tx
- Urgent surgical debridement
- Amputation
- Hyperbaric o2
Necrotizing fasciitis- Eti
- Spreads along fascial plane
- Rapid progression
- Clostridium perfringens most common
Necrotizing fasciitis- Sx
- Systemic toxicity
- Fever
- Pain out of proportion
- Crepitus and bullae
- Hemorrhagic bullae
Necrotizing fasciitis- Tx
- Surgical removal of dead skin and fascia
- Abx
Abscess- Eti
- Fibrin trapped collection of pus
Abscess- Sx
- Fluctuation
- Fever, pain at surgical site
- Edema of surrounding skin
Abscess- Dx
Culture for abx
Abscess- Tx
- Open and drain
- Remove necrotic tissue
- Abx
Fistulas/ sinus tracts- Eti
- Progression of abscess
Fistulas/ sinus tracts- Timeline
5-10 days post op
Fistulas/ sinus tracts- Sx
- Prolonged ileus
- Fever
- Abd tenderness
- Wound infection
Fistulas/ sinus tracts- Dx
CT with contrast
- Fistulogram
Fistulas/ sinus tracts- Tx
- Drain
- Abx
- TPN
Bacteremia/ Septicemia- Eti
- Bacteria in blood
- Infected GI or Uro tract
- Speticemia = inflammatory response to infection
Bacteremia/ Septicemia- Sx
- Delerium
- Hypoxia
- Shock and edema
- Multiple organ system dysfunction
- Warmth, erythema and tenderness at site of incision
Bacteremia/ Septicemia- Dx
- Cutures
Bacteremia/ Septicemia- Tx
- Abx
Pneumonia- Eti
- Aspiration d/t oropharyngeal secretions
- Psuedomonas aeruginosa or gram negative
Pneumonia- Sx
- Tachypnea
- Lung consolidation
- Purulent sputum
- CXR
Pneumonia- Tx
Empiric abx
UTI- Eti
- E coli
- Immunocompromised
- Catheterization
UTI- Timeline
48-72 hrs
UTI- Sx
Fever, dysuria
- Frequency, urgency
- Flank pain
- Confusion in elderly
UTI- Tx
- Sulfa abx