Surgical infection

Question 1

What counts as an SSI?

Answer 1

Within at surgical site within 30 days post op OR up to a year if implants are added

Question 2

What are the signs of surgical infection?

Answer 2

• Pain/ tenderness
• Localised swelling, redness, heat
• systemic signs e.g. pyrexia, inappetance
• Wound dehiscence (breakdown)
• Abscess?

Question 3

What are the consequences of an SSI?

Answer 3

• Delayed healing
• Wound breakdown
• Failure of the surgery
• Septicaemia
• Prolonged hospitalisation
• Client dissatisfaction
• Increased treatment costs

Question 4

Whats the level of bacterial burden in an infected surgical wound?

Answer 4

More than 10^6

Question 5

What is the WHO definition of a nosocomial infection?

Answer 5

Infection acquired in hospital by a patient that was presented for a different reason than the infection. Includes infection acquired in hospital that present after discharge.

Question 6

How are surgical wounds contaminated?

Answer 6

Clean
Clean-contaminated
Contaminated
Dirty

Question 7

What counts as a clean wound?

Answer 7

• Elective procedure
• No break in aseptic technique
• No acute inflammation
• Not entered into resp/ GIT-No need for antibiotics (either peri/ post op)

Question 8

When would you give peri-op antibiotics to an animal with a ‘clean’ wound?

Answer 8

• When the procedure lasted more than 90 mins
• Use of orthopeadic implants
• Significant skin traums

Question 9

What main bacteria would you expect to find on skin?

Answer 9

-Staphylococcus

Question 10

What is clean/ contaminated?

Answer 10

• Minor break in aseptic techqniue
• Enter into resp/ GIT/urinary (no sig contamination)
• Give antibiotics periop

Question 11

What is contaminated?

Answer 11

• Traumatic wound < 4 hrs old
• Break in aseptic technique
• Spillage from viscus
• Def peri-op AB and maybe post op too

Question 12

How long during surgery does it take for infection rate to double?

Answer 12

1 hour

Question 13

Define a biofilm

Answer 13

Structure community of cells enclosed in a self-produced matrix and adherant to an inert/living surface

Question 14

What is the problem with biofilm development?

Answer 14

• Once developed a biofilm allows bacteria within it to be a lot more resistant to antibiotics

Question 15

What are Halsteads 7 principles?!

Answer 15

• Gentle tissue handling
• Strict asepsis
• Haemostasis
• Preservation of the blood supply
• No tension on tissues
• Good approximation of tissues
• Obliteration of dead space

Question 16

What are the perioperative factors that increase infection rate?

Answer 16

• Anaesthesia
• Ischameia
• Some drugs
• Nursing

Question 17

Complete the sentence…

For every additional hour of GA…

Answer 17

there is a 30% greater risk of infection

Question 18

How can antibiotics be used to limit bacterial activity int he wound?

Answer 18

Use them perioperatively, much better to have them on board at time of exposure e.g. surgery
-Lowers contamination and then you may be able to avoid handing them out to owner

Question 19

What bacteria is commonly found on the skin of cats?>

Answer 19

Pasteurella multocida
(dogs: staphs/ streps)

Question 20

What bacteria is normally found in the respiratory tract?

Answer 20

Staphs and streps