Surgical infection Flashcards
What counts as an SSI?
Within at surgical site within 30 days post op OR up to a year if implants are added
What are the signs of surgical infection?
- Pain/ tenderness
- Localised swelling, redness, heat
- systemic signs e.g. pyrexia, inappetance
- Wound dehiscence (breakdown)
- Abscess?
What are the consequences of an SSI?
- Delayed healing
- Wound breakdown
- Failure of the surgery
- Septicaemia
- Prolonged hospitalisation
- Client dissatisfaction
- Increased treatment costs
Whats the level of bacterial burden in an infected surgical wound?
More than 10^6
What is the WHO definition of a nosocomial infection?
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.
How are surgical wounds contaminated?
Clean
Clean-contaminated
Contaminated
Dirty
What counts as a clean wound?
- Elective procedure
- No break in aseptic technique
- No acute inflammation
- Not entered into resp/ GIT-No need for antibiotics (either peri/ post op)
When would you give peri-op antibiotics to an animal with a ‘clean’ wound?
- When the procedure lasted more than 90 mins
- Use of orthopeadic implants
- Significant skin traums
What main bacteria would you expect to find on skin?
-Staphylococcus
What is clean/ contaminated?
- Minor break in aseptic techqniue
- Enter into resp/ GIT/urinary (no sig contamination)
- Give antibiotics periop
What is contaminated?
- Traumatic wound < 4 hrs old
- Break in aseptic technique
- Spillage from viscus
- Def peri-op AB and maybe post op too
How long during surgery does it take for infection rate to double?
1 hour
Define a biofilm
Structure community of cells enclosed in a self-produced matrix and adherant to an inert/living surface
What is the problem with biofilm development?
- Once developed a biofilm allows bacteria within it to be a lot more resistant to antibiotics
What are Halsteads 7 principles?!
- Gentle tissue handling
- Strict asepsis
- Haemostasis
- Preservation of the blood supply
- No tension on tissues
- Good approximation of tissues
- Obliteration of dead space
What are the perioperative factors that increase infection rate?
- Anaesthesia
- Ischameia
- Some drugs
- Nursing
Complete the sentence…
For every additional hour of GA…
there is a 30% greater risk of infection
How can antibiotics be used to limit bacterial activity int he wound?
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
What bacteria is commonly found on the skin of cats?>
Pasteurella multocida (dogs: staphs/ streps)
What bacteria is normally found in the respiratory tract?
Staphs and streps
