Surgical site infections Flashcards
What is a surgical site and how does an SSI occur?
the incision or cut in the skin made by a surgeon to carry out a procedure, during which tissue is handled or manipulated, SSI occurs when microbes inter the surgical site and multiply in tissues
Incisional SSI is further divided in to superficial and deep, what do they both involve?
superficial involves only the skin and subcutaneous issue but deep involves the deep soft tissues including fascia and muscle
When is a wound judged to be clean?
when the operative procedure does not enter into a normally colonized viscus or lumen of the body.
What is the difference between a contaminated wound and a dirty wound?
contaminated procedures occur when gross contamination is present at the surgical site in the absence of obvious infection, but a wound is when the procedure’s performed when active infection is already present
What are clean-contaminated wounds?
where the procedure enters into colonized cavity of the body but under controlled circumstances
What factors increase the risk of an SSI?
BMI, length of procedure, surgical site (cosmetic surgery on face and neck have lower risk, elective procedures have lower risk than emergency), age
What are coagulase and Protein A?
virulence factors
Coagulase stimulates clot formation and is present in S.aureaus bacteria
Protein A facilitates the adherence of S.aureus bacteria in host which increases how infectious the bacteria is at the surgical site
What does the elastin binding protein do?
allows binding to tissues
How can the incidence of an SSI be reduced?
surveillance, warming, oxygenation, prep of incision site, prophylactic antibiotics, asepsis, glucose control
When should antibiotic prophylaxis not be used?
routinely for clean non-prosthetic, uncomplicated surgery
When should antibiotic prophylaxis be used?
clean surgery involving placement of a prosthesis or implant, clean-contaminated surgery and contaminated surgery
What hair removal method is currently used for surgery and why?
clippers as razors could increase risk of SSIs as it can cause damage to skin (abrasions) and can cause bleeding and might disturb microorganisms in sweat glands and allow entry into body. Hair is also removed to improve view and access
What is used for surgical site antisepsis?
Chlorhexidine alcohol or povidone iodine. Chlorhexidine can stick to skin and provide longer term antiseptic effect so more effective
A dedicated infection control team is required in hospitals, what is their role?
constantly improve practice to reduce incidence of hospital acquired infections, robust surveillance and reporting to frontline staff, education, and training of staff, producing infection control policies, audit policies and guidelines, supporting and reassuring patients and families
