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MD2001 NG > surgical site infections > Flashcards

surgical site infections Flashcards

1
Q

what is and SSI?

A

infections occurring in an incision made by a surgical procedure

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2
Q
  • SSI’s are responsible for what percentage of HCAI?
A
  • 20%
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3
Q

what is the differance between primary and secondary wound closure ?

A

PRIMARY
- heels from top to bottom due to sutures, this creates a gap at the bottom where fluid can collect and cause infection.
-scalpel made, deep and narrow
SECONDARY
- broader based wound, with granulation tissue
- granulates from the base and heels from the bottom to top
- scar more apparent

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4
Q

what are different signs of infection?

A
  • inflammation
  • discharge
  • collection of puss
  • pain
  • systemic symptoms, sepsis
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5
Q

what are the 5 signs of inflammation?

A
  • redness
  • heat
  • swelling
  • pain
  • loss of function
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6
Q

what are examples of mild to severe presentation of SSI?

A
  • wound discharge
  • dehiscence
  • adbscesses
  • necrosis
  • gangrene
  • sepsis
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7
Q

what are patient factors for risk of SSI?

A
  • age
  • nutrional state/diet
  • diebetes
  • immunosupressed
  • smoker
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8
Q

what are operation factors for risk of SSI?

A
  • poor closure of wound
  • legnth of procedure
  • foreign material in surgical site
  • shaving
  • insertion of surgical drain
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9
Q

how and why do surgical site infections occur?

A
  • contamination of incision by normal microbiota
  • damage to tissue
  • damage to blood vessels
  • foreign bodies
  • reduced inflmmatory response
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10
Q

when can surgical site infections occur

A

before, during and after surgery

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11
Q

example of skin bacteria that causes SSI

A

staph aureus

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12
Q

example of bowel bacteria that causes SSI

A

e. coli

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13
Q

what are 3 conseqeunces of SSI?

A
  • microbial penetration of deeper tissue
  • infection spread to bloodstream
  • spread of bacteria to other site
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14
Q

what are the 3 groups of factors that influence the development of SSI?

A
  • pre operative
  • intraoperative
  • post operative
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15
Q

what are preoperative factors that influence the development of SSI

A
  • MRSA (has to be screened for)
  • pre op shower (clean as possible)
  • do not remeve hair
  • give antibiotic prophylaxis before.
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16
Q

3 main things and how for disinfection

A

1- hands of hosp staff (wash with non-antimicrobial soap or alcohol based hand rub)
2- hands of surgical team ( scrub with antiseptic surgical solution)
3- patients skin (iodine or alcoholic chlorhexidine)

17
Q

what is the responsibility of the surgical team in the operation theatre?

A
  • skill of individual surgeon
  • quality of aseptic technique
  • wear gloves
  • follow protocl
  • protective clothing
18
Q

what are intraoperative factors that infleunce SSI?

A
  • decontamination of hands
  • sterile field
  • sterile gown and gloves
  • debridment of death and necrotic tissue
  • wound closure
  • cover insision with appropriate dressing
  • establish a good blood supply
19
Q

what is the purpose of the laminar flow?

A

all air flows down the way into vents at the bottom of the room and the air will never be recirculated

20
Q

what are risk factors for prosthetic joint infections?

A
  • rheumatoid arthritis
  • diabeties mellitus
  • malnutrition
  • obesity
21
Q

clean class I surgical wound

A
  • elective surgery
  • no acute inflmmation
  • does not nvolve respiratory, GI or GU
22
Q

clean/contaminated II surgical wound

A
  • urgent/ emergency case
  • clean wound with a higher risk of infection
  • uncomplicated respiratory, GI or GU
23
Q

contaminated III surgical wound

A
  • outside object comes into contact with wound
  • large amounts of spillage from GI into wound
24
Q

dirty IV surgical wound

A
  • purulent inflammation
  • foreign object lodged in wound
  • trauma or infected
25
Q

what are the different microbial loads of the 4 different types of surgical wound?

A

clean = <10 cfu/ml
clean/contaminated = 20-40 cfu/ml
contaimated = 1000-1500 cfu/ml
dirty = >3500 cfu/ml

26
Q

what happens to the incidence of SSI with or without antibiotic prophylaxis

A

the incidence will decrease with antibiotic prophylaxis

27
Q

what are post op factors that will infleunce SSI

A
  • use appropraite dressing
  • use aseptic or non touch tenchniques to chnage or remove dressing
  • use sterile saline for 48 hrs
  • keep post op stay in hosp to a minimum
28
Q

3 types of conventional dressing

A
  • gauze
  • non adhesive farics
  • tulle gras
29
Q

2 types of occlusive dressing

A
  • hydrocolloids
  • foams
  • polyurethane films
30
Q

when will vacum dressings be used

A
  • wound heeling by secondary intention
  • wounds with high amount of exudate

MD2001 NG (28 decks)

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