Surgical site infections

Question 1

Name some different types SSI’s

Answer 1

Wound discharge
Dehiscence
Lymphadenitis
Formation of abscesses
Necrosis
Gangrene
Spread to deeper tissue
Sepsis

Question 2

Name the first 2 classes of surgical wounds and describe them briefly

Answer 2

Clean (class ll): Elective surgery, no acute inflammation, no involment or GI, R or GU tracts

Clean/contaminated (class lll): Urgent/ emergency situation, Uncomplicated GI, R and GU tract surgery

Question 3

Name the last 2 classes of surgical wounds and describe them briefly

Answer 3

Contaminated: (class lll): outside object comes in contact to wound, large amounts of spillage from GI tract into wound

Dirty: (class IV): Purulent inflammation, foreign object lodged into wound, infected or traumatic wounds

Question 4

With examples, what is used before surgery to decrease the chance of SSI’s?

Answer 4

Antibiotic prophylaxis is given before surgery to lower chance of SSI’s. Examples, malaria tablets, vaccines, antibiotics

Question 5

What unit measures the microbial load during surgery

Answer 5

cfu/ml or colony forming units per milliliter

Question 6

What are the appropriate measures to take during preoperative care?

Answer 6

Preoperative showering
Do not remove hair if possible
If hair must be removed, it must be done on the day of surgery with disposable heads
give antibiotic prophylaxis but not to dirty infections
Do not routinely use mechanical bowel preparation
Do not routinely use nasal contamination

Question 7

What are the appropriate measures to take during intraoperative care?

Answer 7

Surgical team decontamination
Wear sterile gloves and sterile gown
Prepare skin at surgical site immediately before incision
Maintain patient homeostasis
Do not use intraoperative disinfection or topical antibiotics
Cover incisions with appropriate dressings at the end

Question 8

What are the appropriate measures to take during postoperative care?

Answer 8

Use apsetic or non touching techniques to change or remove dressings
Use sterile saline for wound cleansing up to 48 hrs after surgery
Do not use topical antimicrobial agents for wound healing of primary intention

Question 9

What are some examples of dressings to prevent SSI’s?

Answer 9

Gauze, Tulle gras, non adhesive fabrics,

Occlusive examples:
Hydrocolloids
Polyuretherane films
Foams

Question 10

What are the steps on reventing catheter related infections?

Answer 10

Wash hands
Wear gloves
Use single antiseptic wipes
cover insertion site with dressing