Surgical Site Infections Flashcards
How often do SSIs occur?
In ~2.6% of all operations - 3rd most common HAI
What does CDC classify SSIs into?
Incisional (superficial or deep)
Organ space
Where do superficial SSIs occur?
Skin and subcutaneous tissue
Where do deep incisional SSIs occur?
Deep soft tissue, including fascia and muscle
What are organ space SSIs?
abdominal abscesses of peritoneal cavity or infection of the pleural space
What is a clean wound?
doesn’t enter a normally colonised viscus or lumen of the body
What is clean contaminated wound?
seen when a procedure enters colonised viscus or cavity of the body but under elective and controlled circumstances
What is a contaminated wound?
contamination present at the surgical site before any obvious infection
What is a dirty wound?
infection already present. E.g. abdominal exploration for acute bacterial peritonitis
How can the incidence of SSIs be reduced?
- surveillance
- prophylactic antibiotics
- asepsis
- preparations of incision site
- warming
- oxygenation
- glucose control
When should antibiotic prophylaxis be given?
To patients prior to:
- clean surgery involving prosthetics or implant
- clean-contaminated surgery
- contaminated surgery
When shouldn’t antibiotic prophylaxis be given?
In clean, non-prosthetic uncomplicated surgery
What should the choice of antibiotics be based on?
Local antibiotic formulary and consideration should be given to potential ADRs when choosing them for prophylaxis
What should be used to remove hair?
clipper and not razors as they damage skin and increase the risk of SSIs.
What is used as SS antisepsis?
- Chlorhexidine alcohol
- Povidone iodine
