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MD2001 Week 6 > Surgical Site Infections > Flashcards

Surgical Site Infections Flashcards

1
Q

What percentage of healthcare associated infections are caused by SSI?

A

20%

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2
Q

What are some examples of SSIs?

A

Wound discharge

Dehiscence

Lymphadenitis

Formation of abscesses

Necrosis

Gangrene

Sepsis

Spread to deeper tissue

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3
Q

What are the possible consequences of SSIs?

A

Microbial penetration of deeper tissues

Invasion of bloodstream

Spread of bacteria to other sites

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4
Q

What are the causes of SSIs?

A

Contamination of incision by normal microbiota

Damage to tissues

Damage to blood vessels

Presence of foreign bodies- sutures, implants

Reduced efficacy of inflammatory response

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5
Q

When can a SSI occur?

A

Before, during and after surgery

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6
Q

What factors can influence the development of SSIs?

A

Type of surgical wound

Pre-,intra and postoperative care

Age and general health of patient

Extent of tissue injury

Infection prevention procedures

Presence of prosthesis or foreign body

Presence or absence of drain

Duration of surgery

Place in operation list

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7
Q

What are the different classifications of surgical wounds?

A

Clean- Class 1

Clean/contaminated- Class II

Contaminated- Class III

Dirty- Class IV

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8
Q

Describe class I

A

Elective surgery

No acute inflammation

Do not involve respiratory, GI or GU tracts

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9
Q

Describe class II

A

Urgent/emergency care

Clean wounds with higher risk of infection

Uncomplicated respiratory, GI or GU tract surgery

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10
Q

Describe class III

A

Outside object comes into contact with wound

Large amounts of spillage from GI tract into wound

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11
Q

Describe class IV

A

Purulent inflammation

Foreign object lodged in wound

Traumatic or infected wounds

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12
Q

What are the microbial causes of SSIs on the skin?

A

Staphylococcus aureus

Streptococci spp.

Enterococci spp.

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13
Q

What are the microbial causes of SSIs in the bowel?

A

Escherichia coli

Bacteroides fragilis

Clostridium perfringens

Enterococci spp.

Anaerobic cocci

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14
Q

Does shaving increase the risk of SSI?

A

Yes

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15
Q

What steps can the surgical team do to prevent and reduce the chances of SSIs?

A

Hand decontamination

Not use non-iodophor-impregnated incise drapes

Wear sterile gown and 2 pairs of gloves

Prepare skin at surgical site immediately before incision

Maintain homeostasis

Do not use wound irrigation

DO not use intraoperative disinfection or topical antibiotics

Cover incisions with appropriate dressings

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16
Q

Examples of conventional dressings

A

Gauze

Tulle gras

Non-adhesive fabrics

17
Q

Examples of occlusive dressings

A

Hydrocolloids

Polyurethane films

Foams

18
Q

How do we reduce the risk of postoperative infection?

A

Reduce time in and out of hospital

Treat any current infections before the surgery

Keep length of surgery as short as possible

Maintain good operative technique

Debridement of dead and necrotic skin

Establish good blood supply

Prevent pressure sores by good nursing

Arrange active physiotherapy to minimise risk of URTIs and UTIs

19
Q

How do we prevent catheter -related infections?

A

Always wash hands before procedure

Wear gloves when handling catheter

Use single use antiseptic wipe

Cover insertion site with dressing

20
Q

How does early prosthetic joint infections present?

A

Fulminant with wound spesis

21
Q

How does delayed prosthetic joint infections present

A

Indolent, low grade infection

22
Q

How does late onset prosthetic joint infections present

A

Septic arthritis

23
Q

What are the different time periods for prosthetic joint infections?

A

Early- less than a month

Delayed- less than a year

Late onset- greater than two years

24
Q

What increases the risk of developing a prosthetic joint infection?

A

Rheumatoid arthritis

Diabetes mellitus

Malnutrition

Obesity

25
Q

How do we diagnose a prosthetic joint infection?

A

Blood culture

Collection of pus by needle aspiration

Bone biopsy

Raised ESR (erythrocyte sedimentation rate) and CRP

Polymorphonuclear leucocytes

Radiological imaging

MD2001 Week 6 (7 decks)

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