Wound Classification, Wound Infection, Antimicrobial Use

Question 1

what are the classifications of operative wounds

Answer 1

clean

clean-contaminated

contaminiated

dirty

Question 2

what are characterisitics of clean wounds

Answer 2

surgically created wound

no infection encountered, aspeptic technique maintained, no structure normally containing bacteria opened

Question 3

what is a clean-contaminated wound

Answer 3

surgically created wound but:

• hollow viscous organ normally containing bacteria is opened but not contents spilled
• minor break in technique occurs (e.g. hole in glove detected)

Question 4

what are contaminated wounds

Answer 4

surgical wounds but:

• hollow viscus is opened with gross spillage
• major break in technique

Traumatic wound

Question 5

what is a dirty wound

Answer 5

contain pus

contain contents of perforated hollow viscus

Question 6

what is the goal of aseptic techniques

Answer 6

minimize the incidence of surgical wound infection

Question 7

how often does the risk of infection double under anesthesia

Answer 7

every 70-90 minutes

rule of thumb: risk doubles every hour

Question 8

dirty surgical wounds imply ______

Answer 8

infection

Question 9

what is the most common sourse of operative wound infections

Answer 9

patients endogenous flora

skin, GI tract

Question 10

sources of operative wound infections

Answer 10

operating room environement

operating team

surgical instruments and supplies

patients endogenous flora

Question 11

T/F there is little evidence on the role of aseptic technique

Answer 11

True

Question 12

what classifies a surgical site infection

Answer 12

infection at the surgical site occuring within 30 days or surgery or up to 1 year with implants

can be superficial or deep

Question 13

T/F anitbiotics are a substitute for good surgical technique

Answer 13

False!

Question 14

when should prophylactic antibiotics be used

Answer 14

high risk of infection or infection would have catastrophic results

Question 15

prophylactic antibiotics should be administered ________

Answer 15

30-60 minutes prior to skin incision (usually when IVC placed)

continued perioperative- but not longer than 24 hours

Question 16

what should be considered when selecting antibiotics

Answer 16

single agent prefered

should be effective against expected pthogens

dead bugs dont mutate! -cidal, dose

Question 17

which antibiotic is good when dealing with the GI tract, particularly the colon or when obstruction is present

Answer 17

cefoxitin

Question 18

T/F intraoperative administration of antibiotics when unexpected contamination occurs or surgery is longer than expected has been shown to decrease incidence of infection

Answer 18

False

Question 19

how are postoperative infections minimized

Answer 19

good nursing care practices

protect incision lines, wash hands between patients (gloves preferred), remove catheters and drains as soon as no longer needed