Wound Classification, Wound Infection, Antimicrobial Use Flashcards
Surgically created wound with NO infection encountered; Aseptic technique maintained; No structure normally containing bacteria opened
Clean Wound
Surgically created wound but…
- Hollow viscus is opened with gross spillage
- Major break in aseptic technique
- Traumatic wound
Contaminated Wound
Surgically created wound but…
- Hollow viscus or organ normally containing bacteria is opened but no contents are spilled.
- Minor break in (aseptic) technique occurs
Clean- contaminated Wound
- Surgical wound contains: pus - contains: contents of perforated hollow viscus
Dirty Wound
A spay with appropriate aseptic technique and no complications is an example of
A. Dirty wound
B. Clean- contaminated wound
C. Clean wound
D. Contaminated wound
C. Clean wound
You are performing an abdominal surgery and notice that you have a small tear in your glove. You quickly change your surgical glove using aseptic technique. This would be an example of:
A. Dirty wound
B. Clean- contaminated wound
C. Clean wound
D. Contaminated wound
B. Clean- contaminated wound
– also if a hollow viscus normally containing bacteria was opened such as the stomach but no contents were spilled this would also be an example of clean contaminated.
You are performing a surgery on a dog with a foreign body and upon abdominal exploratory surgery you notice that intestinal contest has spilled into the abdomen. This wound is best described as:
A. Dirty wound
B. Clean- contaminated wound
C. Clean wound
D. Contaminated wound
D. Contaminated wound
–A major break in aseptic technique is also an example of a contaminated wound
–Hollow viscus is opened up with gross spillage
You are performing surgery on a dog with pyomentra. It ruptures when you begin to perform surgery, filling the abdominal cavity with pus and bacteria. Which of the following best describes this surgical wound:
A. Dirty wound
B. Clean- contaminated wound
C. Clean wound
D. Contaminated wound
A. Dirty wound
–True contamination into our surgical wound with bacteria!
–contains pus
What is the goal of aseptic technique?
To minimize the incidence of surgical wound infection
What is the rule of thumb concerning risk of infection vs. time spent under surgical anesthesia?
THE RISK OF INFECTION DOUBLES EVERY HOUR! = RULE OF THUMB!!
—Risk of infection really doubles every 70-90 minutes- just think of it as doubling every hour.
If your surgery goes longer than 90 minutes what should you consider giving to the patient?
antibiotic prophylaxis! – it is the protective factor for infection.
Presence of purulent drainage, Abscess, or Fistula is indicative of…
Infection
What are the 3 major risk factors for infection?
- Duration of surgery (over 70-90 minutes doubles the risk for infection)
- Increased number of people in the operating room
- Dirty surgical site
Infection/ Inflammation is associated with 6 significant factors which are…
- Duration of anesthesia
- Duration of post-op ICU stay
- Wound drainage
- Increased patient weight
- Dirty surgical site
- Antimicrobial prophylaxis (if you use them inappropriately you can cause increased risk of infection)
Clean procedures have what incidence (%) of surgical infections?
0-4.4% change of getting an infection
Dirty procedures have what incidence of surgical infection?
DIRTY IMPLIES INFECTION!!
What is the most common source of operative wound infections?
The patient’s endogenous flora!! (skin, GI tract)
–other sources include the operating room environment, operating team and surgical instruments & supplies
T/F:
Infection at a surgical site can occur up to a year or more post surgery.
TRUE!!! WITH IMPLANTS!
–Example: cranial cruciate ligament repair- the animal licked the surgical site- bacteria formed a biofilm layer over the implant used, the bacteria can stay dormant for many months to years, a small wound can occur and track to the site of initial surgery and cause those bacteria within the biofilm to cause an infection.
T/F:
Overused or misused antibiotics decreases the risk to develop antibiotic resistant strains, and is a substitute for surgical technique.
FALSE!!!
Overused or misused antibiotics INCREASES the risk to develop antibiotic resistant strains (think about it- if you give antibiotics that target gram (+) bacteria to an infection of gram (-) bacteria how is that going to help you?), and it is NOT A SUBSTITUTE for surgical technique (but you are going to be a terrific doctor and you already knew that).
When would you want to use prophylactic antibiotics?
Then risk of infection is high or infection would have catastrophic results!
–take into consideration patient factors, type and length of surgery and the experience of the surgeon (are they new to performing surgeries and may take a long time, or are they are a pro and do this surgery multiple times a day?)
