Wound Healing and SSI's Flashcards
What are other names for the subcutaneous tissue? What types of cells are found in the subQ?
hypodermis or superficial fascia; adipose tissues, fibroblasts, macrophages
What is the main purpose of subQ?
fat storage
A superficial/incisional SSI may go through which layers?
epidermis, dermis, subQ
Is staph aureus a native skin flora?
yes, up to 20% of the population are long-term carriers
What are some conditions that can be caused by S. aureus?
minor skin infections, such as pimples, impetigo, boils (furuncles), cellulitis folliculitis, carbuncles, scalded skin syndrome, and abscesses, to life-threatening diseases such as pneumonia, meningitis, osteomyelitis, endocarditis, toxic shock syndrome (TSS), bacteremia, and sepsis
Define whether these are aerobic or anearobic, gram+ or -, and where they are found: staph aureus, escherichia coli
S. aureus: anaerobic, gram+, skin/anterior nares; E. coli: anaerobic, gram-, colon
Which is more virulent, S. aureus or MRSA?
neither, MRSA is just more difficult to treat
What type of bacteria is found in the small intestine?
minimal, nearly all is in colon, but there is some anaerobic, gram-
Where in the digestive tract is aerobic bacteria found?
the cecum (the beginning of the colon)
What is a major commensurate function that intestinal bacteria perform? (in general terms)
aid in digestion of food (one study showed that rats in a sterile environment had to consume 30% more food just to maintain weight)
What can E. coli cause?
Virulent strains of E. coli can cause gastroenteritis, urinary tract infections, and neonatal meningitis. In rarer cases, virulent strains are also responsible for hemolytic-uremic syndrome, peritonitis, mastitis, septicemia and gram-negative pneumonia. Most E. coli are harmless.
Explain how a surgical wound could cause skin flora to contaminate the body? gut flora?
skin flora - the subQ, deep soft tissue or organ/space is exposed to skin flora after incision; gut flora - the outside of the intestines, the organ space, deep soft tissue, subQ and dermis are exposed to gut bacteria when the gut is opened up
How are HgA1c and post-op glucose related to SSI’s?
both elevated A1c (>8%) and elevated post-op BG (>200mEq/L) are associated with higher rates of infection
What can we do as AA’s to prevent SSI’s?
avoid hypothermia (keep pt >36*C), avoid elevated post-op glucose (>200mEq/L), give appropriate broad spectrum ABX within time frame and re-dose accordingly
What types of cases have high rates of SSI’s? what type of patients?
major abdominal sx, colorectal, prosthetic joints, prolonged sx time, large blood loss; obese, diabetic, smokers
