Surgical Site Infections
- Created by: Labake
- Created on: 13-02-17 13:24
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- Surgical site infections
- High infection risk surgeries
- Micro-organisms present on skin and in gut (intestines)
- Types of operation procedures
- Contaminated (15-30%)
- E.g. intestinal spillage= contaminates surgical site
- Clean (below 2%)
- Elective, not entering lumen, superficial e.g. hernia repair
- Clean contaminated (5-15%)
- Enters colonised region BUT elective
- Dirty (over 30%)
- Emergencies, active infection ALREADY present e.g. abscess or bacterial peritonitis
- Contaminated (15-30%)
- Bile duct, liver, pancreatic,gall bladder, gastric (all gut) = highest SSI risk
- Guidelines to minimise SSIs
- Warming
- Immune system works best when warm
- Asepsis & preparing incision site
- To kill microbes in air and on skin
- Oxygenation
- For immune system
- Prophylactic antibiotics
- For surgery that is not clean or elective
- Can reduce SSIs by 50%
- For surgery that is not clean or elective
- Glucose control
- For diabetics- hyper-glycaemia= poor immune system
- Surveillance (follow up surgery)
- Warming
- Types of microbes causing SSIs
- Mostly Staph. a (30%)
- Has virulence factors e.g. coagulase for sticking to tissue, TSST-1 (toxic shoch syn toxin), B-lactamase
- Coagulase neg Staph. a, enterococcus, E. coli
- Can take weeks for microbes to grow and become apparrent
- Mostly Staph. a (30%)
- Antibiotic prophylaxis and treatment
- Local antibiotics- think about adverse effects
- SINGLE IV dose less than 60 mins before surgery
- Only given earlier if tourniquet used for amputation
- Hair removal for vision and less infections (using clippers as razors cause micro-abrasions)
- Chlorhexadine- alcohol paint down most effective
- Other healthcare associated infections= UTIs, RTIs, Sepsis and C. difficile diarrhoae
- SSI occurs in 2.6% of operations and 3rd most common HAI
- High infection risk surgeries
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