1- Types of wound contamination and minimising surgical infections

Question 1

define bacterial infection

Answer 1

Bacterial infection is defined as having more than 10(to the power of 5) bacteria per gram of tissue

Question 2

Define SSI (surgical site infection)

Answer 2

Infections of the tissues, organs or spaces exposed by surgeons during performance of an invasive procedure

Question 3

Name the 4 classifications of surgical wounds

Answer 3

• Clean
• Clean contaminated
• Contaminated
• Dirty

Question 4

Describe a clean wound

Answer 4

Non traumatic, non inflames operative wounds in which the respiratory, gastrointestinal, genitourinary and oropharyngeal tracts are not entered

Question 5

Describe a clean contaminated wound

Answer 5

Operative wounds in which the respiratory, gastrointestinal or genitourinary tract are entered but under controlled conditions without unusual contamination
- an otherwise clean wound in which a drain is placed

Question 6

Describe a contaminated wound

Answer 6

• Open, fresh, accidental wounds
• procedures which GI contents or infected urine is spilled or a major break in aseptic technique occurs

Question 7

Describe a dirty wound

Answer 7

• Old traumatic wounds with purulent discharge, devitalised tissue or foreign bodies
• Procedures in which a viscous is perforated or faecal contamination occurs

Question 8

Host factors that can affect incidence of infections

Answer 8

Age
Physical condition- e.g. malnourishment
Nutritional status
Diagnostic procedures- placing catheters can increase risk
Concurrent metabolic disorders- e.g. Cushing’s
Current medication- can delay wound healing and make it more likely that infections can occur

Question 9

Rationale use of antibiotics

Answer 9

surgery time longer than 90 mins
prosthesis implantation
patients with a pre-existing prosthesis
Severely infected or traumatised wounds