Peri-op Infection Control Flashcards
What complications are associated with the development of a Surgical Site Infection (SSI)?
Poor healing/delayed healing time
Increased medical costs
Possible revision surgery
Client relationships
Patient welfare
Increased antibiotic use
What steps should we take if we suspect an SSI?
Identify infection
Assess extent - at incision site/tissue/organs or implants?
Culture-based antibiosis
Good wound management - aseptic handling, clean dressings
Good infection control techniques
Define exogenous microorganisms.
From a source ‘outside’ the patient e.g. surgeon, equipment, environment
Define endogenous microorganisms.
I.e. patients’ skin flora
Most SSIs are endogenous
What three kinds of factors predispose to infection?
Patient factors
Environmental factors
Treatment factors
Describe patient factors predisposing to infection.
Body condition/age - old/young = poor immune response/underdeveloped immune system, malnutrition = decreased albumin levels
Immunosuppressed / endocrinopathies e.g. Diabetes Mellitus
Remote infection (bacteria already in bloodstream)
Skin disease
Recent operation
Prior radiation of site
Peri-op temp?
What environmental factors predispose to infection?
Patient prep
Cross contamination - good hand hygiene!
Aseptic technique
Theatre conduct
Cleaning methods
Inadequate ventilation
What treatment factors predispose to infection?
Surgical time - infection rate doubles with every hour?
Experience
Inadequate prophylactic antibiosis
Drains
Emergency procedures - non-ideal candidates/prep
Surgical implants
Suture material selection
When are the 5 times to wash your hands?
Before and after touching a patient
Before and after touching surroundings
Before carrying out aseptic tasks
Before gloving
After possible exposure to contaminated fluids/tissue
Describe the 4 classifications of surgery.
Clean = non-traumatic surgical wounds that do not involve opening of respiratory, GI, genitourinary or oropharyngeal tracts
Clean-contaminated = surgical wounds which involve entering the above tracts in controlled conditions or placement of a drain
Contaminated = open wounds or spillage of GI contents/infected urine or break in aseptic technique
Dirty = old purulent wounds, FBs, faecal contamination
When are clean wounds most likely to result in infection?
Duration of surgery greater than 90 mins
Implants
Inexperienced surgeon
How can we prevent infection in clean-contaminated wounds?
Antimicrobial prophylaxis indicated according to anticipated flora
How can we help manage degree of infection in contaminated wounds?
Lavage
Debridement
Good antibiotic therapy (wound swab, culture)
When should we use antibiotics?
Implants - infection would be catastrophic!
Surgery over 90 mins
Clean-contaminated, contaminated, dirty procedures
When should we administer antibiotics?
Most effective time e.g. 30-60mins pre-surgery
Given before start of surgery and discontinued within 24hrs of completion of surgery
