Common skin and soft tissue infections 2

Question 1

what is the most common cause of surgical site infections

Answer 1

staphylococcus aureus (mostly), but also coagulase negative staphylococci, enterobacteriaceae and anaerobes

Question 2

what are some of the SSi predispoing factors (preoperative)

Answer 2

elderly, obesity, smoking, diabetes (the usual yadadada)

Question 3

what are the SSI predispoing factors peri-operative

Answer 3

large incisions, foreign bodies, lengthy operations, spilage of micro-organisms

Question 4

what are the SSi predispoing factors postoperative

Answer 4

ischaemia, haematomas, foreign bodies, exposed deep tissues

Question 5

what is the diagnosis of surgical site infections

Answer 5

insepction, fever, raised infalmmatory markers (neutrophilia, CRP), micrscopy and culture of purulent discharge

Question 6

what is the treatment for superficial incisional infections

Answer 6

Anti-staph antibiotics - flucloxacilin

Question 7

what is the treatment for deep incisional infections

Answer 7

Tazocin. This covers gram positive, and aerobic gram negative bacilli + anaerobes

Question 8

what is medical asepsis

Answer 8

defined as any practice that helps reduce the number adn spread of microorganisms

Question 9

what is surgical asepsis

Answer 9

the complete removal of microorganisms and their spores from the surface of an object

Question 10

i have skipped all of the usual stuff that is covered properly in the disinfection and sterilisation lecture

Answer 10

i have skipped all of the usual stuff that is covered properly in the disinfection and sterilisation lecture

Question 11

how can we prevent surgical site infections

Answer 11

treat infection at distant sites before the procedure, screen and treat staphylococcus aureus colonisation, prepare the site with antiseptic (chlorhexidine) and good surgical technique

Question 12

what are some of the microbes we can find in cat and dog bites

Answer 12

pastuerlla species, capnocytophaga canimorsus (good luck remembering them). These are both gram negative species
The usual yadadada of s.aureus and streptococci

These can cause massive problems for those without a spleen

Question 13

what is the treatment for cat and dog bites

Answer 13

wounds debrided and irrigated
There’s a low threshold for antibiotic therapy especially if it’s after 48 hours
If there’s puncture wounds that can’t be debrided, wounds on face, hands and feet or wounds with underlying bone/joint involvement/immunocompromisation, use Augmentin

Question 14

what is the cause of erysipeloid/fish handler’s disease?

Answer 14

erysipelothrix rhusiopathiae, found in saltwater fish, shellfish, meat and hides

Question 15

Ehat is the treatment for erysipeloid, and what can infections be complicated with?

Answer 15

Penicillin

Endocarditis, meningitis and osteoarticular infections can complicate

Question 16

Why can human bites be worse than cat/dog bites?

Answer 16

They contain a greater number of bacterial species, including things like Eikenella spp, and anaerobes. Manage them as animal bites + consider blood-borne virus risk

Question 17

What bacterial species can you be exposed to from fish tanks?

Answer 17

Mycobacterium marinarum.

This can cause sporotrichoid infections

Question 18

What does antibiotic prophylaxis do?

Answer 18

Reduces SSI’s by 80%, especially in high risk patients. Needs to be timed so that initial dose peaks at time of procedure.