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Flashcards in Infection Deck (14)
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1

What are the three things required for establishment of a wound infection?

1. Sufficient dose of pathogenic microorganisms
2. A suitable microbial nutrient medium
3. Impairment of natural host defenses

2

What is asepsis?

Prevention of wound contamination

3

What is antisepsis?

Killing bacteria that are already present

4

What harm does surgery do?

- A surgical incision is a wound: tissue trauma
- Surgery must be performed in such a way as to minimise trauma

5

Can can trauma manifest into?

- Haemorrhage
- Infection
- Swelling
- Loss of function

6

What may infection be due to?

- Pre-existing tissue contamination
- Surgical exposure of tissues to contamination
- Relative or absolute immunodeficiency

7

What are some predisposing factors to surgical wound infection?

- Systemically compromised patient
- Tissue hypoxia
- Tissue trauma
- Inadequate debridement
- Prolonged tissue exposure to the environment
- Foreign material in the wound
- Haematoma ( inadequate haemostasis + dead space)
- Presence of resistant organisms in the environment

8

Where can the source of self infection/ cross infection come from?

- Operative area
- Operative personnel
- Airbourne
- Equipment
- Post-op area

9

What factors influence the battle between contaminants and the host's defences?

- Patient Factors
- Surgeon Factors
- Environmental Factors

10

Describe what patient factors are...

Who we do it to:

- Age
- Health status
- Low body weight - can become hypothermic
- Dermatitis at site
- Propensity to lick and scratch wounds
- Lack of compliance with dressings
- Obesity
- Chemotherapy
- Corticosteroids

11

Describe what surgeon factors are...

How we do it

- Disruption of local blood flow
- Tissue trauma
- Blood clots act as growth medium
- Foreign material e.g. sutures
- Electrocautery
- Creation of dead space
- Wicking of bacteria by multifilament sutures
- Long anaesthetic periods
- Drying of tissues
- Thermal damage from drills etc.

12

Describe what environmental factors are...

Where we do it

- Theatre cleanliness
- Theatre air flow
- Theatre traffic
- Hospital and ward cleanliness
- Skin clipping
- Skin disinfection
- Instrument sterility
- Draping
- Gowning and gloving
- Nosocomial infection
- Sink water sterility

13

When should prophylactic antibiotics be given?

- Long surgeries
- Implant surgeries
- Contaminated/ dirty surgeries

14

How should prophylactic antibiotics be given?

- High dose IV
- First generation cephalosporin or penicillin G
- At induction, blood levels are high at surgery
- Repeat after 90 minutes