SSI Flashcards
(16 cards)
What are surgical site infections (SSIs)?
Infections of the tissues, organs or spaces exposed during the performance of an invasive surgical procedure
SSIs can lead to increased morbidity and prolonged hospital stays.
What are the two classifications of factors leading to SSIs?
General factors related to the patient and local factors related to the wound
Understanding these factors can help in the prevention of SSIs.
List general host factors that can increase the risk of SSIs.
- Old age
- Obesity
- Anemia and malnutrition
- Immunosuppression (e.g., diabetes mellitus, uraemia, malignancy)
- Intake of immune-suppressing drugs (e.g., corticosteroids, chemotherapy)
These factors can compromise the body’s ability to fight infections.
What are some local factors that can contribute to SSIs?
- Poor skin preparation
- Defect in sterilization of instruments
- Lack of adherence to theatre discipline
- Prolonged surgical procedures
- Improper surgical technique
- Poor blood supply
- Nature of the operation
Local factors are often within the control of the surgical team.
What defines a clean wound in surgical terms?
Elective non-traumatic wounds in which the gastrointestinal, urinary or respiratory tracts are not entered
Clean wounds have the lowest risk of infection.
What characterizes a clean contaminated wound?
Elective surgery into the gastrointestinal, urinary or respiratory tracts with no significant spillage
These wounds have a higher risk of SSIs compared to clean wounds.
What are contaminated wounds?
- Open accidental wounds encountered within 4 hours
- Gross spillage from the gastrointestinal tract
- Incision through inflamed, non-purulent tissues
Contaminated wounds have a moderate risk of SSIs (10-20%).
What defines dirty wounds?
- Traumatic wounds more than 4 hours old
- Purulent infection or necrotizing soft tissue infection
- Perforated viscus with high contamination
Dirty wounds have the highest risk of SSIs, up to 40%.
When do surgical site infections typically appear postoperatively?
Between the fifth and tenth days postoperatively, but may appear earlier or later
Early recognition is crucial for effective management.
What are the earliest manifestations of a surgical site infection?
- Increasing wound pain
- Postoperative fever
These symptoms should prompt further evaluation for SSIs.
What are some clinical features of surgical site infections?
- Swollen, tender, and red wound
- Fluctuant areas or crepitus
- Discharge from the wound
Infections deep to the fascia may be harder to recognize.
What recommendations can minimize the risk of surgical site infections?
- Correct predisposing factors (e.g., control diabetes)
- Avoid operations in patients with active infections
- Shave or clip hair just before skin incision
- Skin preparation with antiseptics
- Surgeons should have short nails and scrub properly
- Meticulous surgical technique
These practices can significantly reduce the risk of SSIs.
When should prophylactic antibiotics be given?
Pre-operatively and in the early postoperative period
This is especially important for patients with high risk for infection.
Which type of antibiotic is usually used for prophylaxis?
First-generation cephalosporin
The choice of antibiotic may vary by hospital based on prevalent microorganisms.
What should be done if there is evidence of invasive infections?
Administer antibiotics based on culture and sensitivity tests
This ensures targeted treatment of the infection.
True or False: The presence of foreign bodies or prosthetic material increases the risk of SSIs.
True
Foreign materials can harbor bacteria, increasing infection risk.
