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1. Surgical site infections (SSIs) are the second most common nosocomial infection and the most common among surgical patients. Approximately 2/3 of SSIs are incisional infections involving only the skin and subcutaneous tissue of the incision. 2. SSIs occur within 30 days of an operation if no implant is left in place, or within 1 year if an implant is present. The infection must appear related to the operation and involve only the part of the body where the surgery took place. 3. Risk factors for developing an SSI include the patient's age, health status, type of surgery performed, and techniques used during the operation. Proper sterile technique and antimicrobial prophyl
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- 3. econd mos C·ommon nosoco· mlal infec ion (17%). ost common nosocomia l infec ion among surgica pa ien s (38.%). 2/3 incisional.
- 4. • tha a t of t he body aft s ry here the su g y too p ace.
- 5. • a a ter a es · t in a o nd ith o s1 ,gn.s or s · pto1 ms sys c 1n al . Us .a ess than 1 5 cu/ml. C - r . _- - - • - - . L - . - - - - - _ r - . - . - _I .o.. - - - - .o.. - - -
- 6. Infection: Sys em·c and oca s·gns of :1nflammat·on. Bae erial co ·n s 105 C U/ml.
- 7. lnfectio i occu s with·n 30 ays after he o e ation and involves only sk· or subcu aneo s iss e o the I c·s1on. sk·n Superf·ciat incisiona --"-···----··-r
- 8. Infection occurs within 30 days after the operaf on if no implant is .eft in place or within 1year if imp ant is in place. The infection appears to be re ,ated to the ope afon and the infection invo ves t e .-.I - - · - - - i:.,._ .a.. - - • • - I - - L - - - -
- 9. Inf ct·on cc rs w1 aft t e opera io if o 30 ays la t is ft · Iac o wit ·n 1y i ant s i place and inf ction a p ars o a · th at d t t I o ation. II fecf on invo v s a v oart ot ,er Deep incisional SSI
- 10. 1. - ndogenous floraof he pa ient. 2. pera ing heater environmen . 3. ospi al personnel. 4. Seeding of he opera ive si e from dis an foc1 us o
- 11. I An unin ec ed operative wound without 8 9 II n amina ed inflammation. r o in rinsic bacterial lora Ope.ra ive wounds in which the respiratory, alimentary, 22 g n1tal, or urinary tracts are en ered und r con rolled condi ions andwi hou unusual contamina ion. Opera ions involving the biliary ract, appendix, vagina, and oropharynx ...._ - ,. • • • l
- 13. I
- 14. h Relative Percentage bySite of Infection 043 Pathogen All Sites BSI Pneumonia SSI n=235,758 n=S0,091 n=64, 056 n=22, Coag neg Staph 14.3 39.3 2.5 1 3.5 Saureus 11.4 10.7 16.8 1 2.6 Enterococcispp. 8.1 10.3 1.9 14 . 5 P. aeruginosa 9.9 3.0 1 6 . . 1 9. 2 Enterobacter spp. 7 . . 3 4.2 10.7 8..8
- 16. Duration of surgical scrub. Skin antisepsis. Preoperat ive shaving. Durati1 on of operation. Antimicrobia l prophylaxis. Foreign materia l at surgical site. Surgica l drains. Surgical technique: Poor hemostasis. " - - - ·- - ... -- - - - -- - - - - __ _ . . . 1 _ _._ - - -
- 17. Age Increasing age. Diabetes. Smoking: d·elays primary wound healing. Steroids. Malnutrition. Preoperative colonizat ion with 5. aureus. Perioperative transfusi,o,n. Coexistent infections at a remote body site. Altered immune response.
- 22. Inc eased x at . Inc eased swe ling. Increased eryth a. Inc as .dpain.
- 24. SR...... 1' 1 • C m ete blood ict W C...... CR . i ro 1 1 oloi(cal.
- 25. P I or x a es from infected wounds is usua . ly sampled v : 1 g . ee he w, o :, which must be soaked we · the s a ex dates. he us itself is a ways prefer ed and can be A spe obt aine, d .i ge and transfer o a sterile t be or screw cap ,,,,. y using a ed bottles. .
- 26. o d st da d l!e t·on m t d t do a d T n .
- 27. I , . OU nr t b t riI u on th w und it st iI s a y wa t b th I w W' t '"" - - - und t a s 0 t. L t _ _ _ .L _ - • - • - - - L • - -
- 30. 1. u t 2. I • UI a a. • •
- 31. • tifi n f t • n •
- 33. D Avoid antibiotics. o Minimize hospitalisation. D Treat any remote infection. D Avoid shaving. D Chlorhexidine bath. - - • • I • • •· · •
- 34. • I • • • • • - • a • • • I •
- 35. s• • • D • "-·- I I
- 37. bodies. t issu s. emov necroti A t·. ept ics.