This document provides a detailed overview of the history, pathophysiology, etiology, risk factors, management, and prevention of surgical site infections (SSIs). It discusses the typical microorganisms involved in SSIs and outlines recommendations for preoperative patient preparation, surgical team preparation, operative and postoperative wound care, and maintenance of the operating theater environment to minimize infection risk. Key factors that influence SSI risk include patient comorbidities, wound classification, surgical technique, and adherence to aseptic protocols during the perioperative period. Proper antibiotic prophylaxis and wound management are essential to treatment when infections do occur.
Surgical site Infection during Internship in medical college.pptxrautkrisna
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between 814 and 6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wllbeing
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
Surgical Site Infection: Its Causes & PreventionNehaNaayar
An infection that occurs in the part of a body after surgery is known as Surgical Site Infection (SSI). The incidence of SSI is monitored by the National Nosocomial Infections Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC). In India, according to NNIS data, SSIs are the third most frequently reported nosocomial infection and are associated with substantial morbidity that endangers a patient’s life. Let us understand in details about surgical site infection, the causes and the preventive measures.
Surgical site Infection during Internship in medical college.pptxrautkrisna
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between 814 and 6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wllbeing
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
Surgical Site Infection: Its Causes & PreventionNehaNaayar
An infection that occurs in the part of a body after surgery is known as Surgical Site Infection (SSI). The incidence of SSI is monitored by the National Nosocomial Infections Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC). In India, according to NNIS data, SSIs are the third most frequently reported nosocomial infection and are associated with substantial morbidity that endangers a patient’s life. Let us understand in details about surgical site infection, the causes and the preventive measures.
Definition of Isolation, Need of isolation, Types of Isolation, Mode Of Transmission Of Disease, Modes of Isolation, Types of precautions, Universal / standard precautions, Transmission based precautions, Advantages of Isolation, Disadvantages of Isolation, Isolation Ward in Hospital, Isolation Room in Hospital, Disease Wise Periods of Isolation Recommended etc.
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Over 1.4 million people each year worldwide suffer from hospital acquired infections. We can follow simple steps and protocols to prevent many of these cases.
Definition of Isolation, Need of isolation, Types of Isolation, Mode Of Transmission Of Disease, Modes of Isolation, Types of precautions, Universal / standard precautions, Transmission based precautions, Advantages of Isolation, Disadvantages of Isolation, Isolation Ward in Hospital, Isolation Room in Hospital, Disease Wise Periods of Isolation Recommended etc.
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Over 1.4 million people each year worldwide suffer from hospital acquired infections. We can follow simple steps and protocols to prevent many of these cases.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. HISTORY
Edwin Smith papyrus (circa 1600
BCE)
Hippocrates (Greek physician and
surgeon, 460-377 BCE)
Galen (Greek surgeon to Roman
gladiators, 130-200 CE)
3. Koch (Professor of Hygiene and
Microbiology, Berlin, 1843-1910.
Semmelweis (Austrian
obstetrician, 1818-1865)
Joseph Lister (Professor of
Surgery, London, 1827-1912)
4. Antoine Depage (Belgian
military surgeon, 1862-1925)
Sterilization of instruments
began in the 1880
Penicillin first was used
clinically in 1940 by Howard
Florey
5. Unfortunately, eradication of the
infective plague affecting surgical
wounds has not ended because of the
insurgence of antibiotic-resistant
bacterial strains and the nature of more
adventurous surgical intervention in
immunocompromised patients and in
implant surgery.
6. Pathophysiology
Wound healing is a continuum of complex
interrelated biologic processes at the
molecular level. For descriptive purposes,
healing may be divided into the following
three phases:
9. Etiology
A complex interplay between host,
microbial, and surgical factors ultimately
determines the prevention or
establishment of a wound infection
10. Micro-organsisms
Microbial factors that influence the
establishment of a wound infection are
1. The bacterial inoculum
2. Virulence.
3. The effect of the microenvironment.
When these microbial factors are
conducive, impaired host defenses set the
stage for enacting the chain of events that
produce wound infection.
11. Most SSIs are contaminated by the
patient's own endogenous flora.
The traditional microbial concentration
quoted as being highly associated with
SSIs is that of bacterial counts higher
than
10,000 organisms per gram of
tissue
12. The usual pathogens on skin and mucosal
surfaces are gram-positive cocci (notably
staphylococci); however, gram-negative
aerobes and anaerobic bacteria
contaminate skin in the groin/perineal
areas. The contaminating pathogens in
gastrointestinal surgery are the multitude of
intrinsic bowel flora, which include gram-
negative bacilli (eg, Escherichia coli) and
gram-positive microbes, including
enterococci and anaerobic
organisms. [8] (See Table 1 below.)
13. Pathogen Frequency (%)
Staphylococcus aureus
Coagulase-negative staphylococci
Enterococci
Escherichia coli
Pseudomonas aeruginosa
Enterobacter species
Proteus mirabilis
Klebsiella pneumoniae
Other streptococci
Candida albicans
Group D streptococci
Other gram-positive aerobes
Bacteroides fragilis
20
14
12
8
8
3
3
3
3
3
2
2
2
14. Sources of such pathogens include
surgical/hospital personnel and
intraoperative circumstances, including
surgical instruments, articles brought into
the operative field, and the operating room
air.
The group of bacteria most commonly
responsible for SSIs are Staphylococcus
aureus strains. The emergence of resistant
strains has considerably increased the
burden of morbidity and mortality
associated with wound infections.
15. Risk factors (other than
microbiology)
Decreased host resistance can be due to
systemic factors affecting the patient's
healing response
local wound characteristics
operative characteristics
17. Wound characteristics -
Nonviable tissue in wound,
Hematoma
foreign material (eg, drains and sutures,
dead space, poor skin preparation (eg,
shaving)
Pre-existent sepsis (local or distant)
18. Operative characteristics
Poor surgical technique
lengthy operation (>2 hours)
intraoperative contamination (eg, from
infected theater staff and instruments or
inadequate theater ventilation),
prolonged preoperative stay in the
hospital
Hypothermia
19. The type of procedure is a risk factor.
Certain procedures are associated with
a higher risk of wound contamination
than others. Surgical wounds have been
classified as
1. Clean,
2. clean-contaminated,
3. contaminated, and
4. dirty-infected
24. Prognosis
SSIs are associated not only with
increased morbidity but also with
substantial mortality.
In one study, 77% of the deaths of
surgical patients were related to surgical
wound infection.
25. SSIs are classified into
Incisional SSIs. (which can be superficial or
deep)
organ/space SSIs
30. Southampton wound grading
system for healing and
infection:
Grade 0 is normal healing;
Grade 1 is with bruising/mild erythema
Grade 2 is severe erythema with other
features of inflammation at or around
wound;
Grade 3 is serous or bloody discharge;
Grade 4 is presence of pus or deep
infection or tissue breakdown or
significant haematoma.
31. Management of SSI
All infected material and pus should be
removed from the
wound site—debridement.
Sutures are removed to allow free drainage of
infected
material.
Infected fluid is sent for culture and sensitivity
and suitable
antibiotics are started.
Once wound shows signs of healing by healthy
granulation
tissue, secondary suturing is done. Often it is
allowed to
heal by scarring.
32. Most patients with wound infections are
managed in the community
Resultant increased hospital stay due to
surgical site infection (SSI) has been
estimated at 7-10 days, increasing
hospitalization costs by 20%.
33. Antibiotics
Prophylactic antibiotics: For clean-contaminated and
contaminated wounds
. Antibiotics for dirty wounds are part of the treatment
because infection is established already.
Clean procedures might be an issue of debate.
clean procedures in which prosthetic devices are
inserted; infection in these cases would be
disastrous for the patient
34. Antibiotics are administered
intravenously, generally 30 minutes prior
to incision.
Postoperative administration of
preventive systemic antibiotics beyond
24 hours has not been demonstrated to
reduce the risk of SSIs
36. Preoperative patient
preparation
Category IA
Identify and treat all infections remote from the
surgical site; delay operation in elective cases
until infection is treated
Do not remove hair.
If hair removal is required, it should be removed
immediately before operation and preferably
with electric clippers
37. Category IB
Patients should cease tobacco consumption in
any form for at least 1 month preoperatively
Optimize blood glucose level and avoid
hyperglycemia
Patients are to shower/bathe with antiseptic on
at least the night before surgery
Necessary blood products may be administered
39. No recommendations are made regarding the
following:
Gradual reduction/discontinuance of
steroid use before elective surgery
Enhanced nutritional intake solely to
prevent SSI
Preoperative topical antibiotic use in nares
to prevent SSI
Measures to enhance wound space
oxygenation.
41. Keep fingernails short.
Scrub hands and forearms as high as the
elbows for at least 2-5 minutes with
appropriate antiseptic
After scrub, keep hands up with elbows
flexed and away from the body; use a sterile
towel to dry the hands and put on a sterile
gown and gloves
Masks should be worn.
42. The hair on the head and face is to be covered with a hood
or cap
Liquid-resistant sterile surgical gowns and sterile gloves
are to be worn by scrubbed surgical team members
Visibly soiled gowns are to be changed
Personnel with skin lesions that are draining are to be
excluded from duty until treated and the infection has
resolved
Educate and encourage surgical personnel regarding
reporting illness of transmissible nature to supervisory and
occupational health personnel
43. Category II
Clean under the fingernails prior to the
first scrub of the day
Do not wear arm/hand jewelry
44. operative and postoperative
wound care
category IA
Asepsis is necessary in the insertion of
indwelling catheters,
such as intravascular,
Spinal
epidural catheters
subsequent infusion of drugs.
45. Category II
Use sterile technique for wound
dressing change
Educate the patient and relatives
regarding wound care symptoms of SSIs
and the need to report such problems
46. Category IB
Handle tissues gently with good
hemostasis,
minimize foreign bodies
minimize devitalized tissue and dead space
For class III and IV wounds, use delayed
closure or leave the wound incision open to
heal by secondary intention.
47. If draining of a wound is necessary, the
drain exit should be via separate incision
distant from the wound; remove the
drain as soon as possible
Primary closed incisions should be
protected with a sterile dressing for 24-
48 hours
Hands are to be washed before and
after wound dressing changes/or contact
49. Maintain positive-pressure ventilation of the
operating suite relative to corridors and
surrounding areas
Maintain a minimum of 15 air changes per hour,
with at least three being fresh air
Appropriate filters (as recommended by the
American Institute of Architects) should be used
for filtration of all air, whether recirculated or
fresh
Air should enter through the ceiling and exit
near the floor
Keep operating room doors closed except for
necessary entry
The use of ultraviolet lamps in the theater is not
necessary as a deterrent of SSI
50. Prior to subsequent procedures, visibly soiled
surfaces should be cleaned with Environmental
Protection Agency (EPA)–approved
disinfectants
After a contaminated or dirty procedure, special
cleaning or closure of the operating suite is not
necessary
Use of tacky mats prior to entry in the operating
suite is not necessary
Sterile surgical instruments and solutes should
be assembled just prior to use
All surgical instruments should be sterilized
according to guidelines; flush sterilization
should only be used for instruments that are
required for immediate patient use
51. Category II
Limit the number of personnel entering the
operating suite.
Orthopedic implant surgery should be
performed in an ultraclean-air environment.
Wet-vacuum the floor of the operating
theater at the end of day/night using an
EPA-approved disinfectant
52. TAKE HOME MESSAGE
Although an SSI rate of zero may not be
achievable, continued progress in
understanding the biology of infection at
the surgical site and consistent
applications of proven methods of
prevention will further reduce the
frequency, cost, and morbidity
associated with SSIs.