Postoperative infection always has been a feared complication of surgical procedures. Skin incision, organ manipulation, and surgical trauma increase the likelihood for development of local infection. Surgical procedures traditionally are classified as clean, clean-contaminated, and contaminated (Table 249-8).
Germs can infect a surgical wound through various forms of contact, such as from the touch of a contaminated caregiver or surgical instrument, through germs in the air, or through germs that are already on or in your body and then spread into the wound.
Surgical risk factors include prolonged procedures and inadequacies in either the surgical scrub or the antiseptic preparation of the skin.
Staphylococcus is one of the five most common causes of infections after injury or surgery. It affects around 500,000 patients in American hospitals annually. It is abbreviated to “S. aureus” or “Staph aureus” in medical literature.
PREVENTION OF SURGICAL SITE INFECTIONS
The most critical factors in the prevention of postoperative infections, although difficult to quantify, are the sound judgment and proper technique of the surgeon and surgical team, as well as the general health and disease state of the patient.
Risk factors associated with postoperative complications were the presence of comorbidities, higher ASA grade, higher BMI, emergency surgery, open surgery, palliative surgery, deeper cavity surgery, higher intraoperative blood loss, prolonged duration of surgery, the occurrence of intraoperative complications, and ...
Equipment – medical equipment that enters the body can introduce bacteria and infection into the body. For example, urinary catheters, intravenous drips and infusions, respiratory equipment, and drain tubes. Wounds – wounds, incisions (surgical cuts), burns, and skin ulcers are all prone to infection.
The majority of SSIs are caused by an endogenous infection, which is when the incision becomes contaminated with microorganisms derived from the patient's skin or from an opened internal organ.
Wounds break the continuity of the skin and allow organisms to gain access to tissues and cause infection.
A surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. Surgical site infections can sometimes be superficial infections involving the skin only.
Some postoperative complications are related to the exact surgery that you have had, but many (such as wound infection) may occur after any kind of surgery. The most common postoperative complications include fever, small lung blockages, infection, pulmonary embolism (PE) and deep vein thrombosis (DVT).
Patient risk factors for wound infection include advanced age, malnutrition, hypovolemia, obesity, steroid use, diabetes, use of immunosuppressive agents, smoking, and coexistent infection at a remote site.
Most infected wounds are caused by bacterial colonization, originating either from the normal flora on the skin, or bacteria from other parts of the body or the outside environment. The most common infection-causing bacteria is Staphylococcus aureus and other types of staphylococci.
Hand hygiene and strict asepsis during dressing changes are critical. Monitor the patient's temperature; as needed and ordered, implement warming techniques. At discharge, carefully review postoperative instructions with the patient.
What causes post-operative sepsis? A condition that has caused a hole in the bowel can result in normal 'friendly' bacteria to spill out into the abdominal cavity. Surgeons can wash the areas with sterile fluids, however, the bacteria may still be present and multiply.
Hospital-acquired infections are caused by viral, bacterial, and fungal pathogens; the most common types are bloodstream infection (BSI), pneumonia (eg, ventilator-associated pneumonia [VAP]), urinary tract infection (UTI), and surgical site infection (SSI).
Healthcare associated infections (HAIs) are infections that people catch when they are receiving care in a healthcare facility – for example, in hospital, at a GP surgery, in a nursing home, or even at home. Bacteria are the most common cause of HAIs.
Common general postoperative complications include postoperative fever, atelectasis, wound infection, embolism and deep vein thrombosis (DVT). The highest incidence of postoperative complications is between one and three days after the operation.
Risks. Understand how certain health factors, conditions, or habits such as age, smoking, obesity, and sleep apnea may increase the chance for complications. Certain health factors can increase surgery and anesthesia risks.
Poor wound healing can occur due to the disruption of any of the three phases of healing. Common risk factors for abnormal healing include the presence of necrotic tissue, infection, ischemia, smoking, diabetes, malnutrition, glucocorticoid use, and radiation exposure.