Surgical site infection (SSI)
surgical site infections are responsible 38% of nosocomial infections DEF: Infection within 30 days of operation
Excption: Infection within 1 year if prosthetic device used. By def. it must contain purulent drainage, positive cultures or documentrd abscess
Classification:
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Superficial SSI: skin & subcutaneous plane (47%)
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Deep SSI: subfascial and muscle plane (23%)
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Organ/ space SSI: intra-abdominal, other spaces (30%)
Staph. aureus- most common organism E coli, Entercoccus , B fragilis
Risk factors:
- . age
- . malnutrition
- . obesity
- . Immune compromised
- . poor surgical technique
- . prolonged surgery
- . preoperative shaving
- . type of surgery
Diagnosis:
Sup.SSI- Local signs: erythema, oedema, discharge and pain Treatment: antibiotics & remove suture/clips and drainage of pus (ClS).
Deep infections:- no local signs, fever, pain, hypotension, need investigations. Treatment: surgical / radiological intervention.
Prevention: A- Pre-op:
- Treat pre-existing infection
- Improve general nutrition
- Shorter hospital stay
- Pre-op. shower
- Hair removal
- shaving vs clipping
B- Intra-operative:
- Antiseptic technique
- Good surgical technique
- Normothermia
C- Post-operative:
- Wound dressing in 48-72 hours
- Early drain removal
- Blood sugar control
