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Posted: January 13th, 2019

Reducing Surgical Site Infections: A Guide for Patients and Healthcare Providers

Reducing Surgical Site Infections: A Guide for Patients and Healthcare Providers

Surgical site infections (SSIs) are infections that occur at the site of a surgical incision. They are a serious complication that can prolong the hospital stay, increase the risk of death, and lead to additional surgeries. SSIs can be caused by a variety of bacteria, including Staphylococcus aureus, Enterococcus faecium, and Escherichia coli. These bacteria can enter the surgical wound through the skin, the air, or the surgical instruments.

According to the Centers for Disease Control and Prevention (CDC), SSIs are the most common type of healthcare-associated infection, accounting for 31% of all infections reported by acute care hospitals in the United States. SSIs affect about 2% of patients who undergo surgery in developed countries, and up to 11% of patients in low- and middle-income countries. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies.

SSIs are not only a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at an additional cost of US$ 900 million per year. SSIs also increase the use of antibiotics, which can lead to antibiotic resistance and make infections harder to treat.

How to Prevent SSIs

There are a number of things that can be done to prevent SSIs, both by patients and healthcare providers. The World Health Organization (WHO) has issued global guidelines for the prevention of SSIs, based on systematic reviews of the best available evidence. The guidelines cover three phases of surgery: preoperative, intraoperative, and postoperative.

Preoperative measures:

– Patients should bathe or shower with an antiseptic soap before surgery.
– Patients should not shave the hair at the surgical site, as shaving can cause skin irritation and increase the risk of infection. If hair removal is necessary, it should be done with clippers or depilatory creams.
– Patients should receive antibiotics before surgery, as recommended by the guidelines. The antibiotics should be given within 60 minutes before the incision, and should be stopped within 24 hours after surgery.
– Patients should inform their surgical team about their medical history, especially if they have diabetes or another chronic illness that can affect wound healing.
– Patients should stop smoking before surgery, as smoking can impair blood circulation and oxygen delivery to the wound.

Intraoperative measures:

– Healthcare providers should use sterile surgical instruments and techniques, and follow standard precautions to prevent cross-contamination.
– Healthcare providers should keep the surgical site clean and dry, and avoid touching it unnecessarily.
– Healthcare providers should use an appropriate antiseptic solution to disinfect the skin before making the incision.
– Healthcare providers should use sterile drapes to cover the patient and the operating table, leaving only the surgical site exposed.
– Healthcare providers should maintain adequate ventilation and temperature control in the operating room, and minimize traffic and noise.

Postoperative measures:

– Healthcare providers should monitor the surgical site for signs of infection, such as redness, swelling, pain, pus, or fever.
– Healthcare providers should change the dressing regularly, using sterile gloves and aseptic technique.
– Healthcare providers should educate patients and their caregivers on how to care for the wound at home, including how to clean it, how to change the dressing, and when to seek medical attention.
– Patients should follow the instructions given by their healthcare providers on how to care for their wound at home.
– Patients should avoid touching or scratching their wound, as this can introduce bacteria and delay healing.
– Patients should report any signs of infection to their healthcare providers as soon as possible.

Conclusion

SSIs are a major cause of morbidity and mortality among surgical patients worldwide. They can be prevented by following evidence-based guidelines and best practices. Patients and healthcare providers have a shared responsibility to reduce the risk of SSIs and improve patient outcomes.

Bibliography

CDC (2010) Surgical Site Infection (SSI) | HAI | CDC [online] Available at: https://www.cdc.gov/hai/ssi/ssi.html [Accessed 13 Jan. 2024].

WHO (2018) Global guidelines for the prevention of surgical site infection [online] Available at: https://www.who.int/teams/integrated-health-services/infection-prevention-control/surgical-site-infection [Accessed 13 Jan. 2024].

WHO (2016) Decontamination and reprocessing of medical devices for health-care facilities [online] Available at: https://www.who.int/infection-prevention/publications/decontamination/en/ [Accessed 13 Jan. 2024].

American Nurse Journal (2015) Preventing esay pro surgical-site infections [online] Available at: https://www.myamericannurse.com/preventing-surgical-site-infections/ [Accessed 13 Jan. 2024].

Johns Hopkins Medicine (n.d.) Surgical Site Infections [online] Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections [Accessed 13 Jan. 2024].

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