Prevention of Postoperative Wound infection


Surgical site infection (SSI) may occur in 5–20% after surgery. Up to 60% of SSI can be prevented. Elderly patients (70 years or more) with SSI caused by S. aureus have approximately three times greater risk of death than the same age group without infection. Bjørg Marit Andersen made an interesting scientific article about the prevention of postoperative wound infection.

 

Surgical site infection (SSI) is dependent on the type of operation and may occur in 5–20% after surgery. Up to 60% of SSI can be prevented.

Surgical site infection may occur up to 30 days after surgery and up to 1 year of the implanted prosthesis and other foreign matters. The prevention of SSI is dependent on enough resources, interest, studies, surveys, organization and responsibility.

Prevention of postoperative wound infection is done by a good hygienic and safe conditions for the patient at surgical wards, in the operation department and during the postoperative phase. It is important to have enough personnel, expertise, and resources for professional and proper surgical treatment. It is important to have also a modern sterile centre with knowledge and good storage conditions for sterile, surgical equipment.

The patient should be informed about Good body wash, including the hair, and change to clean clothes—from the inside to the outside –before hospitalization. Use a disinfecting soap containing chlorhexidine the night before and in the morning. To Quit smoking at least 1 month before elective surgery. Do not shave the area to be operated on before surgery. Preferably admission the same day as the operation. Not be placed together with patients with infections — either before or after surgery. Do not touch the wound or the bandages. The physiotherapist will help you with breathing so you get well soon after surgery.

Superficial Wound Infection Occurring within 30 days after the operation, involving the skin, subcutaneous tissue or musculature over fasciae. The clinical sign could be: 1) pus from the wound or the drain. 2) Microorganism isolated from sore fluid prior to primary suture. 3) The wound is opened/drained.

Deep Wound Infection Inflammation/pus involves deeper tissues (like the fascia, intra-abdominal, intramuscular, osteitis, arthritis, mediastinitis). It occurs within 30 days postoperatively or up to 1 year after implant (foreign) prosthesis, a metal wire (sternum, etc.). The clinical sign could be: 1) It involves tissue under the fascia. 2) pus from the wound or the drain. 3) Wound is opened spontaneously with pus production. 4) patient could have a fever (>38 °C) and/or localized pain or tenderness. 5) Abscess occurs.

After general surgery, the risk of death maybe 7.5% with one postoperative infection, and if there are more hospital infections in the patient at the same time, the risk of death may increase to 17.1%.

Elderly patients (70 years or more) with SSI caused by S. aureus have approximately three times greater risk of death than the same age group without infection.

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