SSIs

Question 1

If an SSI is in the subcutaneous tissue, what is it classed as?

Answer 1

Superficial incisional SSI

Question 2

If an SSI is in the deep soft tissue (fascia and muscle) what is it classed as?

Answer 2

Deep incisional SSI

Question 3

If an SSI is in the organ space, what is it classed as?

Answer 3

Organ/space SSI

Question 4

Risk of SSI for the following:

1) Clean
2) Clean-contaminated
3) Contaminated
4) Dirty

Answer 4

1) <2%
2) 5-15%
3) 15-30%
4) >30%

Question 5

Name the top 5 pathogens associated with SSIs in order

Answer 5

1- S.auerus
2-CoNS
3- Enterococcus
4- E.coli
5- P.aeroginosa

Question 6

How do you reduce the incidence of SSI?

Answer 6

• surveillance
• propylactic antibiotics
• asepsis
• preparation of incision site
• warming
• oxygenation
• glucose control

Question 7

When can antibiotic prophylaxis be given to reduce SSIs?

Answer 7

• clean surgery involving the placement of a prosthesis or implant
• clean-contaminated surgery
• contaminated surgery

Question 8

When should antibiotic propylaxis NOT be given to reduce SSIs?

Answer 8

For clean, non-prosthetic uncomplicated surgery

Question 9

How are the antibiotics for prophlaxis chosen? How are they given?

Answer 9

• Via local forumlary
• consideration given to potential adverse effects
• Given as a single dose IV on starting anaesthesia, but can be given earlier as propylaxis in which a tourniquet is used

Question 10

Why does hair need to be removed prior to surgery?

Answer 10

• improved view and access

- perceived reduction in infection rate

Question 11

How should hair be removed at a surgical site?

Answer 11

Clippers preferred

Question 12

How should hair removal NOT be done at a surgical site? Why?

Answer 12

Not razors as they damage skin and cause abrasion. Consider the sweat glands.
Razors are not normally used as skin damage increases bacterial numbers

Question 13

How is surgical site antisepsis performed?

Answer 13

• 2% chlorhexidine, 10% povidone iodine
• paint versus scrub and paint
• clean-contaminated category only