Surgical Site Infection

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Surgical Site Management

Surgical site management in the post-operative time frame is paramount in preventing infection and wound dehiscence. It is essential to use practical knowledge in good wound cleansing and skin care and in providing moisture balance in surgical site wound care management.

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bioburden management

Surgical site infections (SSIs) are a risk for the more than 10 million patients who undergo inpatient surgical procedures every year in the United States. Between 300,000 and 500,000 Americans develop SSIs annually. SSIs are defined as infections related to an operative procedure that occur at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted.

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Aseptic: Aseptic surgical procedures are those that aim at eliminating the risk of transmission of all harmful microorganisms. Aseptic practices can prevent the cross-contamination of pathogens.

Bioburden: The number of microorganisms within a wound is referred to as bioburden. Bioburden management is crucial in post-operative care to prevent infection.

Cellular/tissue-based products: These are products, commonly derived from cadavers or other human and other animal cells, that can aid in closing dehisced surgical wounds by providing a substitute for the skin to act as a barrier while healing.

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Preventing Cross-Contamination

Surgical site infections (SSIs) are wound infections that occur after invasive surgical procedures. Depending on the location of the wound and the level of post-operative care that the patient receives, the risk of developing an SSI can be as high as 20%,1 although across all patients undergoing inpatient procedures in the United States, the rate of SSI occurrence is between 2% and 4%.2

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Dehiscence

By the WoundSource Editors

Dehiscence occurs when a surgical incision that was closed opens, either partially or completely. Dehiscence is most likely to take place within the first two weeks after surgery, but it can occur as late as one month after surgery.

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Frequently Asked Questions

By Thomas E. Serena, MD, FACS

Conceived in the operating theater and born in the home, surgical site infections (SSIs) reach maturity in the outpatient wound clinic. The woundologist, whether surgically trained or not, must understand the prevention and treatment of SSIs and wound dehiscence. For the past two years I have had the honor of giving the SSI lecture for the WoundSource Practice Accelerator™. This year listeners had more questions than I could answer on the call or address individually. I decided to dedicate this blog to the most frequently asked questions from the October presentation.

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Surgical Wound Healing

By the WoundSource Editors

The number of surgical procedures performed in the United States has been increasing annually by as much as 300% over a 10-year period. Although technological advances in surgical procedures have allowed some procedures to be performed using minimally invasive techniques, many operations still require incisions, which require special care to prevent dehiscence and surgical site infections (SSIs). SSIs occur in 2% to 4% of all patients undergoing surgical procedures, and they are among the most expensive inpatient harms, adding approximately $30,000 to the total hospital cost per infection.

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Preventing Surgical Site Infections

By the WoundSource Editors

The Centers for Disease Control and Prevention (CDC) define a surgical site infection (SSI) as "an infection that occurs after surgery in the part of the body where the surgery took place." The CDC go on to say the infection can be superficial involving just the skin or more serious infections can occur that involve deeper structures, such as tissue under the skin, organs, or implanted devices or materials. The CDC offer tools and guidelines to prevent SSIs and provide education to the public. Public education includes tips and advice on how to prevent patient surgical sites from becoming infected. Although such steps may not always prevent a surgical wound from becoming infected, it is always important to involve the patient in postoperative care.

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Surgical Wound Infection Assessment

By the WoundSource Editors

With an associated cost of $3.5 billion to $10 billion spent annually on surgical site infections (SSIs) and complications in the United States, it is important to know how to assess for surgical wound complications. There is a difference between the normal cascade response and a brewing infection. Symptoms of infection are often the first clue that there is more occurring in the wound than meets the eye.

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SSI

by the WoundSource Editors

Surgical site infections (SSIs) account for 20% of total documented infections each year and cost approximately $34,000 per episode. SSIs are responsible for increased readmission rates, length of stay, reoperation, morbidity, and mortality, as well as increased overall health care costs.1,2