Assess SSI risk in patients, procedures
Recently released guidelines on surgical site infection (SSI) from the Centers for Disease Control and Prevention (CDC) emphasize basic infection prevention principles and minimizing risk where possible, says Alicia Mangram, MD. She was the lead author of the guidelines while at the CDC hospital infections program and now is in surgical residency at the University of Texas in Houston.
"Prior to planning an elective operation, look at the risk factors that we have mentioned and see if there is anything that can be done to change them," she recommends. While same-day surgery managers should consult the CDC SSI guidelines for specific guidance on particular factors, the following were listed as the prime characteristics that can contribute to SSI development:
1. Patient risk factors
• age
• nutritional status
• diabetes
• smoking
• obesity
• coexistent infections at a remote body site
• colonization with microorganisms
• altered immune response
• the length of preoperative stay
2.Operation risk factors
• duration of surgical scrub
• skin antisepsis
• preoperative shaving
• preoperative skin prep
• duration of operation
• antimicrobial prophylaxis
• operating room ventilation;
• inadequate sterilization of instruments
• foreign material in the surgical site
• surgical drains
• surgical technique (i.e., poor hemostasis, failure to obliterate dead space, tissue trauma)
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