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Surgical site infections (SSIs)

11/1/2009

What are surgical site infections (SSIs)?

A surgical site infection is one that occurs following surgery, around the site of the surgical incision. While SSIs are uncommon, they occur in about 1%-3% of every 100 surgery patients.

Some of the common symptoms of a surgical site infection are:

  • Redness and pain around the area where you had surgery
  • Drainage of cloudy fluid from your surgical wound
  • Fever


Can SSIs be treated?

Yes, most surgical site infections can be treated with antibiotics. The antibiotic given depends on the bacteria (germs) causing the infection. Sometimes patients with SSIs also need another surgery to treat the infection.

What are some of the things that hospitals are doing to prevent SSIs?

To prevent SSIs, doctors, nurses, and other healthcare providers:

  • Clean their hands and arms up to their elbows with an antiseptic agent just before the surgery.
  • Clean their hands with soap and water or an alcohol-based hand rub before and after caring for each patient.
  • May remove some of your hair immediately before your surgery using electric clippers if the hair is in the same area where the procedure will occur. They should not shave you with a razor.
  • Wear special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean.
  • Cleanse your body and site of surgery with a special product to reduce the number of germs on your body.
  • For certain surgical procedures they may give you antibiotics before your surgery starts. In most cases, you should get antibiotics within 60 minutes before the surgery starts, and the antibiotics should be stopped within 24 hours after surgery.


What can I do to help prevent SSIs?

Before your surgery:

  • Tell your doctor about other medical problems you may have. Health problems such as allergies, diabetes, and obesity could affect your surgery and your treatment.
  • Quit smoking. Patients who smoke get more infections. Talk to your doctor about how you can quit before your surgery.
  • Do not shave the area near the surgical site. Shaving with a razor can irritate your skin and make it easier to develop an infection.
  • Take a shower or bath the night before and morning of your surgical procedure, washing with an antiseptic soap (chlorhexidine is the most effective), paying particular attention to the area of your body that will be operated on. During your preoperative visit ask if you can be given soap containing chlorhexidine to take home for this purpose.


At the time of your surgery:

  • Speak up if someone tries to shave you with a razor before surgery. Ask why you need to be shaved and talk with your surgeon if you have any concerns.
  • Ask if you will get antibiotics before surgery.


After your surgery:

  • Make sure that your healthcare providers clean their hands either with soap and water or an alcohol-based hand rub before your exam.
  • Avoid touching your wound. Family and friends who visit you should not touch the surgical wound or dressings.
  • Family and friends should clean their hands with soap and water or an alcohol-based hand rub before and after visiting you. If you do not see them clean their hands ask them to do so.


What do I need to do when I go home from the hospital?

  • Before you go home, your doctor or nurse should explain everything you need to know about taking care of your wound. Make sure you understand how to care for your wound before you leave the hospital.
  • Always clean your hands before and after caring for your wound.
  • Before you go home, make sure you know whom to contact if you have questions or problems after you get home.
  • If you have any symptoms of an infection, such as redness and pain at the surgical site, drainage, or fever, call your doctor immediately.
  • Surgical site infections may not always occur within a few days or a week; if signs of infection are seen even a few weeks after surgery notify your doctor.


*This material is excerpted from the “Patient Guides on Healthcare-Associated Infections” co-sponsored by SHEA, IDSA, AHA, APIC, CDC and the Joint Commission.

Resources:
http://www.shea-online.org/about/compendium.cfm

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