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Prevention of Surgical Site Infections at UWHC HF#7217

Surgery



 



Surgical Site Infections (SSIs)

 

Surgical site infections (SSIs) may occur after having surgery.  The infection can be at the incision site or it can be deep in the part of the body where surgery occurred.  Most patients do not get an infection after surgery.  In the U.S., SSIs occur in 2%-5% of patients who are admitted to the hospital after surgery.  That is about 500,000 SSI cases each year.  Most SSIs can be treated with antibiotics, but some patients may need surgery. 

 

Symptoms of SSIs include

  • Pain or tenderness at surgical site
  • Swelling 
  • Redness 
  • Fever 
  • Increased drainage or cloudy drainage from incision

 

Contact your doctor right away if you have any of these symptoms after your surgery.

 

Practices that UW Hospital and Clinics follow to prevent SSIs

 

  • Screening - If possible, your doctor or nurse will complete screening tests or ask questions to find out if you are a carrier of bacteria called S. aureus or MRSA.  If you are a carrier, measures can be taken to reduce these bacteria on your skin before surgery.
  • Handwashing - The surgical team will clean their hands and arms with an antiseptic agent before surgery.  Any healthcare providers who care for you during your hospital stay should first clean their hands with soap and water or an alcohol-based hand rub. 
  • Preparing the surgical site - Clippers, not a razor, may be used if needed to remove hair from the surgical site.  You will be asked to clean your skin with a special soap on the night before and morning of surgery.  An antiseptic liquid will be applied to the surgical site right before surgery.
  • In the operating room - The surgical team will wear special hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean.  
  • Antibiotics - You will be given an antibiotic before your surgery starts.  In most cases, you will get it within 1 hour of the start of surgery.  The antibiotic will be stopped 24 hours after surgery.  If you have certain allergies or carry bacteria called MRSA on your skin, you will be given an antibiotic 2 hours before your surgery starts.

 

More about screening for S. aureus and MRSA

 

Some SSIs are caused by bacteria called S. aureus.  Sometimes S. aureus can be resistant to treatment with most antibiotics.  This type of S. aureus is called MRSA.  In order to know if you carry these bacteria on your skin, you will be tested for them before your surgery.  S. aureus is often found in the nose, so the test consists of swabbing each nostril.  If there is not enough time for you to be tested, you may be asked questions to find out if you are high risk for carrying these bacteria.  If you are found to carry S. aureus or MRSA, your doctor or nurse will provide you with details on what can be done to further reduce your risk of SSI.

 

What you can do to help prevent SSI 

 

  • Discuss health problems with your doctor before surgery.  Problems such as diabetes, allergies, obesity, and current or past infections including MRSA could affect your treatment.
  • People who smoke are more likely to get a SSI.  If you smoke, talk to your doctors about ways to quit smoking before your surgery.
  • Do not shave near the area where you will have surgery for at least 2 days before surgery.  Shaving with a razor can create nicks and cuts in your skin.  These can increase your risk of getting an infection. While in the hospital, if anyone tries to shave you at the surgical site using a razor before surgery, please speak up and question them.  Electric clippers may be used.
  • Follow directions given to you for bathing the night before and morning of surgery.
  • If you are found to carry the bacteria S. aureus or MRSA, follow the directions given to you by your nurse or doctor. 
  • Make sure that healthcare workers wash their hands with soap and water or alcohol-based hand rub before they touch you.  If you do not see them wash their hands, do not be afraid to ask them to.
  • People who visit you in the hospital should also wash their hands with soap and water or alcohol-based hand rub when they enter your room.  They should not touch your wound or dressing.  If your visitors are ill, please ask that they not visit you in the hospital.
  • Make sure you know how to care for your wound before going home.  This includes knowing who to contact if you have any problems or questions.

 

The Spanish version of this Health Facts for You is #7220.

 

 

References

 

Bode L, et al. Preventing Surgical-Site Infections in Nasal Carriers of Staphylococcus aureus. N Engl J Med, Vol. 362, No. 1. January 7, 2010.

 

FAQs about "Surgical Site Infections". The Society for Healthcare Epidemiology of America. http://www.shea-online.org/ForPatients.aspx

 

Perl T, et al. Intranasal Mupirocin to Prevent Postoperative Staphylococcus aureus Infections. N. Engl J Med, Vol. 346, No. 24. June 13, 2002.

 

Strategies to Prevent Surgical Site Infections in Acute Care Hospitals. Infection Control and Hospital Epidemiology. Vol. 29, No. S1, A Compendium of Strategies to Prevent Healthcare Associated Infections in Acute Care Hospitals (October 2008), pp. S51-S61.



The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/01/2011

Copyright © 05/25/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7217

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