Surgical Site Infections
Post by Karla Frick, MPAS, PA-C; PAOS BOD secretary
SURGICAL SITE INFECTIONS (SSIs) - What Can We Do?
Surgical site infection (SSI) is defined as microbial contamination of the surgical wound within 30 days of an operation or within 1 year after surgery if an implant is placed in a patient. It is estimated that annual incidence of SSI in the United States is 1.07%; with over 8000 deaths directly related to SSI and a financial cost of treatment up to $10 billion. (1)
Many surgical variables have been identified as risks for SSI including antimicrobial prophylaxis, duration of surgical scrub, operating room ventilation, sterilization of instruments and environment, surgical techniques, preoperative hair removal, duration of surgery and preoperative skin preparation. It is also noted that patients, surgeons, and nurses, as well as operative room atmosphere are prime areas of concern. Various methods have been established to reduce infections in implant surgery and if proper measures are implemented, the incidence could be reduced.
As a Physician Assistant, you are in a prime position to help reduce SSI. It should be your responsibility to help police the room for appropriate sterile attire (surgical clothing, shoe covers, masks worn properly etc.). Make sure that the patient is prepped correctly and that prophylactic antibiotics are given at the proper time and at the correct strength. Make sure preoperative scrubbing is done thoroughly. During the surgical prep and draping portion of the case, ensure sterility is maintained. Intra-operatively watch sterile techniques of other members of the surgical team which allows your surgeon to focus on the case itself. Also, pay attention to the flow of staff in and out of your room and speak with those that are entering and exiting too often. Don’t be afraid to use your voice! Always put your patients first!
1. Scott RD., II . The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Atlanta, GA: Centers for Disease Control and Prevention; 2009.
Sam Dyer, PA-C, MHS