Surgical Site Infections

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Surgery is usually a life-saving procedure used to treat different diseases and illnesses. Although many surgeries have a high success rate, there are significant risks that come with going under the knife. In most cases, the benefits of surgery far outweigh the risks, which is why doctors recommend necessary procedures to their patients. One significant risk of surgery is surgical site infections that occur post-op. Although the highest care is taken to maintain sterile conditions both in the operating theatre and in caring for patients afterward, cases of infections still occur in patients. Surgical site infections are preventable and treatable when they do occur. This paper will examine the effects of surgical site infections on healthcare, prevention, treatment, and effects of technology in managing surgical site infections.

The Centers for Disease Control and Prevention defines surgical site infections as “an infection that occurs after surgery in the part of the body where the surgery took place” (Borchardt & Tzizik, 2018). These infections may be superficial and only affect the skin, but in some cases, it goes deeper into the organs and tissue under the skin. The CDC classifies surgical site infections into three. The first is superficial incisional surgical site infection which only affects the skin around the surgical incision. The second type is a deep incisional surgical site infection, affecting tissue and muscle under the incision. The third type is an organ and space surgical site incision, which affects any other area of the body besides that in the first two types. This includes any body organs and space between the organs. The deeper infections are more challenging to treat and could pose a significant threat to the patients’ health, especially when they are not quickly discovered and treated. Some of the main symptoms that help patients and health providers detect a surgical site infection include fever, pain, warmth, redness around the site, and discharge of cloudy fluid or pus from the surgical wound. When these symptoms occur after a surgical procedure, they must be quickly addressed to prevent further harm to the patient.

Surgical site infections are caused by germs, the most common of which are streptococcus, pseudomonas, and staphylococcus. These germs come into contact with a surgical incision in different ways. One of these is contact through contaminated surgical instruments, touch from a caregiver, and germs already in the body that spread after surgery. Different types of surgical wounds present varying degrees of risk of developing a surgical site infection. There are four types of surgical wounds. Clean wounds do not involve an internal organ and are clean and uncontaminated at the time of surgery (Borchardt & Tzizik, 2018). Clean-contaminated wounds involve an internal organ but have no infection at the time of surgery. The third type of surgical wound is a contaminated wound that involves internal organs whose contents spill into the incision. The fourth type is a dirty wound which is known to be infected at the time of surgery.

Surgical site infections have a significant effect on healthcare. One of these is financial costs. Patients who develop surgical site infections require prolonged hospitalization, diagnostic procedures, and treatment, which costs money. Badia et al. conducted a study on the effects of surgical site infections. They found that patients with SSIs had, on average, double the admission times of patients who did not have any SSIs. Additionally, some patients may require reoperation after the SSI, which further adds to their financial burden. For example, in France, patients with SSIs spent on average €17434 more on treatment than patients who did not get an infection (Badia et al., 2017). Hospitals also suffer adverse effects when their patients develop SSIs. For example, longer admission times for patients take away medical resources that could have been used in other ways, such as caring for other patients. Other patients also suffer when their treatments and surgeries have to be delayed as health providers address SSIs in other patients.

Surgical site infections pose a significant threat to the well-being of patients and the healthcare system. Because of this, hospitals, healthcare providers, and other relevant bodies have come up with preventive measures to avoid SSIs. One of these organizations is the Centers for Disease Control and Prevention that published guidelines for the prevention of surgical site infections in 2017. The number of surgeries in the US continues to increase with time, and patients face a lot of risks, one of which is SSIs. One prevention measure is strict hygiene measures. Doctors and other healthcare providers involved in surgery should thoroughly clean their hands and arms up to the elbow just before getting into the operating room. Healthcare providers should also clean their hands before and after caring for each patient with an alcohol-based rub or soap and water (Berríos-Torres et al., 2017). During surgery, surgeons and other providers should wear protective clothing such as masks, gowns, gloves, gowns, and hair covers to prevent the spread of germs. Patients should also bathe with soap or antiseptic agents before their surgery to eliminate any germs on their bodies (O’Hara et al., 2018). The surgical site should be cleaned with alcohol-based agents. These guidelines provide a comprehensive guide to the prevention of surgical site infections.

Treatment of surgical site infections depends on the severity and location. Antibiotics are the most common treatment for surgical site infections. These antibiotics may be administered orally or through IV. The healthcare providers may drain any abscess from the wound for testing to determine which antibiotics work best. Some SSIs require surgery to treat, especially those that involve organs. During the procedure, doctors reopen the wound, drain and test any fluid, remove dead or infected tissue, disinfect the wound with saline solution, and close it back up (Rickard & Beilman, 2020). Surgical wounds require regular dressing, which may be done by a healthcare provider or the patient themselves. This involves removing the old dressing, cleaning the wound with prescribed material, and then covering it with new dressing. Surgical site infections vary in the time they take to heal and the treatments required.

Technology and informatics are critical in addressing surgical site infections. Data gathered from patients help in discovering and treating any SSIs much faster. A study conducted by Lee et al. examined the effects of patient data on the surveillance of SSIs. Patients used apps in their smartphones to send images and other data on their post0surgery wounds to their healthcare providers. It was found that such remote monitoring of post-surgery recovery helped healthcare providers follow their patients’ progress and address any infections as soon as possible (Lee et al., 2019). Telemedicine is another useful way of diagnosing SSIs and monitoring patients” progress post-surgery. Telemedicine is especially useful in cases where patients are far from their health providers and may not have easy access to them. Telemedicine involves conducting post-op interviews with patients to determine their progress and if there is a chance that they may have post-surgery infections (Sandberg et al. 2019). Patients with suspected SSIs are advised to visit the hospital as soon as possible, meaning they can get treated sooner before their infections spread further and pose a severe risk to their health.

In summary, surgical site infections are a common occurrence post-surgery. There are various preventive and treatment measures available to deal with SSIs that reduce the risk to patient’s health and wellbeing.

References

Badia, J. M., Casey, A. L., Petrosillo, N., Hudson, P. M., Mitchell, S. A., & Crosby, C. (2017). Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. Journal of Hospital Infection, 96(1), 1-15.

Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., … & Schecter, W. P. (2017). Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA surgery, 152(8), 784-791.

Borchardt, R. A., & Tzizik, D. (2018). Update on surgical site infections: The new CDC guidelines. Journal of the American Academy of PAs, 31(4), 52-54.

Lee, J. R., Evans, H. L., Lober, W. B., Lavallee, D. C., & ASSIST Investigators. (2019). A stakeholder-driven framework for evaluating surgical site infection surveillance technologies. Surgical infections, 20(7), 588-591.

O’Hara, L. M., Thom, K. A., & Preas, M. A. (2018). Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): a summary, review, and strategies for implementation. American journal of infection control, 46(6), 602-609.

Rickard, J., & Beilman, G. (2020). A global strategy for the management of surgical infections. Surgical infections, 21(6), 477-477.