The number of surgical procedures performed in the industrialised nations of Europe is steadily increasing. The prevention of surgical site infections (SSI, postoperative wound infection) is therefore becoming an increasingly important issue. SSI is currently the second most common cause of hospital acquired infections (HAIs) in Europe. The Robert Koch Institute (KRINKO) provides detailed recommendations for avoiding SSI in all three phases of an operation. Preventive measures can help to avoid most infections that occur during surgery.
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Preparing the patient
Bathing before surgery No shaving but clipping Decolonisation of S. aureus (intranasal mupirocin)
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Hand disinfection Hand wash
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Wear examination gloves where recommended. Change OR area clothing, surgical shoes, surgical cap, surgical mask, mouth and nose protection (MNS) before each operation & in case of visible soiling
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Antibiotic prophylaxis (PAP)
Use of antibiotics only when recommended
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Hand disinfection
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Sterile gowns (standard and high performance), protective shield in the OR where aerosol or secretions are present
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Normothermia
Devices for patient body warming
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Wear two pairs of gloves (double gloving)
Double gloving in the OR (sterile gloves)
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Skin disinfection of the patient
Patient’s skin disinfection
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Sterile drapes, Equipment cover, Custom procedure trays
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Sterile instruments, Antiseptic sutures
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Wound dressing: Check wound dressing after 48 hours and perform hygienic dressing change
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Controlled negative pressure therapy (CNP)
CNP: Prophylactic negative pressure wound therapy may be used on primarily closed surgical incisions in high-risk wounds and for the purpose of preventing SSI
Of course all requirements for hygiene remain important while caring for the patient’s wounds and working at the Point of Care!
Selection of recommendations for SSI prevention according to Robert Koch Institute, Germany