Infections of a Surgical Wound

Wounds usually break the continuity of the skin and permit organisms to have access to tissues and cause infection.

The first thing that you might want answered is what are wound infections? By definition a wound infection is a surgical site infection or SSI. There are the following varieties of a surgical site infection or SSI.

- A superficial incisional SSI. This is an infection that involves only skin and subcutaneous tissue.

- A deep incisional SSI. This is an infection that involves deep tissues, such as facial and muscle layers.

- An organ/space SSI. This is an infection that involves a part of the body in organs and spaces other than the incision that was opened or manipulated during an operation.

This,as you can see, is a definition of wound infection which is restricted to infections as a result of a surgical incision. If you take a broader view a more general definition would be infection of a wound which was caused by physical injury of the skin as a result of penetrating trauma from plants, animals, guns, knives or other objects.

In a hospital one of the most commonly acquired infections are infections forming in surgical wounds. These are also known to be a cause of morbidity and mortality.

The next question that might come to your mind is what causes wound infections?

In simple terms an infection in a wound is the result of deposition and multiplication of microorganisms in the surgical site of a susceptible host. There are various ways in which microorganisms can find their way into wounds. These include:

- Through direct contact. Here germs are transferred from surgical equipments or the hands of the surgeons or nurses to the wound.

- Via airborne dispersal. Micro organisms are deposited by the surrounding contaminated air.

- Self-contamination. This is a result of migration of the patient's own endogenous flora. These are present on the skin, mucous membranes or gastrointestinal tract to the surgical site.

The organisms that are mostly most commonly associated with wound infections include Staphylococcus aureus/MRSA, Streptococcus pyogenes, Enterococci and Pseudomonas aeruginosa.

To be categorized as a surgical wound infection some symptoms are as follows:

- Infection should occur within thirty days of the operation.

- There is purulent discharge from the site of the surgery.

- There is a purulent discharge from the wound or from the drain placed in wound.

- There are organisms found in the aseptically obtained wound culture.

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4 Ways to Increase the Effectiveness of Infection Control

When at home you will not take simple infections like cold and cough too seriously and simply use common medications to take care of it. But the same infections like these and many other mild ones like a urine infection can lead to more serious issues due to the presence of an earlier illness or the ever present danger of infection in a healthcare environment.

While infection control will help to contain any potentially dangerous outcomes from spreading of diseases, the following 4 points can be useful for increasing the effectiveness of such control.

· Monitor Source: Knowing the source of any infection is of critical importance. You must keep an eye on all the new admissions to the healthcare facility while also monitoring the existing patients to know if the infection was present prior to admission and has in fact come from the community or whether it is originating and spreading from within the facility itself.

· Infection Listing: Considering the number of patients and illnesses to be treated, it is a good idea to track each infection from the beginning to the finish. You must keep a record of all the patients' along with factors such as organism causing the infection, treatment administered, improvement and also any sensitivity report. Putting down the relevant dates of admission and contracting infection is very important. You can then club the patients on various aspects and analyze the gathered data.

· Identifying Patterns: The data on hand may throw up certain patterns that will help you in identifying the infection source. For example, a number of patients in the same unit with an infection may show certain similar signs and sensitivities that may indicate the possibility of a single source of infection. While an infection spread through the facility may be due to random sources or poor hygiene levels. Either way such information can help you to find out if the infection is spreading due to the staff, patients, and outsiders or because of certain procedures of the healthcare facility.

· Educate: The information of the data can be used to educate the staff and even inform the patients on how to contain the infection by taking certain basic hygienic measures or some preventive actions. The staff must be asked to stay vigilant and look out for any signs and symptoms of similar infection in differ units or among patients. Since healthcare staff works at the ground level and regularly interacts with the patients, the infections may be noticed early on enabling steps to be taken quickly to contain the situation.

Infection control must have a high priority in all the healthcare facilities because any ineffective management will lead to increased periods of illness and not to mention several cost factors. On the other hand a proper handling will not only ensure quicker treatment but will also protect the patients and staff from contracting infections. Alternatively, if you do notice a particular pattern to certain infections you can share the data with the local or state health departments which can also prove to be useful for other healthcare facilities in your area.

Did You Know These 4 Aspects of Infection Control?

Infection control encompasses all the factors that are related with the containment of infection in any healthcare facility. Due to the perpetual possibility of contracting infections in such a set-up, infection control needs to constantly on its toes looking out for possibilities of infection due to its patients, staff or any other reason within the facility. Thus infection control should be considered not a concept but a process, which is always working in the background.

The following 4 points will tell you about key matters concerning infection control.

• Standard Measures: Whether you merely suspect a patient of having a certain infection or have it confirmed on paper, there are some standard measures that must be adhered to while dealing with all the patients in any kind of healthcare facility. This includes wearing personal protection equipment like gloves, masks and gowns at all times. Also you must know how to handle used equipment whether they are to be sterilized for reuse or to be disposed of safely. Environmental cleanliness is very important and several common surfaces like the furniture and floors must be kept clean with the help of a disinfectant. And finally hand hygiene must be maintained at all times, which is a very basic yet one of the most effective ways to prevent spread of infections.

• Isolation: A patient may be required to be isolated if suspected of having a communicable infection. A healthcare facility must have such areas and even isolated room for particularly contagious diseases. Any staff treating such patients must wear gloves, gown and face masks, and should be visited by the required medical personnel only. Since such patients might experience loneliness, their psychological needs and physical comfort must be well looked after.

• Training and Education: Some regions have made infection control training mandatory for certain medical professionals and particular fields in the healthcare industry. Accordingly, certain recognized organizations offer standardized training to health professionals. Some training modules also award a practitioner certificate subject to particular qualifications, experience and passing the relevant examination. Such certification has to be renewed after a certain number of years to keep your skills and knowledge updated. Besides this even healthcare facilities can impart certain education to their staff about effective infection control by taking the necessary precautions during treatment and safe disposal of infected materials afterwards.

• Investigation: Investigation may be required in a healthcare facility if an infection is seen in several patients or a certain pattern is noticed. A team will be required to investigate such matter and can collect and analyze information to find out if the infection is spreading due to random factors concerning people or place or if there is an outbreak. Accordingly steps can be taken to contain the situation. Investigation also helps to avoid such infections from spreading in the future.

A healthcare facility must have policies in place to manage the above factors effectively and in a way that not only there is constant monitoring for early detection but also a mechanism to take corrective actions immediately.