Keywords

Surgical site infections, Microbiology, Antibiotic

Introduction

Surgical site infections (SSIs) are infections that damage the incision or deep tissue at the operation site and occur up to one month following surgery (or up to one year after surgery in patients receiving implants). Superficial incisional SSI, Deep incisional SSI, and Organ or spaces SSI are the three forms of SSI. Despite advancements in prevention, SSIs continue to be a serious clinical problem since they are linked to significant mortality and morbidity, as well as putting a strain on healthcare resources. SSIs can occur at a rate of up to 20%, depending on the surgical procedure, the surveillance criteria used, and the data collecting quality. The infections that cause many SSIs are found in the patient's endogenous flora. Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp., and Escherichia coli are the most typically isolated pathogens, depending on the type of surgery. SSI risk is influenced by a variety of patient- and procedure-related factors, therefore prophylaxis necessitates a "bundle" approach, with systematic attention to many risk factors in order to lower the chance of bacterial contamination and increase the patient's defences. The CDC's guidelines for preventing SSIs emphasise the significance of appropriate patient preparation, aseptic practise, and surgical skill; antibiotic prophylaxis is also indicated in some instances. Emerging technologies, such as microbial sealants, have the potential to encapsulate and immobilise skin flora for the duration of a surgical treatment; thus, there is a compelling justification for examining and incorporating such technologies into standard clinical practise when appropriate. Sepsis is a bacterial infection that affects patients in both surgical and medical professions. A systemic inflammatory response syndrome is present, as well as evidence or indications of infection. The pathophysiology of sepsis reveals that it affects the majority of the body's organs/systems in a process marked by disruption of vascular endothelium and organ parenchyma, which is triggered by bacterial toxins and the inflammatory process. Sepsis can appear in a variety of ways depending on severity and individual variability. It's been challenging to put together a completely uniform strategy to management advice because of the variances in individual reactions [1]. The cornerstones of successful management are early clinical suspicion, rigorous diagnostic testing, aggressive commencement of appropriate antibiotic medication, extensive supportive care, and efforts aimed at reversing predisposing conditions. In critically ill patients, measures to limit infection acquisition and transmission are crucial. Diabetes, nicotine usage, steroid use, obesity, malnutrition, prolonged preoperative stay, preoperative nares infection, and perioperative transfusion are all factors that put patients at risk for SSIs. Inappropriate antimicrobial prophylaxis, infection at a remote site not addressed prior to surgery, and other preoperative and intraoperative risk factors for SSIs Clipping vs. shaving the spot Long surgery time, insufficient skin preparation, insufficient surgical team hand preparation, operating room environment (ventilation, sterilisation), surgical attire and drapes Asepsis, Haemostasis, sterile field, and foreign bodies are surgical techniques. Prophylactic antibiotics should be stopped within 24 hours of operation completion, according to current standards. Antibiotics have not been shown to reduce surgical site infections when used after wound closure [2]. However, due to the effects of cardiopulmonary bypass on immune function and antibiotic pharmacokinetics, the Society of Thoracic Surgeons recommends that antibiotic prophylaxis be continued for 48 hours after cardiothoracic surgery [3]. There is no indication that prophylactic antibiotics should be used for more than 48 hours [4]. Antibiotics provided for pacemaker or defibrillator implantation should be stopped within 24 hours of surgery. It's critical to quit smoking and inform your surgical team about your medical history, particularly if you have diabetes or another chronic ailment. Also, refrain from shaving in the area where the surgeon intends to operate. Loved ones should not touch your wound or surgical site, no matter how curious they are. After surgery, carefully follow your doctor's wound-care instructions. If you develop a fever, pus, redness, heat, pain, or tenderness near the wound, or any other signs or symptoms of a surgical site infection, contact your doctor right once [5].

Conclusion

Antibiotics can be used to treat the majority of SSIs. To treat the SSI, more surgery or procedures may be required. Ensure that friends and family members wash their hands before and after entering your room throughout your rehabilitation. Doctors, nurses, and other caregivers should all wash their hands.

References

1. Slobogean GP, Kennedy SA, Davidson D (2008) Single-versus multiple-dose antibiotic prophylaxis in the surgical treatment of closed fractures: a meta-analysis. J Orthop Trauma 22(4):264-269.
2. Edwards FH, Engelman RM, Houck P (2006) The Society of Thoracic Surgeons practice guideline series: antibiotic prophylaxis in cardiac surgery, part I: duration. Ann Thorac Surg 81(1):397-404.
3. Ortega GM, Martí-Bonmatí E, Guevara SJ (2003) Alteration of vancomycin pharmacokinetics during cardiopulmonary bypass in patients undergoing cardiac surgery. Am J Health Syst Pharm 60(3): 260-265
4. Harbarth S, Samore MH, Lichtenberg D (2000) Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation 101(25): 2916-2921.
5. Ruiz J (2003) Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother 51: 1109-1117.