Term
| Patient Associated Risk Factors for Surgical Infections |
|
Definition
- Age
- Mulnutrition
- Obesity
- DM
- Smoking
- Coexisting Infections
- Bacterial Colonization
- Immunosuppression
- Prolonged Post-Op Stay
|
|
|
Term
| Operation Associated Risk Factors for Surgical Infections |
|
Definition
- Length of surgical scrub
- Skin antisepsis
- Preoperative shaving
- Preoperative skin prep
- Length of operation
- Antimicrobial prophylaxis
- Operating theatre ventilation
- Inadequate instrument sterilization
- Foreign material in surgical site
- Surgical drains
- Surgical technique
- Post Op Hypothermia
|
|
|
Term
| Major Pathogens Associated with Surgical Site Infections |
|
Definition
- Staph. aureus
- Coagulase-Negative Staph
- Enterococcus
- Escherichia coli
- Pseudomonas aeruginosa
|
|
|
Term
| Resistance associated with: |
|
Definition
- Hospital personnel transmission
- Broad-spectrum antibiotic use
- Extended duration of antibiotic use
- Possible increase with prophylaxis
|
|
|
Term
| Class of antibiotcs not recommended for treating surgical site infections |
|
Definition
3rd Generation Cephalosporins
- Less G+ activity
- Poor anaerobic activity
- Other unnecessary coverage (organisms not encountered in surgical procedures)
- Increased cost
|
|
|
Term
| Pathogens associated with Colorectal Surgery |
|
Definition
Enteric G- bacilli
Anaerobes
Enterococci |
|
|
Term
| Prophylactic Antibiotics for Colorectal surgery |
|
Definition
PO:
Neomycin + Erythromycin or Metronidazole
IV:
Cefotetan or Cefoxitin |
|
|
Term
| Prophylactic Antibiotics for Appendectomy |
|
Definition
IV:
Cefotetan or Cefoxitin |
|
|
Term
| Pathogens associated with Appendectomy |
|
Definition
Enteric G- bacilli
Anaerobes
Enterococci
|
|
|
Term
| Pathogens associated with Cariothoracic Surgery |
|
Definition
Staph. aureus
Staph. epidermidis |
|
|
Term
| Prophylactic Antibiotics for Cardiothoracic Surgery |
|
Definition
Cefazolin
Alt:
Cefuroxime
Vancomycin |
|
|
Term
| Pathogens Associated with Vascular Surgery |
|
Definition
Staph. aureus
Staph. epidermidis
G- bacilli |
|
|
Term
| Prophylactic Antibiotics for vascular surgery |
|
Definition
Cefazolin
Alt:
Vancomycin + Ciprofloxacin OR gentamicin OR Aztreonam (if G- is a large concern, ie, groin incisions) |
|
|
Term
| Pathogens associated with Orthopedic Surgery |
|
Definition
Staph. aureus
Staph. epidermidis |
|
|
Term
| Prophylactic Antibiotics for Orthopedic Surgery |
|
Definition
Cefazolin
Alt:
Vancomycin |
|
|
Term
| Initial dosing for most antibiotics |
|
Definition
| Given after anesthesia and procedure is started within 15 minutes |
|
|
Term
| Initial dosing for Vancomycin |
|
Definition
Initiate infusion 1-2 hrs prior to incision
Need time for drug to get to tissues -- poor penetration into tissues
Infusing vanco too fast would cause "red man syndrome" |
|
|
Term
| When do you redose for antibiotic prophylaxis? |
|
Definition
General rule is you redose 1-2 x the half life of the drug
- If surgery is longer than 4 hours
- If there is major blood loss
|
|
|
Term
| What is the duration of prophylactic antibiotic therapy? |
|
Definition
- Only the single pre-op dose is necessary
- NO more than 24 hrs post-op
|
|
|
Term
| Non-Pharmacological Treatment |
|
Definition
- Normothermia
- Aggressive Glucose Control
- Fluid Resuscitation
Supplemental O2 is debatable |
|
|
