Postdischarge Strategies to Decrease Surgical Site Infection Risk in Patients with Pets
October 15, 2019 | Special HTA Reports
Patients who undergo surgery are at risk of developing an infection at or near surgical incisions. SSIs can be superficial, involving only the skin, or more serious involving tissues under the skin (fascial and muscle layers), organs or organ space manipulated during the surgical procedure, or implanted materials (e.g., prosthetic mesh, sutures). Patient-related, surgery-related, and physiologic factors can increase SSI risk. Patient-related factors include diabetes mellitus, existing infection, ischemia secondary to vascular disease or irradiation, low serum albumin concentration, obesity, older age, and smoking. Surgical risk factors include inadequate surgical scrub, inadequate antiseptic skin preparation, and prolonged procedures. Physiologic states during surgery (e.g., hypothermia, hypoxia, hyperglycemia, shock, trauma) may also increase SSI risk. (See the article by Cheadle) SSIs are most commonly caused by Staphylococcus, Streptococcus, and Pseudomonas**bacteria (see Surgical Site Infections).
Despite the availability of evidence-based strategies to reduce SSI risk in healthcare settings and advances in infection control practices (e.g., improved operating room ventilation, sterilization methods, barriers, surgical technique, availability of antimicrobial prophylaxis), SSIs remain a significant cause of morbidity, prolonged hospitalization, and death. According to an article by Awad, “the mortality rate associated with an SSI is about 3%. "
In the home setting, the care received after a surgical procedure is far less structured or controlled than care received in a hospital setting. Patients with advanced age, chronic illness, or immunosuppression may be at risk for an infection acquired at home. According to a study by Woelber et al., “post-discharge SSIs constitute the majority of SSIs and pose a substantial disease burden for surgical patients globally and for different surgery types. "...