Wound sepsis and infections


:Definition
It is a subtype of surgical infection that occurs following the breakdown of local &
.systemic host defenses
(Pathology: (4 stages 
contamination .1
inflammation .2
Suppuration .3
Healing .4
Pathogenesis
Wound infection usually stated during or after operation with bacteria 
.(from the patient (autogenous) or due to contamination (exogenous
:The risk of infection increased by 
Rough surgical manipulation with devitalization of tissues & leaving a .1
.large dead space with haematoma formation
.Long time tissue exposure .2
patient defensive mechanisms due to….DM, chemotherapy,↓ .3
…corticosteroids, RF

:Clinical Picture 
:Symptoms
(History of recent operation (within 10 days
General : FAHM
.Local: pain, swelling
:Signs
.Wound is swollen, indurated → abscess burst to form sinus discharging pus

:Prophylaxis of wound infection

:Good aseptic precautions .1

Skin preparation, sterilization, care of operative theaters. avoid -
.excessive dressing
:Proper surgical techniques .2
Gentle handling of tissue, haemostasis, avoid excessive cauterization, -
avoid excessive unnecessary sutures and dead spaces and put a drain if it is
.needed
:Support body defenses .3
.Good nutrition, blood transfusion if indicated -
:Prophylactic antibiotics .4
? When? How -

:Treatment of wound infection

.Suitable antibiotics: usually broad spectrum for aerobic or anaerobic .1
.Removal of foreign bodies, stitches or pack .2
.Evacuation of haematoma .3
4. Care of wound. If wound infection occurred early drainage of .4
.infection

PRINCIPLES OF ANTIBIOTIC PROPHYLAXIS

 SURGICAL PROPHYLAXIS

Definition:The administration of an antibiotic prior to a surgical 

.procedure to prevent postoperative infection