DEMOCRATIC AND POPULAR ALGERIAN REPUBLIC

MINISTRY OF HEALTH

NATIONAL INSTITUTE OF HIGHER PARAMEDICAL TRAINING

-SETIF-

Professional mini thesis

Public Health Nurse

THEME

The superinfection of wounds in the postoperative period

Thesis supervisor: Developed by:

Mr. Azizi Toufik. Bensid Hanane

Bounabi Halima

Cherit Chaima

Mezmaz Wissal

Ouchefoune Nawel

Touati Hanâa Mother of Essâad

Academic year: 2023/2024

 Thank you:

First of all, we would like to thank God the Almighty and Merciful who has
given the strength and patience to accomplish this modest work.

We would like to thank first and foremost, the director of our institute, as well as Mr.
Bounechada Nadjibl, the educational inspector.

Secondly, we would like to express our heartfelt thanks, especially to Mr. Azizi Toufik, our chief.

of option and our coach for his help, guidance, and valuable advice.

Finally, thanks to our colleagues from the 2021/2024 class and to all those, near or far,
have contributed to the development of this work.
 Table of contents
Introduction
Choice of theme :.........................................................................................................................2
Issues.............................................................................................................................3
Hypotheses..................................................................................................................................4
Theoretical section ..........................................................................................................................5
6
I. Generalities: Definitions:......................................................................................................6
II. Classification of postoperative wounds..............................................................................7
III. Classification of infections..............................................................................................8
IV. Risk factors for postoperative infection..........................................................9
a) Factors related to the intervention...........................................................................................9
b) Factors related to the patient..................................................................................................10
c) factors related to the environment......................................................................................10
V. Prevention of infections in post-operative care...............................................................11
Chapter II :...............................................................................................................................12
II.1. The preoperative preparation of the patient........................................................................12
A- personal hygiene......................................................................................................12
B - hair removal
C - the preparation of the operative field.................................................................14
II.2. Sterilization................................................................................................................17
II.2.1.The different methods of sterilization.................................................................17
II.2.2. The steps of pre-disinfection of medical instruments......................................18
practical section ....................................................... 20

1. Survey methodology ..................................................................................................21

2. Analysis and interpretation of data ...............................................................................22
2.1. The global analysis...........................................................................................................36
2.2. Verification of the hypothesis............................................................................................37
Conclusion
Suggestions
Bibliography............................................................................................................................40
Appendix ............................................................. 41
 Introduction

An infection refers to the invasion and subsequent multiplication of a microorganism.

invisible to the eye within an organ of a living body. This microorganism can be a bacterium,
a virus, a fungus or a parasite likely to cause a health problem.

Surgical site infection is an exception, it is called postoperative wound infection.

corresponds to the invasion of subcutaneous tissues by bacteria and the inflammatory response
which results in local inflammatory signs (redness, heat, swelling,
pain) and bacterial multiplication (pus discharge) in some cases of infection
extends to tissue muscular and bony adjacents.
It is a serious complication that can jeopardize the patient's vital prognosis.
postoperative infectious complications are a major problem in surgery, they
are the primary cause of morbidity and mortality in surgery and increase the cost and duration
of a patient's hospital stay.

At the surgery department - CHU of Sétif - we noticed that there is a number

a significant number of patients who had infections of their wounds post-surgery.

So, in order to arrive at answers regarding the increase in superinfection of

Post-operative wounds, we began our research work with a theoretical component that
contains two chapters and a practical section.

Theoretical aspect:

The first chapter: Generalities, classification of postoperative wounds, classification of

infections, the risk factors for postoperative infection, and prevention of infections in
post-operative.

The second chapter: the preoperative preparation of the patient, sterilization, the different
methods of sterilization, and the steps of pre-disinfection of medical instruments.

The practical section includes:

Survey methodology, overall analysis, and hypothesis verification.

Choice of theme:

1
 As part of our training and during our internship in the various departments,
particularly in the surgery service, we noticed that the majority of the wounds of
patients in postoperative are infected.

This is the case of our study on: "postoperative wound superinfection", which this
Problem we are inspired to look behind the increase in the proportions of wounds
infected in the postoperative period.

Problematic
2
 The occurrence of wound infections increases morbidity, mortality, and prolongs
the hospitalization stay of patients. They represent a major health issue especially
In the post-operative ward, their rate only continues to increase.

And for this reason, we ask the following question:

Why is the proportion of post-operative infected wounds on the rise?

Hypotheses

3
The insufficiency of the preoperative preparation of the patient affects the increase of
post-operative wound infections.

2- Failure to comply with sterilization measures for equipment leads to wound infections.
post-operative.

4
 Chapter I:
I. Generalities: Definition:

Surgery:

Medical discipline specialized in the treatment of diseases and injuries, which

consists of performing, manually and with the use of instruments, surgical acts on a body
alive.

5
Wound:

A wound can be defined as a break in the skin barrier, for any reason.
whether it is: a stab wound or a gunshot wound, a surgical wound, a burn, trauma
divers.

Infected wound:

Invasion and multiplication of microorganisms causing an inflammatory response

local and/or systemic and symptoms and clinical signs of infection (fever, redness)
, heat, pain, swelling).

Infection:

An infection is an invasion of the organism or a site of the organism by an agent.

pathogen, It can be a bacterium, a virus, a fungus, or a parasite. These micro-
Organisms can cause a disease by disrupting the normal functions of the body.

Post-operative infections:

Postoperative infections are infections that develop after a procedure.

surgical. They appear at the site of the incision and can develop on the surface of
the skin only, but also on organs, implanted material or underlying tissues
related to the skin.

II. Classification of post-operative wounds:

Class 1 – Clean: As its name suggests, these are very clean wounds. They are not
infected, inflamed and they are generally closed wounds. Moreover, the wounds of this

6
class cannot involve the respiratory system, the gastrointestinal tract or the
genitourinary tract. An example of this is a cut, which is the result of a biopsy.

Class 2 – Contaminated clean: These wounds are always clean, with no signs of infection.
and inflammation. However, these involve the parts of the body mentioned above,
which increases the likelihood of an infection. Tonsillectomy, which is the removal of
Tonsillectomy is an example of a procedure resulting in a class 2 surgical wound.

Class 3 – Contaminated: Wounds classified as contaminated may result from a

injury, of operations with major interruptions of the sterile technique or of a
gastrointestinal tract spill.

Class 4 - Contaminated wounds: These wounds have come into contact with fecal matter or
you put during the surgery. In addition, the traumatic wounds that were not properly
well-groomed belong to this category.

III. Classification of infections:

1. superficial incisional infection of surgical wound:

Any infection of the surgical wound affecting the skin and underlying tissues
cutaneous and whose diagnosis is suggested in the presence of one or more of the criteria

7
following:
Purulent fluid at the incision site;

Positive culture of the fluid or superficial tissue sampled at the incision site;

Wound with signs of infection (pain, heat, redness, swelling) with

reopening of the wound by the surgeon;

Infection diagnosis made by the surgeon.

2. deep incisional infection of surgical wound:

Any surgical wound infection that involves the muscles and fascias and whose
diagnosis is mentioned in the presence of one or more of the following criteria:

Purulent liquid at the incision site;

Spontaneous dehiscence or reopening by the surgeon in the presence of signs of infection;

Abcesses or other signs of infection on direct examination,

histopathological or radiological;

Infection diagnosis made by the surgeon.

3. Organ or space infection:

Any surgical site infection involving an organ or anatomical space

opened or manipulated during the intervention and whose diagnosis is mentioned in front of
one or more of the following criteria:
Purulent liquid from a drain placed through an incision in the organ or space;

Positive culture obtained from a fluid or tissue from the organ or space;

Abcès or other signs of infection upon direct examination,

histopathological or radiological;

Diagnosis of infection made by the surgeon.

IV. The risk factors for postoperative infection:

a) Factors related to the intervention:

- Type of surgery

8
The duration of the intervention:

The lengthening of the intervention duration negatively influences the rate

postoperative infection due to wound exposure.
A duration of 2 hours is a limit beyond which the risk increases.
thus showed that the duration of the intervention increased the probability
postoperative infections, probably due to the increased duration of
the exposure to infectious risks from manipulations and air, but also by
contamination from skin section slices by flora
deep endogenous not destroyed by antiseptics at the time of
initial skin disinfection.
The site of the intervention:

The intervention near an infected area and on a hairy and humid region
increases the risk of infection at the surgical site

b) Factors related to the patient:

The risk of postoperative infection is conditioned by the state of the patient.

and various other factors. This concerns his immune status, status
nutritional, age, diabetes, cigarette, concomitant use of steroids, long
preoperative hospitalization.

Malnutrition:

It globally increases the infectious risk by reducing the

synthesis of immunoglobulin, serum levels of proteins and
supplements by atrophy of

lymphoid tissue and the thymus and by the weakening of cell activity
macrophages, monocytes, B and T lymphocytes.

Diabetes:

When it is not balanced, it can lead to local ischemia due to micro.

9
 angiopathy multiplying the infectious risk.
The age:

It influences the rate of postoperative infection which increases at external ages.

of life (under one year and over 65 years).

Corticotherapy, chemotherapy, and radiotherapy: modify the

defenses in the sense of immunosuppression.

Abusive antibiotic prophylaxis: promotes infections at the surgical site by

modification of the physiological flora and selection of mutant floras
resistant.

c) environmental factors:

Hospitalisation

The hospital ecosystem is an environment that constitutes a risk factor

postoperative infection due to the presence of multi-resistant germs.
Indeed, the lengthening of the preoperative hospitalization period increases
the risk of infection ranging from 1% for a duration longer than one day, to 4%
for a period longer than 14 days in clean surgery.
Surgical facilities:

The absence of isolation of the operating rooms, of an anesthesia room,

The architecture of the block and its ventilation circuit influence the risk of infection.
Hygiene in the operating room in relation to the number of people present
the course of interventions and the regular cleaning of the premises play a decisive role
.

The ventilation conditions of the operating room:

The lack of air renewal influences the occurrence of infections.

postoperative due to the presence of ambient air containing charged particles
of germs.

10
V. Prevention of infections in postoperative care:

The prevention of infectious risk on a sutured postoperative wound revolves around

several axes:

the regular monitoring of the wound by the healthcare professional;

the choice of a suitable dressing for the wound, a poorly fitted dressing being the main cause
from the formation of blisters;
the careful adherence to aseptic rules during dressing changes;
Patient information on factors that may promote infection: hygiene, tobacco,
alcohol, unbalanced diet...;
the early detection of local warning signs of infection: pain, change of
color, appearance and color of the exudate...
the later detection of general signs such as hyperthermia.

11
Chapter II:

II.1. The preoperative preparation of the patient:

The preoperative skin preparation:

The objective of skin preparation is the prevention of infections at the surgical site.
This preparation consists of 3 fundamental elements:

Personal hygiene: shower or toilette,

Hair removal of the operative area (when requested by the surgeon),

The preparation of the operative field.

A- personal hygiene

The shower, or when that is not possible, the wash, allows for the elimination of a large
part of the scales present on the skin surface and reduce bacterial colonization
cutaneous. It is indicated before any surgical intervention and certain invasive procedures.
the evening and the morning of the intervention.

It will be made with a broad-spectrum antiseptic soap, based on iodinated products or

Chlorhexidine. The antiseptic soap will be from the same range as the antiseptic used.
in the operating room.

In case of formal and simultaneous contraindications to iodized products and to the

chlorhexidine, the alternative could be the use of a mild soap and an antiseptic
chlorinated.

So that the incision during the procedure takes place at the moment of skin colonization
is the weakest, it is necessary that the antiseptic shower or toilet be carried out
before the preparation of the operative field. In all cases, the shower must be taken.
after depilation.
The shower or the toilet should be designed as a complete care whose importance and
the technique must be properly explained to the patient. The quality of the execution and
its effectiveness will be monitored by the nurse particularly at the points
strategic (navel, sub-mammary grooves, nails, interdigital spaces…).

12
1- The day before the procedure: It is imperative to remove jewelry and nail polish.

Wet the hair and body.

Wash with bare hands, or with a single-use glove or a clean washcloth.

Wash from the cleanest area to the most contaminated area.

Start with the face, neck, chest, back, limbs, feet, armpits,
then the genital-anal region.

Insist on the navel, the submammary grooves, the folds, the nails, the spaces
interdigital and the genito-anal region.

Perform the soaping with vigorous, circular movements. In case

Using iodine-based soap, the foam should turn white.

Rinse thoroughly until all the foam is gone.

Dry thoroughly with a clean towel.

Put on clean pajamas.

Change the sheets and prepare the patient.

2 - The morning of the intervention: - Make sure that jewelry and prosthetics have been removed.

Proceed to take a shower using the same technique as the day before.

Carefully brush your teeth, which may be followed by a mouthwash with

an antiseptic solution.

Put on a clean block shirt.

Change the sheets and set up the patient.

13
 B - hair removal:

Hair removal aims, without harming the skin, to cut the hairs at the base when they are
embarrassing for the intervention or for the dressing. The absence of hair removal does not increase

the infectious risk. Whatever method is used for hair removal, it

always presents a higher infectious risk than the absence of hair removal.

If hair removal is desired by the surgeon (visual comfort, adhesion of the drapes)
and dressings...), it is established that:

the hair removal is further away in time from the moment of the incision
surgical, the greater the risk.When it is to be carried out, one must:

perform it as close as possible to the intervention before the shower or bathing.

perform it in the patient's room.

limit the area to be depilated: it seems desirable to develop some

specific depilation schemes for the service or surgical specialty.

C - the preparation of the operating field:

The preparation of the operating field completes the action of the shower or toilet.
preoperative. It is the final step of skin preparation. It includes 4 phases:

a detersion phase, a rinsing phase, a drying phase, an antisepsis phase

dermic.

The preparation of the operative field should preferably be done in the operating room in the
preparation room or the induction room if the architectural conditions and the organization of
the operational activity allows it

in the hour preceding the intervention. The preparation carried out under these conditions allows
a better continuity of the different stages of the procedure in a shorter time. These
Two associated elements promote the level of quality of the preparation. However, it is
imperative to complete all steps while particularly adhering to the time criteria
necessary for the activity of the products used. Also in some cases the beginning of the preparation
In the care unit, it will be the only guarantee of this completeness.

14
1/Detersion:

The cleansing must be performed after the antiseptic shower or bed bath.
better in the hour preceding the surgical intervention in order to limit the risks
decolonization of the site.

Perform the cleansing of the operative area with antiseptic soap.

starting with the incision line. In the case of multiple surgical areas, start
by the area located the highest and/or the cleanest.

Apply circularly using a sterile compress soaked in sterile water and

antiseptic soap for foaming (in case of using a Polyvinyl)
iodine pyrrolidone, the foam should turn white)

2/ Rinsing:

The rinsing must be abundant and done with sterile water and compresses.
Sterile.

3/ Drying:

Dab dry using compresses or sterile care squares.

For non-shaven cranial surgery, debridement corresponds to a shampooing

carried out in the department.

4/ Dermal antisepsis:

It must be done immediately after the cleaning:

For the patient prepared in the operating room, dermal antisepsis will consist of
the successive application of 2 coats. It is important to respect the time of
drying between the two coats.

For the patient prepared in service, the first application of antiseptic is carried out.
in the unit. The other two applications will be carried out in the block.

Draping the operating area in a sterile field is not recommended because it

accelerates the kinetics of recolonization. In any case, the last coat is
carried out, in the operating room, by a member of the team in surgical attire in

15
 using: cups, forceps, compresses and sterile gloves.
Chronology of the skin preparation of the patient:

Hair removal
Shower or
the eve or the
toilet
the day before day of
the intervention

Rinsing Detersion

asepsis of
Drying champs
operative

as a whole
in service
2nd
First application
application

16
II.2. Sterilization:
Sterilization is a process that involves completely and permanently eliminating everything.
micro-organism (bacterium, fungus, parasite, virus...) on a medical device. The
sterilization must allow for the eradication of contamination of medical equipment and
surgical.

II.2.1. The different sterilization methods:

1. Steam sterilization:

The association of heat and water (in saturated form) induces denaturation.
Protein. The operation is governed by three parameters: temperature and duration, and there is
a relationship between temperature and saturated water vapor pressure (Regnault's law)
That's why there should be no air presence inside the autoclave. The action
Bactericidal is related to the duration of the treatment.

2. Sterilization by ethylene oxide:

Used for thermosensitive materials (PVC, rubber), sterilization by oxide

ethylene is a restrictive sterilization method, practiced only in service
specialized (central sterilization unit and especially in industry). This process is
complex to implement. It requires a particular installation and significant
precautions.
It has immediate and delayed toxicity. It is toxic to personnel.
by inhalation and by contact. It is toxic to the sick by enteral route
and by reactions with different chemical bodies.

3. Plasma gas sterilization:

It is done with a Sterrad type device.

Intended for thermosensitive materials, it uses hydrogen peroxide,
which has a bactericidal, sporicidal, fungicidal, and virucidal action.
This gas is activated in plasma state (the fourth state of nature along with the states
solid, liquid, and gaseous) by an electromagnetic field induced by a wave
radio in a very depleted void. The components of the plasma thus formed
destroy the nucleic acids and cell membranes of micro-
organisms.

4. Sterilization by ionizing radiation:

It is a reliable and reproducible cold sterilization that does not require
desorption and is done in final packaging (good preservation of the
sterility).
But it imposes heavy and costly installations, subject to
authorization and controls (installation and work environment).

17
 II.2.2. The steps of pre-disinfection of medical instruments

1. Pre-disinfection and cleaning:

This step is not necessary if the medical devices are cleaned without delay.
after use. In other cases, pre-disinfection helps prevent drying of the
stains on the equipment and limit microbial contamination to protect the
personnel and its environment. After verifying that your instruments are working
good (the forceps are aligned, the handles are fixed, the joints move freely…)
put them immediately after use in a bath ofdisinfectant detergent product
without aldehyde(open pliers and scissors).

First rinse:

The first rinse eliminates the pre-disinfectant product and dirt. Rinse.
abundantly by soaking and/or with tap water.

3. Cleaning:

Cleaning is useful for removing dirt for a visually clean DM.

Once disassembled if necessary, clean the equipment in a new detergent bath.
that can be the same as that used for pre-disinfection, with the help of a brush
non-abrasive. An ultrasonic bath can be used for fine, hollow, fragile materials.
or complexes.

4. Rinsing:

Rinsing can be done by immersion in a basin or sink before being passed.

under running water.

5. Drying:

After rinsing, the medical device is dried before use (if it is a non-critical medical device) or
before high-level or intermediate-level sterilization or disinfection for the
other DM. Drying prevents the disinfectant from being diluted, avoids the
microbial multiplication and optimize the effectiveness of sterilization. It is done via
a clean absorbent non-woven support.

18
 6. Verification of the medical device:

After sterilization, check:

Cleanliness to the naked eye

The obsolescence

The absence of corrosion point

The absence of cracks
The state of operation

7. Sterilization

There are different methods of sterilization (dry heat, ethylene oxide, gas
plasma...) but sterilization by steam under pressure or moist heat
remains the reference process for reusable medical devices. Thedevice of
sterilizationmust meet the following conditions:

Having an air removal system (pump type),

Equipped with a cycle with a thermal plate of 134°C for 18 minutes,
Be able to record parameters for traceability (temperature,
pressure, duration.

19
 1. Survey methodology:

1.1. The objective of the survey:

Determine the causes of the increase in wound superinfection postoperatively

operative.

20
1.2. The place and the period of the survey:

Our survey was conducted at the surgery service - Sétif University Hospital.
The period of our survey: from January 14, 2024 to February 4, 2024
(for 20 days).

1.3. The Target Population:

The target population for the study consists of 20 staff members.

caregivers

1.4. The survey tool:

The tool used in this research is a questionnaire.

2. Analysis and interpretation of the data:

Question No. 1

How old are you?

The answers The number The percentage

Aged between 30-35 years 4 20%
Between 35-40 years old 12 60%

More than 40 years 4 20%

21
 20 20
% %

Between 30-35 years old

Between 35-40 years old

60% Over 40 years

Analysis of the results:

60% of healthcare personnel are aged between 35 and 45 years.

20% of healthcare staff are aged between 30-35 years.
20% of healthcare professionals are over the age of 45.

22
Question No. 2

What is your rank?

The answers The number The percentage

ISP 8 40%
AS 12 60%
Total 20 100%

40%
ISP
60% AS

Analysis of results:

60% of the targeted population are nursing assistants.

40% of the targeted population are public health nurses.

23
Question No. 3
Since when have you been working in the surgery department?

The answers The number The percentage

From 1 to 5 years 5 25%

From 5 years to 10 years 7 35%

For more than 10 years 8 40%

25
40 %
%
From 1 to 5 years
From 5 years to 10 years

35 More than 10 years

%

Analysis of results:
40% of healthcare personnel have more than 10 years of experience.

35% of healthcare staff have 5 to 10 years of experience.

25% of healthcare staff have 1 to 5 years of experience.

24
Question No. 4:
Are there post-operative wound infections in your department?

The answers The number The percentage

Yes 20 100%
No 00 0%
Total 20 100%

yes
no

100%

Analysis of the results:

100% of healthcare personnel confirm the existence of wound infections.
in postoperative care in the ward.

Interpretation of the results:

According to the results obtained, we conclude that the proportion of infected wounds in
post-operative is increased.

25
Question No. 5:
In your opinion, what is the main cause of postoperative infection?

The answers The number The percentage

The insufficiency of the 10 50%
preoperative preparation
Non-compliance with measures 10 50%
sterilization of the equipment
Total 20 100%

50% 50%
the insufficiency of the prep
preoperative diet
The non-compliance of
sterilization measures
the equipment

Analysis of results:

50% of paramedical staff say that the lack of pre-training

Operative is the main cause of post-operative superinfection.
50% of people say that the lack of sterilization of the equipment is the
main causes of postoperative superinfection.
Interpretation of the results:

Based on the results obtained, we conclude that there are 2 main causes of the
post-operative superinfection: the insufficiency of pre-operative preparation and the non
compliance with the sterilization measures of the equipment.

26
Question No. 6
In your opinion, does preoperative preparation reduce the risk of infection?
post-operative wounds?

The answers the number The percentage

Yes 17 85%
No 03 15%
Total 20 100%

15
%

Yes
No

85
%

Analysis of results:
85% of healthcare staff say that pre-operative preparation reduces the risk
post-operative wound infection.
15% of nurses say that preoperative preparation does not reduce the risk
of wound infection in postoperative.
Interpretation of the results:
According to the results obtained, we affirm that the preoperative preparation prevented the
risk of wound superinfection in the postoperative period.

27
Question No. 7
So; Why is the preoperative preparation insufficient in your department?

The answers The number The percentage

The service structure is not equipped. 17 85%

Done at home 3 15%

Total 20 100%

15
%

The service structure

is not equipped
Done at home
85
%

Analysis of results:

85% of healthcare staff confirm that the service structure is not equipped.
to make a pre-operative preparation.

15% of healthcare personnel say that preoperative preparation is done at home.

Interpretation of the results:

Through the obtained results, we conclude that the lack of prior preparation
operational due to the absence of equipment in the service.

28
Question No. 8
Is the equipment sterilized?

The answers The number The percentage

At the service level 20 100%
There is a centralized service 0 0%
of sterilization
Total 20 100%

At the service level

There is a central service.
sterilization device
100%

Analysis of the results:

All staff members say that the sterilization of equipment is done at the level of
service.

Interpretation of the results:

Based on the results obtained, we conclude that the sterilization of the equipment carried out
at the service level.

29
Question No. 9

What is the most commonly used method of sterilizing equipment?

The answers The results The percentage

Autoclave 20 100%
Poupinel 00 00%
Total 20 100%

Poupinel
100% Autoclave

Analysis of the results:

100% of healthcare personnel affirm that the sterilization of equipment is done

the autoclave.

Interpretation of the results:

According to the results obtained, we observe that the autoclave is the most
used in the sterilization of equipment.

30
Question No. 10

Do you follow the steps of sterilization?

The answers The number The percentage

Yes 4 20%
No 16 80%
Total 20 100%

20%

yes
no

80%

Analysis of results:

20% of healthcare personnel say they follow the sterilization steps.

80% of healthcare personnel do not follow the sterilization steps.

31
Interpretation of the results:

According to the results obtained, most nurses do not follow the steps of the
sterilization.

Question No. 11

Do you respect the duration of the sterilization of the equipment?

The answers The number The percentage

Yes 9 45%

No 11 55%

Total 20 100%

yes
no
45%

55%

Analysis of results:
32
 45% of nurses answered yes to the adherence to the duration of
sterilization of equipment.
55% of healthcare personnel answered no regarding the adherence to the duration of
sterilization of equipment.
Interpretation of the results:

Through the results obtained, we find that half of the targeted population does not
do not respect the sterilization duration of the equipment.

Question No. 12
Is the handling of the equipment done according to the standards?

The answers The number The percentage

Yes 05 25%
No 15 75%
Total 20 100%

25
%

no
yes
75
%

Analysis of results:

25% of paramedical staff handle equipment according to standards.

33
 75% of paramedical staff do not handle the equipment according to the
standards.

Interpretation of the results:

According to the results obtained, we conclude that the majority of the staff
paramedics do not handle the equipment according to the standards.

2.1. The global analysis

After this survey directed at healthcare staff in the surgical department,

we will list all the following results:

All healthcare staff confirm the increase in post infections.

operative.

Most nurses assure that the lack of preoperative preparation and the
non-compliance with sterilization measures are the causes behind the superinfections of
post-operative wounds.

It is found that the majority of healthcare personnel report a lack of equipment.

in the service this leads to a lack or insufficiency of the pre-preparation
operational.

The majority of nurses confirm that they do not comply with either the duration or the
steps for sterilizing materials as well as their mishandling.

34
 2.2. Verification of the hypothesis

According to the results of this questionnaire regarding our issue:

Why is the proportion of post-operative infected wounds in

augmentation?

We have reached the following conclusion regarding the confirmation of our

hypotheses:

1-The insufficiency of the pre-operative preparation of the patient impacts the increase of
post-operative wound infections.

Failure to comply with sterilization measures of equipment leads to infection of

post-operative wounds.

Are validated by the answers to the questions: No. 6, No. 7, No. 9, No. 10, No. 11.

35
 Conclusion

Through this research, we conclude that post-surgical wound infections...

surgical complications are serious complications that can have harmful consequences
on the quality of life of patients, the cost of care, and morbidity.

It presents a challenge for healthcare professionals, who must train and

raise awareness of good practices, and for researchers, who must develop
new prevention and treatment strategies.

To prevent and treat them, it is necessary to respect the principles of hygiene and asepsis.
establishment of a preoperative preparation as well as the as well as the good
manipulation of sterile materials.

36
 Suggestions

Establish a protocol for pre-operative preparation in the surgical department.

Create a protocol for the sterilization of equipment.

The proper monitoring of postoperative wounds before they become infected.

The importance of the Bétadine shower in pre-operative preparation.

Education and awareness of healthcare staff about the importance of hygiene in

prevention of postoperative infections.

Educate patients about the signs and symptoms of postoperative infection so that they
may report any issues to their doctor.

37
 Bibliography:

French _pos_doc 2006, management of wound infection.

MDS_WOUNDS_the_wound

Theses:

POST-OPERATIVE INFECTIONS IN THE DEPARTMENT OF

TRAUMATOLOGY AND ORTHOPEDICS OF GABRIEL TOURE HOSPITAL, By Miss.
Rokiatou SIDIBE.

PREOPERATIVE CARE Study conducted in the SURGERY DEPARTMENT

WOMEN CHU –BATNA-.

Electronic sites:

surgery

Wound

The provided URL does not contain text to translate.

infections.html#.

Unable to access the content of the provided URL.

symptoms-and-treatments/b377c0_ar.html

Invalid input. Please provide text for translation..

Unable to access external links.

post-operative-sutured.html.

https://www.pharma-gdd.com/en/disinfection-and-sterilization-of-instruments-
Sterilization is an operation...
medical and surgical equipment.

Unable to access the provided URL. Please provide the text you would like translated.
sterilization-of-medical-equipment.html.

38
39
National Institute of Paramedical Training Setif

Questionnaire for public health nurses

What is your age?

Between 30 and 35 years old between 35 and 40 years old more than 40 years

2/What is your rank?

ISP AS

Since when have you worked in the surgery department?

From 1 to 5 years from 5 to 10 years for more than 10 years

Are there postoperative wound infections in your department?

Yes no

In your opinion, what is the main cause of postoperative infection?

The inadequacy of pre-operative preparation

The non-compliance with the sterilization measures of the equipment

6/ In your opinion, does preoperative preparation reduce the risk of infection?

post-operative wounds?
Yes No

7/Why is preoperative preparation insufficient?

The service structure is not equipped.
Done at home

8/Is the sterilization of equipment done?

At the service level there is a centralized sterilization service

9/What is the most commonly used method of sterilizing equipment?

Autoclave pouplet

10/Do you follow the steps of sterilization?

Yes no

40
11/Do you respect the duration of sterilization of the equipment?

Yes no

12/Is the handling of equipment done according to the standards?

Yes no

41