Surgical Site Infection: Prevention, Control, and Global Implications

This report provides a comprehensive overview of surgical site infections (SSI) within a global health context, emphasizing the importance of prevention and control strategies. It begins by defining SSI and highlighting its significance as a common healthcare-associated infection, discussing the rationale for focusing on this issue due to its impact on patient outcomes, increased hospital stays, and mortality rates. The report delves into the challenges of managing SSI, exploring various prevention and control methods across pre-operative, intra-operative, and post-operative phases, including the use of prophylactic antibiotics, proper skin preparation, sterile dressing, and wound monitoring. It synthesizes findings from various studies, underscoring the role of surveillance methods, environmental factors, and wound closure techniques. The report also discusses the importance of stakeholder awareness, including patients, surgeons, and nursing staff, in adopting and implementing effective strategies to minimize SSI risks and improve patient safety. Finally, it offers recommendations for healthcare organizations and professionals to enhance their approach to SSI prevention and control, considering the global implications of this critical issue.

PUBLIC HEALTH

TABLE OF CONTENTS
TOPIC..............................................................................................................................................1
INTRODUCTION...........................................................................................................................1
RATIONALE FOR THIS QUESTION...........................................................................................1
CRITICAL DISCUSSION OF STRATEGIES FOR THE CURRENT MANAGEMENT OF
THE ISSUE.....................................................................................................................................4
SYNTHESIS OF THE FINDINGS WITH RECOMMENDATION..............................................6
REFERENCES................................................................................................................................7

TOPIC
Surgical site infection prevention and control in global context
INTRODUCTION
Infection is invasion and growth of foreign particles on or in the body. It is a process of
infecting or bring infected. There are various kinds of infection that can be become a threat for
public even at global level. Chances of getting infected for a person are higher if proper
management of wounds, cleanliness or cleanliness of body parts is not done properly. Surgical
site infection is one of the most common type of infection that mostly occurs after surgery in a
part of body take place (Tartari and et. al., 2017). This surgical infection can be superficial i.e.,
infection involving skin only but many times this infection can be more serious that involve
tissues under skin, organs, or implanted material. If prevention and control strategies or methods
for surgical site infection are not focused upon and provided to patient then it can result in
increasing threat or risk of life (O'Hara, Thom and Preas, 2018). This assignment will be
focusing upon identification of surgical site infection prevention and control in global context. In
this assignment with the help of microbiology, epidemiology and various public health theories
analysis explanation of challenges in management of surgical site infection, management
strategies for management of surgical site infection and ways it can be controlled in global
context will be discussed and explained in detailed manner. In this assignment reason for
choosing surgical site infection prevention and control will be provided with critical discussion
of strategies used for management of this issue will further be explained.
RATIONALE FOR THIS QUESTION
This surgical site infection is an important type of infection which is required to be
focused upon because according to healthcare associated infection, surgical site infection is one
of the most common type of healthcare associated infection. These infections mostly associated
with longer-post operative hospital stay, additional or back- to- back surgical procedures, non-
effective treatment given in intensive care unit etc. These infections are increasing drastically.
Due to ineffective management and control of surgical site infection mortality rate of patients is
increasing drastically. It has further been explained that type of surgical site infection suffered by
patients is completely dependent upon type of surgical procedure undergone by them and post-
operation care provided to them (Berríos-Torres and et. al., 2017). Due to this it becomes
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important to explore this topic and understand prevention management and control strategies
with the help of which this surgical site infection can be controlled or prevented.
These infections are important to be understood and very few of general public are aware
of such kinds of infections that can occur after surgery as any people think that rashes or any
kind of skin infection among such people is common or quite general to occur after surgery.
These types of infection are extremely painful, can cause discomfort and can further increase
complications associated with surgery recovery (Saeed and et. al., 2017). Due to this becomes
even more important to focus upon this issue and make people aware about surgical site
infection, ways in which it can be controlled so that people can take measure to safeguard their
own health. There are many different kinds of methods that can be used for prevention and
control of surgical site infection among people. Not only or general public but for all the
stakeholders associated with this issue such as patient, their family members, surgeon, nursing
staff etc.
For surgeons and nursing staff who provide post-operation or surgery care to patient it is
important for them to understand prevention and control strategies with the help of which they
can control chances of occurrence of this surgery site infection. They can focus upon adopting
directly daily monitoring method of surgery site as it is one of the most effectively and
commonly used prevention strategy that can be used for prevention of surgical site infection.
Most of the physicians, surgeons, nursing staff use this method for monitoring, preventing a
controlling surgery site infection (Anderson and et. al., 2017). Most of the surgery’s themselves
observe and monitor surgery site daily for at least 2-3 days post- operation. Many times, they
instruct nursing staff to closely monitor surgery site daily it directly helps in preventing
occurrence of surgical site infection and even if this infection occurs then it can be controlled or
control prevention method can be adopted so that it do not become serious and risk to health.
If this surgical site infection issue is explored from the point of view of healthcare
organization it can directly be understood that it is important for them to ensure that all the
patients who have undergone any kind of surgical procedure, they do not suffer from any kind of
surgical site infection because it can directly impact their reputation or image and can further
impact experience of patients (Steiner and Strand, 2017). If in global context this issue is
observed then it is not at all fruitful for the healthcare organization. But out of all the
stakeholders it is extremely important issue to be focused upon for the patients and their families.
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Patients who have undergone any kind of surgical procedure and infection occurs at surgical site
then it is extremely painful for them and sometimes it can be irritating as well. For facilities
management of patients and their infection becomes even more difficult.
According to the view of Liu and et. al., (2017) surgical site infection can occur within 30
days of surgery and can affect incisions or deep tissues. Even if a patient suffers from surgical
site infection automated Microbiology system can be adopted. These microbiological systems
play a vital and important role in gaining information about surgical site infections and ways in
which it can slowly worsen if it is not prevented or controlled and many times by not focusing
upon this infection can result in failure of healing of surgical wound.
Further Bhangu and et. al., (2018) explains that, if epidemiology of surgical site infection
is focused upon then, about 3 percent of patients admitted in hospitals who have undergone
surgery suffer from this infection. Out of these 3 percent infections recorded in England about
1.4 percent of surgical site infection have been identified in UK. Approximately 10 percent of
large operative cases are preventive and can be prevented from occurrence of surgical site
infection it can be said that are various kinds of ways though which it can be prevented and
controlled and these preventions can be taken at both hospital and at home of patient.it is
important to maintain a healthy environment in which patient is being provided within post-
surgical care. It is important for surgeons to focus or pay attention to technical details and
awareness of the operating room environment because these are some important reasons because
of which a patient can suffer from surgical site infection. Surgeons and nursing staff need to
focus upon selecting an appropriate short- duration, narrow-spectrum antibiotic prophylaxis for
patients undergone surgical procedure because it will directly help them in reducing changes of
occurrence of surgical sit infection
Findings of Ban and et. al., (2017) clearly helps in understanding that slowly prevalence
of surgical site infection among patients is being reduced slowly. But mortality rate due to these
infections have increased especially in patients above 60 years. Surgeons can focus upon
adopting environmental theory for providing an appropriate environment to patient which will
further help patient is seedy recovery from surgical site infection. This theory helps in
understanding that operating room environment and post- operative care of patient should be
focused upon in an effective manner which will directly help surgeons and nursing staff to
reduce chances of occurrence of surgical site infection among patients. As per this theory
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environment is one of the most important factor which is required to be focused upon while
focusing upon prevention of surgical site infection among patients who have recently undergone
a surgery. Carvalho and et. al., (2017) explains that in order to reduce changes of surgical site
infection principles of wound closure should be adopted by surgeons for closure of surgical
wounds. This will help them in ensuring that wounds are properly closed and there is no chance
of occurrence of surgical site infection.
CRITICAL DISCUSSION OF STRATEGIES FOR THE CURRENT
MANAGEMENT OF THE ISSUE
According to the view of De Vries and et. al., (2017) there are many different strategies
that can be adopted for management of surgical site infection issue within patients who have
recently undergone surgery. Surveillance method is one of the most common and effective
method that can be used for management of surgical site infection. Surveillance method consist
of checklist, reminders etc. that can directly help in management of this infection in adequate and
appropriate manner. this method can directly help in enhancing efficiency of intervention of
management of surgical site infection.
As per the view of Kolasiński, (2019) some of the basic infection management strategies
of surgical site infection that can focused upon for controlling and minimizing chances of
occurring are: any kind of sutures or clips used for closing wounds should be removed after a
certain time period. Drainage of puss or any fluid from should be allowed to be flown and
provision for this should be given at the time of wound closure. Empirical antibiotic should be
started after completion of surgical procedure as it is one of the best ways of reducing changes of
infection or development of any kind of micro-organisms. These prevention methods can be
linked with surveillance method were a checklist and reminders of these prevention measures is
created and reminder for the same is also given so that chances of occurrence of infection within
patient who has undergone surgical procedure can be reduced.
Other than this, (Berríos-Torres and et. al., 2017) explains that there are various
management strategies that can be used for prevention and control of surgical site infection.
These prevention measures can be taken at the time of pre-operative, intra-operative and post-
operative settings. At the time of pre-operative phase prophylactic antibiotics should be given. If
it is necessary to remove hair then it should be done prior to surgery with an electric clipper.
Proper advice should be given to patients about maintaining their diet, nutrition, hygiene before
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surgery. At interoperative phase skin at surgical site should be prepared first before incision of
skin take place. if gloves get contained then it should be changed quickly. Post-operative phase
is an important phase where main prevention strategies take place. In this phase, it is important to
do continuous monitoring of wounds. This will directly reduce chances of bacterial
contamination. Wounds that are specially under the skin or underneath of skin are closely
monitored. Nursing staff should be given proper instructions about type of dressing that should
be done on the would.
Saeed and et. al., (2017) further elaborates that are there are many different kinds of
strategies that can be used for controlling surgical site infection. But control measures for such
type of infection is only required if prevention measures are not taken in an adequate manner,
then it can result in development of infection on surgical site. For this it is important to focus
upon adopting some important control strategies such as: patient or nursing staff should avoid
shaving at operative site. It can directly lead to development of surgical site infection at the place
where wounds are present. Not shaving surgical body part can directly help in controlling
prevalence of infection, patients with prior infection should not be operated because it can
increase chances of suffering from other kinds of surgical site infection that can risk life of
patients. After surgery sterile dressing should be applied for at least 48 hours as per the need and
requirement of dressing. Other than this closed suction drains can be used for leakage of fluids
like puss from surgical site.
Anderson and et. al., (2017) explains their point of view that surgical site infection are
third most prevailing infections in hospitals among patients. But in provision of prevention ad
control measures there are various challenges that can be faced by surgeons or nursing staff
members such as: prevailing disease such as diabetes which makes healing of wounds difficult,
longer pre- operative stay, nicotine use, obesity etc. Surgeon should always be prepared with
antiseptic agents. Treatment of occurrence of infection within 30 days should be managed, this
will directly help them in controlling of this infection. From time- to- time monitoring and
inspection of incision should be done daily when dressing is changed. At this point it should be
cleaned with a clean pad and when dressing is changed after cleaning it should be covered rom
all the four sides. From time to time it should be cleaned with soap in order to remove the crust,
wounds should not be scrubbed or soaked. Incision should be cleaned with dry and clean cloth
before dressing is done. Other than this, surgeons should remain in touch with the patients and
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every alternate day should visit the patient and check their wounds i.e., if there is need and
requirement of applicability of antiseptic, or cleaning with spirit or provision of antibiotics then
it should be provided to the patient in timely manner (Steiner and Strand, 2017). Same nursing
staff should treat the patient who has undergone surgical operation as they will be aware about
history of the patients and will be able to attend patient in more appropriate manner as they will
be easily able to identify unusual things or factors within their incision.
SYNTHESIS OF THE FINDINGS WITH RECOMMENDATION
From the above assignment critical analysis it has been found that surgical site infection
can be superficial if it is diagnosed and treated early in which only outer skin of body is infected.
It can be deep incisional in which inner tissue that are deep under skin ate infected. Whereas it
can be sometimes becoming serious as well when it infects inner organs of the body because of
which risk or threat to patient and their life increases. Many times, it can also become a reason
for death or organ failure of patient. Multiple studies analysis helped in understanding that most
of the precaution and control measures that can be taken for preventing or controlling this
infection from occurring within patients undergone a surgery it is important focus upon pre-
operative settings, intraoperative setting and post- operative care of patient. It has also been
summarized from above findings that environment plays a vital role in prevention of surgical site
infection and precautions taken by all the stakeholders involved in surgery including patients and
their family members. If a proper environment is not maintained then it can directly result in
increasing chances of surgical site infection prevalence within patient.
Some of the following recommendations on the basis of above research that can be given
in order to prevent and control surgical site infection are: after surgery wound closure principles
are required to be adopted by surgeons as it will result in proper and clean closing of wounds.
Other than this for initial at least 3 to 4 days dressing should be changed and cleaning of wounds
should be done daily for controlling infection.
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REFERENCES
Books and Journals
Anderson, P.A., and et. al., 2017. Prevention of surgical site infection in spine
surgery. Neurosurgery, 80(3S), pp.S114-S123.
Ban, K.A., and et. al., 2017. American College of Surgeons and Surgical Infection Society:
surgical site infection guidelines, 2016 update. Journal of the American College of
Surgeons, 224(1), pp.59-74.
Berríos-Torres, S.I., and et. al., 2017. Centers for disease control and prevention guideline for the
prevention of surgical site infection, 2017. JAMA surgery, 152(8), pp.784-791.
Bhangu, A., and et. al., 2018. Surgical site infection after gastrointestinal surgery in high-
income, middle-income, and low-income countries: a prospective, international,
multicentre cohort study. The Lancet Infectious Diseases, 18(5), pp.516-525.
Carvalho, R.L.R.D., and et. al., 2017. Incidence and risk factors for surgical site infection in
general surgeries. Revista latino-americana de enfermagem, 25.
De Vries, F.E.E., and et. al., 2017. Meta-analysis of lower perioperative blood glucose target
levels for reduction of surgical-site infection. Journal of British Surgery, 104(2),
pp.e95-e105.
Kolasiński, W., 2019. Surgical site infections–review of current knowledge, methods of
prevention. Polish Journal of Surgery, 91, pp.41-47.
Liu, Z., and et. al., 2017. Nasal decontamination for the prevention of surgical site infection in
Staphylococcus aureus carriers. Cochrane Database of Systematic Reviews, (5).
O'Hara, L.M., Thom, K.A. and Preas, M.A., 2018. Update to the Centers for Disease Control and
Prevention and the Healthcare Infection Control Practices Advisory Committee
Guideline for the Prevention of Surgical Site Infection (2017): a summary, review, and
strategies for implementation. American journal of infection control, 46(6), pp.602-609.
Saeed, K.B., and et. al., 2017. Incidence of surgical site infection following caesarean section: a
systematic review and meta-analysis protocol. BMJ open, 7(1).
Steiner, H.L. and Strand, E.A., 2017. Surgical-site infection in gynecologic surgery:
pathophysiology and prevention. American journal of obstetrics and
gynecology, 217(2), pp.121-128.
Tartari, E., and et. al., 2017. Patient engagement with surgical site infection prevention: an expert
panel perspective. Antimicrobial Resistance & Infection Control, 6(1), pp.1-9.
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