How to reduce the risk of surgical site infections

Surgical site infections (SSIs) are an example of nosocomial, or hospital acquired, infections. In human medicine in 2011, nosocomial infections, most commonly SSIs, occurred in 6.4% of patients (Mann, 2018). Although there is currently no protocol for reporting incidents, SSIs have been reported in 0.8–18.1% of surgical patients in the United States (Garcia Stickney and Thie-man Mankin, 2018), highlighting a significant threat to veterinary patients.

From the moment that a patient arrives at the practice, the risk of exposure to potentially harmful flora is prominent. The two types of flora that can become problematic are resident and transient flora. Resident flora lives on normal skin and provides protection from other pathogens, whereas transient flora is acquired bacteria and does not normally colonise skin (Gregory, 2005). Exposure of a surgical wound to either resident or transient flora can result in colonisation of the wound and development of clinical signs of infection. In addition to exposure of the open wound to bacteria, the risk of SSIs is significantly elevated with increased surgical time, increased persons present during surgery, and a dirty surgical wound (Eugster et al, 2004). Therefore, the efficacy of the surgical team in preparing the patient, and the standard of practice protocols regarding wound management, can directly impact the risk of SSI contraction. Figure 1 demonstrates SSI contraction post-caudectomy in an adult canine patient; note dehiscence of the wound and presence of exudate.