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Surgical Site Infections - Coggle Diagram

- - - - Pain or tenderness
      - Localised swelling
      - Purulent discharge (vs serous)
      - Redness
      - Heat
  - - - May be clinical or radiological diagnosis
      - FEver >38
      - Local pain or tenderness
      - Purulent drainage from deep incision but not from organ / space component of the surgical site
  - - - May not be visible at the wound site as infx develops within internal tissues or organs
      - Signs and symptoms related to the procedure / site
      - Purulent drainage from drain / sinus in the organ / space
      - Organisms isolated from a normally sterile site
      - Abcess or other evidence of infx
        
        Direct examination / during reoperation
        
        Histologically
        
        Radiologically
    - - Vascular - AAA repair
      - Ortho
        
        Osteomyelitis
        
        Prosthetic joint infx
      - Large and Small Bowel
        
        Intra abdominal abcess
      - Abdominal hysterectomy
        
        Intra abdominal abcess
      - C section
        
        Endometritis
      - Breast
        
        Breast Abcess
- - - - Suboptimal - Ideally send
        
        Pus
        
        Tissue
        
        Fluid
  - - - More likely skin flora / Gram Pos
      - Staph aureus
      - Coagulase neg staphylococci
      - Gp A streptococci (strep pyogenes)
    - - Gram neg bacilli
      - Anaerobes
      - Enterococci
      - Often mixed
- - - - High bacterial load
      - Necrotic tissue
      - Foreign body
      - 4 Obesity
    - - Advanced age
      - Shock
      - DM
      - Malnutrition
      - Alcoholism
      - Steroids\
      - Imunocompromisised
- - - - Smoking
      - Glycaemic control
      - Weight loss
      - Nutrition
    - - Within 60 min pre-incision if indication
      - No point after 60 min
  - - - Alcohol
      - Chlorhexidine
  - - - Hand hygiene
- - - - How good is the care we provide