SURGICAL SITE

INFECTIONS
Presented by:
Sheryl Durr, DNP, MSN, CRRN, CWCN, COCN
Department of Wound Care Grady Heath
System

Surgical Site Infections (SSI)

OBJECTIVES
1.
2.

3.
4.

5.

6.

The practitioner will define and describe rationale for the prevention of
wound infection in surgical patients.
The practitioner will describe the roles of proteases within both acute
and chronic wounds and how the manipulation of protease activity may
aid in wound healing and decreasing surgical site infections.
The practitioner will identify the four major phases and sequences of
acute wound healing.
The practitioner will become familiar with the advanced wound care
products used to decreased bacterial proliferation in acute wounds
(surgical, traumatic and chronic).
The practitioner will consider the importance of cost-effectiveness in
prevention of surgical site infections using advanced wound care
products.
The practitioner will describe evidence-based practices for prevention of
SSI

Surgical Site Infections (SSI)

https://
www.youtube.com/
watch?v=XdKlmyfp
5_w
Human Skin

Human Skin

Surgical Site Infections

And Post-Operative
Outcomes

SURGICAL SITE
INFECTION
Background/Epidemiology
SSI infection generally occurs within 30 days
following
surgery
Some procedures monitored up to 90 days for
SSI
2% -5% surgical patients acquire SSI (300500K per year)
3% die (77% of deaths directly attributable to
the SSI)
Many result in long term disability
SSI increases hospital length of stay 7-10 days
Cost estimates vary, ~$30,000 per SSI
Most estimates do not account for rehospitalization,
outpatient treatment, post-discharge expenses,

SURGICAL SITE INFECTION

Pathogenesis of SSI
Source of infecting
pathogen
Endogenous
Patient Flora
Skin
GI tract
Mucous membranes
Seeding from preexisting
sites of infection

SURGICAL SITE INFECTION

Pathogenesis of SSI
Exogenous
Surgical personnel flora
Breaks in aseptic
techniques
Inadequate hand hygiene
Contaminated garments
Equipment, surgical tools,
materials within operative
field
OR environment, including
ventilation

SURGICAL SITE INFECTION

SSI Pathogens
Staphylococcus aureus - 30.0%
Coagulase-negative
staphylococci - 13.7%
Enterococcus spp - 11.2%
Escherichia coli - 9.6%
Pseudomonas aeruginosa - 5.6%
Enterobacter spp - 4.2%
Klebsiella pneumonia - 3.0%
Candida spp - 2.0%
Klebsiella oxytoca - 0.7%
Acinetobacter baumannii - 0.6%

SURGICAL SITE INFECTION

CDC Prevention Strategies Core
WOUND CARE
Surgical Wound Dressing
Protect primary closure incisions
with sterile dressing for 24-48
hours post-op
Question..What is our current
best practice for post-op
dressings?
What is our current post-op
dressing change protocol?
What are our evidence-based
wound care products used (At
Grady) in prevention of SSIs?

Innovative Wound Care Products

in Preventing Wound Infection
Current State

3M Tegaderm Absorbent Clear

Acrylic Dressing

Future State
Using Improved
Surgical
Dressings

Innovative Wound Care Products in Preventing Wound Infection

Ovine-Based Collagen Matrix Dressing: Next-Generation
Collagen Dressing for Wound Care
Collagen ECM dressing to treat acute and chronic
wounds from Day One.
Contains 90% native, intact collagen and 10%
extracellular matrix components
Broad spectrum MMP reduction
Advanced care accessible to all clinicians
Cost efficiency through weekly applications
A collagen ECM treatment option within your reach
Can be used to treat chronic wounds from Day One
No physician fixation required
Accessible to all healthcare providers across the
continuum of care
Endoform dermal template dressings may be reapplied
as infrequently as once per week, reducing cost and
inconvenience compared to other collagen dressings
that may need reapplication more than twice as often,
per the instructions for use.
http://www.hollisterwoundcare.com/products/endoform
.aspx

Innovative Wound Care Products in Preventing

Wound Infection
Ovine-Based Collagen Matrix Dressing: NextGeneration Collagen Dressing for Wound Care
Significance: Broad-spectrum
metalloproteinase (MMP)
reduction along with inherent
aspects of an extracellular
matrix (ECM) dressing can
bring about improved wound
healing outcomes and
shorter treatment duration.
Initial reports of clinical
effectiveness of a new ovinebased collagen extracellular
matrix (CECM) dressing
demonstrate benefits in
chronic wound healing.

Innovative Wound Care Products in

Preventing Wound Infection
Treated with
When Managing Bioburden is a Priority.
Antibacterial Protection
Provides a protective antibacterial cover that inhibits the growth of
microorganisms
Physically binds harmful endotoxins1 which can aid in patient comfort
Hydrofera Blue foam is effective against microorganisms
commonly found in wounds including MRSA, VRE and Candida.
Compatible for use with enzymatic debridement agents and growth
factors
Highly Absorptive
Pulls bacteria-laden exudate up and away from the wound which may
facilitate healing and aid in patient comfort
Maintains similar or superior absorbency as compared to other highly
absorptive dressings

 Indications for Use:

pressure ulcers
diabetic ulcers
venous stasis ulcers
arterial ulcers
superficial burns
donor sites
post-surgical incisions
trauma wounds
abrasions
lacerations

Innovative Wound Care Products in Preventing

Wound Infection
Treated with Hydrofera Blue Ready

May 31, 2016

June 6, 2016

Innovative Wound Care Products in Preventing

Wound Infection
Treated with Hydrofera Blue Ready

June 10,
2016

June 13, 2016

Innovative Wound Care Products in

Preventing Wound Infection
Treated with Hydrofera Blue Ready

June 24, 2016

July 11, 2016

Innovative Wound Care Products in

Preventing Wound Infection Medihoney

Innovative Wound Care Products in Preventing

Wound Infection Medihoney initially for
Debridement and Now treated with Hydrofera Blue
Irradiate
d Skin
after
tumor
resectio
n

May 20, 2016

July 12, 2016

Innovative Wound Care Products in

Preventing Wound Infection and Dehiscence

https://www.youtube.com/watch?
v=T4MiTf-EM8w

Thank you!
Thats all Folks!!!!