Surgical Infection Prevention

Surgical Care Improvement/Surgical Infection Prevention
Hospitals can improve surgical care and reduce the risk of wound infection after surgery by providing the right medicines at the right time on the day of surgery. Sometimes patients get an infection after surgery, even if the hospital took steps to prevent it.

Here are signs to look out for:

• The surgical wound is red, hot, and swollen.
• You have a fever of over 100 degrees after you go home.
• A smelly or yellow/green fluid is coming out of the wound.
• Your pain is increasing even though you are taking pain medication.

Call your doctor or local hospital immediately if you have any of these signs.

View our surgical infection prevention report card.

Key Indicators
Scientific evidence indicates that the following measures represent the best practices for the prevention of infections after selected surgeries (colon surgery, hip and knee arthroplasty, abdominal and vaginal hysterectomy, cardiac surgery - including coronary artery bypass grafts (CABG) - and vascular surgery). Higher scores are better.

• Blood sugar (blood glucose) kept under good control in the days right after surgery
  Even if heart surgery patients do not have diabetes, keeping their blood sugar under good control after surgery lowers the risk of infection and other problems. "Under good control" means their blood sugar should be 200 mg/dL or less when checked first thing in the morning. Higher percentages are better.
   
• Need hair removed from the surgical area before surgery by using a safer method (electric clippers or hair removal cream not a razor)
  Preparing a patient for surgery may include removing body hair from skin in the area where the surgery will be done. Medical research has shown that shaving with a razor can increase the risk of infection. It is safer to use electric clippers or hair removal cream. Higher percentages are better.
   
• Prophylactic Antibiotic Received Within 1 Hour Prior to Surgical Incision
  Research shows that surgery patients who get antibiotics within the hour before their operation are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective.
   
• Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time
  While the likelihood of infection after surgery can be reduced by giving patients preventative antibiotics, taking these antibiotics for more than 24 hours after routine surgery is usually not necessary and can increase the risk of side effects such as stomach aches, serious types of diarrhea, and antibiotic resistance (when antibiotics are used too much, they will not work anymore.) Talk to your doctor if you have questions about how long you should take antibiotics after surgery.
   
• Prophylactic Antibiotic Selection
  Certain antibiotics are recommended to help prevent wound infection for particular types of surgery. It is important that hospital surgical patients get the appropriate antibiotic in order to prevent a surgical wound infection.
   
• Treatments Ordered by Doctors to Prevent Blood Clots (Venous Thromboembolism) for Certain Types of Surgeries
  Certain types of surgery can increase the risk of blood clots forming in the veins. This is because patients don't move much during and, usually, after some surgeries. Venous thrombosis is a condition in which a blood clot (thrombus) forms in a vein. This clot can limit blood flow, causing swelling, redness and pain. Most commonly, clots occur in the legs, thighs, or pelvis. If a part or all of the clot breaks off from where it was formed, it can travel through the veins. The part that breaks off is called an embolus. If the embolus lodges in the lung, it is called a pulmonary embolism, a serious condition that can cause death. A number of factors can increase a patient's risk of developing blood clots, but doctors can order preventive treatments called prophylaxis to reduce the risk. Prophylaxis may include blood thinning medications, elastic support stockings, or mechanical air stockings that promote circulation in the legs.
   
• Treatment Received by Patients to Prevent Blood Clots Within 24 Hours Before or After Selected Surgeries
  Treatment(s) to prevent blood clots must be given at the right time to prevent blood clots forming after selected surgeries.

Source: U.S. Department of Health and Human Services Hospital Compare

Additional Resources
To obtain more quality information regarding Surgical Care Improvement/Surgical Infection Prevention, please visit the websites: The Joint Commission and the U.S. Department of Health & Human Services Hospital Compare.