How to Prevent Surgical Infections

Infection is a complication of surgery most feared by patients and surgeons. While no one goes into surgery expecting an infection, most patients want to do everything possible to prevent this risk of surgery. The chance of infection after surgery depends on a number of factors, some of which are more easily controlled than others. So what can you do (or make sure others do) to ensure you have the lowest possible chance of this complication occurring?

There are three areas that people focus on when taking steps to prevent infection:

1. Host optimization: This means the patient undergoing surgery (the host) is in the best medical condition as possible. Controlling medical comorbidities (conditions that the surgical patient has), avoiding behaviors that increase infection risk, and ensuring optimal health, are all ways to prevent infection.
2. Bacterial count reduction: Bacteria live on our skin, and when having surgery, those bacteria can enter the body. There are a number of steps that are being performed to lower the bacterial counts on the body before entering an operating room.
3. Wound management: Controlling the environment of the surgery, including before the operation, during surgery, and after the surgery, while the wound is healing, are all ways to improve the management of the wound.

Prevention is the key to the management of surgical infections. While the risk of developing a post-surgical infection is small, the consequences can be devastating. Here are some recommendations that you can use to help prevent infection at the time of your surgery.

Hair removal should be done just prior to surgery (not the night before) and should be done with clippers rather than a razor. Many surgeons recommend a shower with antiseptic soap prior to surgery. The use of chlorhexidine wipes or soap are being offered by many surgical centers and may begin hours or days prior to surgery.

Antibiotics may not be needed for all surgical procedures. Ask your doctor if they are needed for your surgery. For orthopedic surgery, if metal implants (such as a hip or knee replacement) are being used, then antibiotics should be used. If antibiotics are needed, they should be given within 1 hour of the start of the surgical procedure. Antibiotics may need to continue after surgery, but in most cases, the dose of antibiotics administered just prior to the surgery is the most important.

Ask the number of personnel in the operating room to be limited to those required for the procedure; excess traffic in the OR should be avoided. Also, ask that the temperature of the OR be maintained at a reasonable level. There is a misconception of many OR personnel that a lower temperature decreases infection risk. This is not true. Infection risk is reduced when the body is kept warm.

Ask your doctor how to care for the bandage post-operatively. Specifically, ask your doctor if you should remove the bandage and when you can get the incision wet. If you have problems with your bandage, call your doctor for instructions.

Maintaining a normal blood glucose level is of utmost importance during the surgery and during the post-operative period. Elevated levels of blood sugar are linked to a higher risk of post-surgical infections. For some surgical procedures that have high chances of infection, or that have more serious consequences of infection, many surgeons may not proceed with surgery in diabetics who have poorly controlled blood sugar levels.

Signs of an infection include fever, chills, and sweats. Also look for redness around the incision. It is normal to have a small amount of drainage from the incision in the first day or two following surgery. But if this persists, or if you see pus draining from the wound, contact your doctor immediately. Infections are best treated when caught early, so let your doctor know of any problems that may be signs of an infection.

Infections are a serious complication of surgery and one most feared by patients. The good news is that many infections can be prevented. Make sure you understand the steps you can take to prevent infection, and if you see any signs that are concerning for infection, let your surgeon know immediately. Prevention is best, early treatment is critical. With a little effort, you can lower your chance of having an infection after surgery.