11/22/2023 0 Comments Asepsis technique merck veterinaryPre-operative grooming and bathing of a patient may be advocated in certain circumstances (e.g. This is achieved via a variety of means as described below. This local bacterial re-colonization of surgical sites represents a significant risk to wound contamination ( Owen, 2007), thus the selection of a skin preparation agent with good residual activity is desirable.Īlthough the skin will never be considered sterile, the proposed incision site and the area surrounding it should be as free from microorganisms as possible prior to surgery. Rebound growth is defined as the tendency of a microorganism to repopulate an area following decontamination, over a much quicker period of time than the original colonization took place ( Scowcroft, 2012). Rebound growth of bacteria deep within the skin also occurs during surgery. It is not possible to completely eliminate resident flora from the skin, as approximately 20% of these microorganisms are inaccessible to skin disinfection as they are sequestered in the deeper layers of the skin, within the hair follicles and sebaceous glands ( Warner, 1988). They have minimal pathogenicity, but may cause infection following surgery or other invasive procedures ( Gregory, 2005). Resident (or colonizing) bacteria live on normal skin and help protect it from invasion by pathogenic species. They are generally easy to remove from the skin through the physical action of scrubbing, and can be almost completely eliminated by effective antiseptics ( Baines et al, 2012). They are acquired by contact with people/animals or the environment. Transient (or contaminating) flora do not normally colonize skin. Skin harbours two major groups of microorganisms transient and residual flora. However the patient is considered the major source of contamination of the surgical wound, with endogenous staphylococci and streptococci reported as frequently cultured organisms from surgical site infections (SSIs) ( Baines et al, 2012). It has been suggested, however, that this figure may oversimplify the situation somewhat, as there are many factors involved in determining whether a level of wound contamination will result in infection ( Baines et al, 2012), including the host's own level of resistance.īacterial contamination during a surgical procedure can originate from endogenous sources (resident flora of the patient) or exogenous sources (environmental or temporary skin contaminants). Quantitatively, it has been shown that if a surgical site is contaminated with >105 microorganisms per gram of tissue, the risk of surgical site infection is markedly increased ( Krizek and Robson, 1975). A critical level of contamination is required before actual infection occurs. Aseptic skin preparation: reducing the risk of surgical site infectionĪll surgical wounds become contaminated by bacteria, but not all become infected. This article will focus on the former of these sources via discussion of aseptic surgical skin preparation. Infections after surgery are often blamed on poor owner compliance or patient interference however the patient's normal skin flora has been shown to be one of the leading causes of SSIs.Efforts to reduce patient sources of infection are aimed at decreasing the number of bacteria on the skin prior to surgery and reducing potential bacterial contamination from within the patient during surgery. SSIs result in increased patient discomfort and client dissatisfaction due to prolonged periods of hospitalization and financial implications. Surgical site infection (SSI) is a potentially serious complication of surgery, with the consequences of infection varying from local inflammation to life threatening septicaemia. Aseptic skin preparation: reducing the risk of surgical site infection
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