The document discusses surgical site infections (SSIs). It notes that SSIs are the third most common nosocomial infection and most frequent cause of infection in surgical patients. It defines the different types of SSIs and lists various patient and operation risk factors that can increase the risk of developing an SSI.

1. Surgical Infections Lu Ning, MD Assistant Professor of Surgery

13. Cellulitis

17. Furuncle

18. Carbuncle

20. Hiradenitis

22. Lymphangitis

24. Breast Abscess

26. Peri-rectal abscess

28. Paronychia An inflammatory reaction involving the folds of the skin surrounding the fingernail. It is characterized by acute or chronic purulent, tender, and painful swellings of the tissues around the nail, caused by an abscess of the nail fold. The pathogenic yeast causing paronychia is most frequently Candida albicans. Saprophytic fungi may also be involved. The causative bacteria are usually Staphylococcus, Pseudomonas aeruginosa, or Streptococcus.

29. Felon

31. DIFFUSE NECROTIZING INFECTIONS

37. Gas Gangrene

40. Necrotizing

49. TETANUS

54. Risus sardonicus

55. Courtesy: Google image on tetanus L ockjaw’s opisthotonos

60. Immunization requires at least three doses of Td. 1 st dose should be administered on the First visit 2 nd dose 4 – 8 weeks after the first dose of Td and 3rd dose after 6 months of the second Td. A booster dose of Td should be repeated every 10 years throughout life Persons Seven Years of Age or Older Who Have Not Been Immunized

71. SURGICAL SITE INFECTIONS

74. Wound Classification

84. Bacterial dose Virulence Impaired host resistance Risk of Infection

85. Bacterial dose Virulence Impaired host resistance Risk of Infection

86. Virulence Impaired host resistance Risk of Infection Bacterial dose Virulence Impaired host resistance Risk of Surgical Infection Bacterial dose

89. SSI – Wound Class vs NNIS Class NNIS. CDC. Am J Infect Control. 2001;29:404-421. Wound Class All NNIS 0 NNIS 1 NNIS 2 NNIS 3 Clean 2.1% 1.0% 2.3% 5.4% N/A Clean contaminated 3.3% 2.1% 4.0% 9.5% N/A Contaminated 6.4% N/A 3.4% 6.8% 13.2% Dirty infected 7.1% N/A 3.1% 8.1% 12.8% All 2.8% 1.5% 2.9% 6.8% 13.0%

93. Questions?????