Prevention of infections in the place of surgical procedure
Pre-operative prevention is assured at our clinic:
by pre-operative antiseptic body hygiene (shower and usage of disinfecting soap)
by shaving the place of surgical procedure directly before the surgery
Perioperative prevention is a prevention during the period spent at the surgical room.
following all rules of asepsis at the surgical room (the state of being free of microorganisms)
preparing patient’s skin with appropriate antiseptics before the surgery (treating surgical wounds with disinfecting solutions)
care for general comfort of a patient during surgical procedure (warming gel below patient)
Post-operative prevention are following procedures that lead to healing of the wound with no problem.
antiseptic procedures by treatment of the wound
rich food with vitamins
trained medical staff
own education of the patient during the hospitalization by medical staff
Types of surgical wounds
If all rules of asepsis were kept at the medical clinic as well as in the post-operative care at home, the surgical wound is healed primarily. If the wound was contamined with microorganisms during the treatment, it is then healed secondarily.
It is important to recognize symptoms of beginning infection and immediately contact the surgeon. It is only the surgeon that can evaluate the state of surgical wound and launch appropriate treatment.
Infection symptoms begin slowly although in some cases even very fast.
Symptoms of local infection:
the surgical wound is locally or completely red
the surgical wound has permanent colorless or yellow secretion
in the place of wound remains permanent swelling or the swelling increases
black coat (necrosis) forms in the surgical wound
pain of the surgical wound does not cease or even increases
the surgical wound widens and is coated
infected wound has unpleasant smell
Symptoms of general infection:
subfebrile (low-grade fever of a body -37°C), febrile (increase in body temperature over 38°C)
tiredness and fatigue of organism
Usage of disinfecting soap or foam at our clinic is part of pre-operative, post-operative and following home care.
Pre-operative preparations of surgical field
The day of the surgery before transfer to the surgical room patient’s operated field is shaved with gentle shaving machines in adequate extent. It is followed by showering with disinfecting soap or foam. We recommend to use disinfecting foam in the intimate area and in the hairy part of head and face. It is more gentle for treatment of these parts. It is also tolerated by allergic people. You will concentrate on the treated area during showering. After rinsing put disinfecting soap (foam) on and do this antimicrobial shower for about one minute. Repeat the whole process two times. After showering dry yourself by gentle touching of a towel, no rubbing. Reason for that is presence of bacteria (staphylococus epidermidis) in deeper layers of skin that can get on the surface by rubbing. Put on clean underwear at the end.
Post-operative care of the surgical wound
The day of the surgery no compress of the wound is performed, if the progress after the surgery does not request it. First or second day after the surgery the surgeon makes compress of the wound. He/she evaluates the healing process and recommends further care. The patient takes shower with the usage of disinfecting soap or foam one to two times a day early post-operative care.
Home care
It is very necessary to follow antiseptic procedures in the home care. Only this way it is possible to assure healing process of the wound without complications and therefore even perfect result of the surgery.
Manual for treatment of the surgical wound
It is absolutely necessary to disinfect hands with water and disinfecting soap (foam) before every manipulation and compress of the surgical wound.
We prepare all devices that are necessary for the compress (sterile cover, prescribed ointment, disinfection, elastic underwear)
We take shower with the usage of disinfecting soap (foam) for one minute. This process can be repeated even two times.
When we dry in the area of surgical wound we put the towel gently. We do not rub the wound.
After taking shower we disinfect the surgical wound with prescribed antiseptic (Braunol, Octenisept), we put on prescribed ointment and plaster the wound sterilely. (Cosmopor).
We put on clean elastic underwear.
We do not smoke in the post-operative period. Even this factor influences significantly the recovery process of the surgical wound.
Rich food with vitamins is another necessary condition for uncomplicated progress.
Inserting elastic underwear for the prescribed time is natural.
Consult immediately any uncertainties and problems at the clinic or with the surgeon.
Statistics
A study from Berlin has been presented on the VIII. International Congress of hospital hygiene in Brno. It was focused on usage of disinfecting soap in the pre-operative preparations of the patient. The result was reduction of nosocomial infections of 30%.
Our study was launched in 2006.
From 2005 to 2006 from 348 patients there were 3 cases of secondary healing of surgical wound. Their cause was secondary infection.
From 2006 to 2007 from total amount of 368 patients there was no secondary infection recorded.
Antiseptic body hygiene with the usage of disinfecting soap (foam) reduces the amount of microbial colonies even of 9%. For better result it is recommended to repeat the shower two times.
The article was created by head nurse of LAUREA Clinic in Brno, Jana Kadlcová.