Infections of a Surgical Wound

Wounds usually break the continuity of the skin and permit organisms to have access to tissues and cause infection.

The first thing that you might want answered is what are wound infections? By definition a wound infection is a surgical site infection or SSI. There are the following varieties of a surgical site infection or SSI.

- A superficial incisional SSI. This is an infection that involves only skin and subcutaneous tissue.

- A deep incisional SSI. This is an infection that involves deep tissues, such as facial and muscle layers.

- An organ/space SSI. This is an infection that involves a part of the body in organs and spaces other than the incision that was opened or manipulated during an operation.

This,as you can see, is a definition of wound infection which is restricted to infections as a result of a surgical incision. If you take a broader view a more general definition would be infection of a wound which was caused by physical injury of the skin as a result of penetrating trauma from plants, animals, guns, knives or other objects.

In a hospital one of the most commonly acquired infections are infections forming in surgical wounds. These are also known to be a cause of morbidity and mortality.

The next question that might come to your mind is what causes wound infections?

In simple terms an infection in a wound is the result of deposition and multiplication of microorganisms in the surgical site of a susceptible host. There are various ways in which microorganisms can find their way into wounds. These include:

- Through direct contact. Here germs are transferred from surgical equipments or the hands of the surgeons or nurses to the wound.

- Via airborne dispersal. Micro organisms are deposited by the surrounding contaminated air.

- Self-contamination. This is a result of migration of the patient's own endogenous flora. These are present on the skin, mucous membranes or gastrointestinal tract to the surgical site.

The organisms that are mostly most commonly associated with wound infections include Staphylococcus aureus/MRSA, Streptococcus pyogenes, Enterococci and Pseudomonas aeruginosa.

To be categorized as a surgical wound infection some symptoms are as follows:

- Infection should occur within thirty days of the operation.

- There is purulent discharge from the site of the surgery.

- There is a purulent discharge from the wound or from the drain placed in wound.

- There are organisms found in the aseptically obtained wound culture.

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